01/14/2026
Dr. Ley is a board-certified plastic surgeon, a transgender woman of color, and a former patient herself. She offers a full spectrum of bottom surgery procedures to transgender and non-binary patients and has extensive experience performing AND teaching the radial forearm flap (RFF) phalloplasty technique shown here.
One of the major advantages of RFF phalloplasty is the ability to connect the sensitive forearm nerve to the cl****al nerve. This gives the phallus the potential for heightened, erogenous sensation once fully healed. Some patients may experience limited or no nerve regeneration, which would result in normal tactile sensation instead.
Nerve healing typically begins around 3 weeks after surgery. Patients may feel tingling sensations as regeneration progresses, and the buried cl****al nerve should continue to provide heightened sensation.
It’s important to know that RFF phalloplasty is a multi-stage surgical process with a long recovery period, which can affect mental health. A strong support network, including loved ones and a mental health professional, is essential.
After the phallus is created in the first stage of surgery (i.e., what this illustration depicts), additional stages of surgery will be needed to accomplish the following:
• A primary urethral lengthening to allow urination while standing
• A split-thickness skin graft to cover the forearm donor site
• G***s construction (glansplasty)
• Scrotoplasty, tissue expanders, and testicular implants
• Mons resection or panniculectomy to reduce skin/fat above the groin
• Placement of an erectile device
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