Preparing for Phalloplasty Surgery
Congratulations, you're on the road to Phalloplasty! Between now and your surgery date, there's going to be a lot to accomplish, from basic logistics to important body/mind optimizations. So, buckle up and get ready for planning one of the biggest events of your life!
In this video, Dr. Richard Santucci, a Reconstructive Urologist who performs Phalloplasty in Austin, Texas, provides an overview of the important steps that you'll need to take to prepare for surgery day. He covers:
- Hysterectomy: Because Phalloplasty on its own is an intensive procedure, Hysterectomy is not performed at the same time and must be completed at least 3 months prior to Phalloplasty.
- Phone consult with your surgeon.
- Picking a donor site and target penis size.
- Hair removal: Start at least 9 months before your surgery date. Be sure to check your insurance to see if hair removal is a covered benefit.
- Support letters: You'll need two from a mental health professional and one from the provider who prescribes your hormones. You can't secure a surgery date without these letters. Once the letters have been submitted, it can take another 3 months before your insurance confirms your coverage.
- Medical clearance: One month before your surgery, you'll need to get some lab tests done and obtain a letter from your primary care provider stating that you are fit for surgery.
- In-person consultation: At Crane Center, your face-to-face consultation and physical exam with your surgeon can happen the same week as your surgery.
NOTE: Brownstein & Crane Surgical Services, mentioned in the video, is now known as the Crane Center for Transgender Surgery.
Preparing Your Body for Phalloplasty
Weight Loss: Most surgeons will require a BMI of under 35 for patients having Phalloplasty. Some surgeons have stricter BMI limits. Now is a good time to get as fit as you can!
Diet: Protein provides building blocks for muscles, bones, and the immune system, so in the month before surgery, eat a high protein diet, along with vegetables high in vitamins C, K and magnesium. Whole grains are a good source of B vitamins which help the body combat stress. Avoid sugars, caffeine, and alcohol which leech nutrients from the body. Consider following the anti-inflammatory diet.
Quitting Smoking: All surgeons will require patients who smoke tobacco to quit before surgery. Many surgeons will do a test to determine if you have indeed quit, and if you haven't your surgery date will be canceled. Don't let smoking screw up the surgery you've fought so hard for!
Preparing Your Mind for Phalloplasty
Meditation. Being confined to bed, not being able to workout, having to sleep on your back, dealing with catheters, being in pain... Seriously consider: How will you manage to THRIVE in recovery when you're so far outside of your comfort zone?? While it's normal to feel anxiety and other uncomfortable feelings before surgery and during recovery, a number of studies suggest that anxiety is associated with more post-operative pain, slower recovery and a higher risk of infection. In other words, your mood and outlook before and after surgery may negatively—or positively!—impact your recovery. Get to work on cultivating practices that will help you relax during recovery. If you need a starting point, check this out: Meditation to Relax Before and After Surgery
Therapy. Consider getting a therapist for a while as you prepare for Phalloplasty. A good therapist can help you develop coping mechanisms and relaxation techniques to use in the face of stress, help you figure out how to talk to your loved ones about your surgery, and give you a safe space to express the jumble of emotions that are common before surgery, from fear to elation.
Build a support network. If you're a social person, having a network of people you trust and can lean on will be invaluable during your Phalloplasty recovery. If you're more of a reclusive type of person, having surgery support pen pals online can also be beneficial.
Expect complications. Phalloplasty is a very complex surgery and complications are common. The importance of educating yourself and your caregiver about Phalloplasty risks and complications can't be overemphasized. That said, focusing on potential complications to the point of causing you anxiety isn't helpful. It's important to remember that: 1) there are things that might look scary during recovery that are not actually a problem; 2) many complications will heal on their own; and 3) most complications that don't heal on their own can be fixed. If you go in expecting a complication and manage to avoid one, hurray!
Important Logistical Tasks
Make travel arrangements. If you're traveling any distance to your surgeon, you'll want to think about how you will get there (and back) and where you will stay. If you're booking a domestic flight, the best deals can be had between three weeks and four months prior to your trip. Consider the popularity of the city and season when booking your surgery date, as hotel rooms and AirBnBs will be at a premium at certain times of the year.
Arrange transportation. You will need a ride from the hospital to where you are recovering, and some surgeons will require you to have medical transport, ie. non-emergency ambulance. (If this is the case, definitely look into insurance coverage for this as ambulance transport isn't cheap!) You will also want a plan in place for transportation to your post-op appointments, as well as emergency transportation, in case you need to get to your local emergency room after you have returned home from surgery.
Arrange for a caregiver. You will need someone to stay with you during your recovery. Most Phalloplasty patients find that they need quite a lot of help with wound care, as well as basic daily tasks, for the first month of recovery.
Tell your employer/educational institution about the time off that you'll need. If you're in the USA, look into applying for FMLA (Family and Medical Leave Act).
Talk with your primary care provider about the support you may need from them around your surgery date, such as letters, pre-op lab tests, prescriptions and post-op referrals in case of complications.
Identify specialists in your area who can help in case of complications. If you're having Urethral Lengthening done, it's a good idea to establish a relationship with a local urologist. While knowledge about FTM Phalloplasty would be an obvious benefit, even a urologist without this expertise can be an invaluable member of your team by performing needed tests and serving as a liaison between your surgeon and primary care provider in the case of a urinary complication.
Lastly, take time for you. It's common to have to deal with a high degree of stress before surgery so it's really important to make sure that you take time for yourself and get lots of rest in the weeks leading up to Zero Day.
More information to help you prepare for Phalloplasty:
Last updated: 07/23/19