In the case of a sex change (könsbyte which is the term in Swedish) from woman to man – or even in the case of reconstructive surgery after an accident – a complicated procedure has to be carried out: the formation of a penoid, a replacement penis. Because this requires the removal of a larger area of skin, including blood supply, scars are inevitable in the affected areas.
After about two years, these scars have mostly healed well, and the skin is smooth again. Different laser treatment techniques subsequently ensure that scars fade and become inconspicuous.
For the construction of the penoid, it is common to use a skin flap from the forearm (radial) on the flexion side, i.e. the inside. Skin from the inside of the thigh is rarely used.
The size of the skin graft depends on the individual wishes of the patient. To form a clitoris penoid, the surgeon stretches the clitoris, lengthens the urethra and moves its opening to the tip of the clitoris. He uses skin from the labia minora, and scars remain invisible.
The penoid itself requires a larger skin graft. The necessary skin is removed and used with its entire blood circulation system. The surgeon rolls it up and forms an elongated urethra and penis (tube-in-tube technique). Nerves, blood vessels and urethra of the clitoris penoid are connected. The clitoris can then be moved and implanted on the outside of the penoid.
The surgeon covers the skin removal point on the forearm with another skin graft. This can be taken from the buttocks region, the inside of the thighs or the lower abdomen. Full or split skin grafts are possible.
To prepare for the operation, permanent hair removal in the skin region intended for transplantation is recommended.
Anyone who consistently undergoes a sex change from woman to man surgically cannot avoid various scars. An important step is the removal of the breast (mastectomy). This, including the removal of the uterus, ovaries and vagina, as well as the build-up of the penoid, can be carried out in up to nine hours under general anaesthesia. A step-by-step gender adjustment is also possible.
