PENILE IMPLANT
PENILE IMPLANT
A penile implant is a medical device that is placed inside the penis to help create an erection. For many transgender and nonbinary people who have had phalloplasty, this implant can help make the neophallus firm enough for penetrative sex or provide a sense of completeness and comfort in their body. [1]
Some people may choose to get a penile implant after masculinizing bottom surgery because it helps with sexual function and confidence. While phalloplasty can create a penis with sensation and the ability to urinate while standing, they don’t usually allow for natural erections. Implants can give you rigidity when you want it and give you more options for pleasure and intimacy.
It’s important to remember that not everyone needs or wants a penile implant, and that’s completely okay. Every transition is deeply personal. Whether or not someone chooses this step, their body and journey are valid. You deserve to feel comfortable, affirmed, and in control of your own healthcare path.
Editor’s note: In our article, we may use terms that are culturally outdated, as many of our patients still rely on them when searching for information. We want to ensure we remain visible to this audience as well.
PATIENT STORIES
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TYPES OF PENILE IMPLANTS
Penile implants can enhance self-confidence and promote a healthy sex life for you. There are two main types of penile implants used in gender-affirming care:
INFLATABLE
NON-INFLATABLE
INFLATABLE
These have two or three parts and can be pumped up when you want an erection. The pump is placed inside the body, usually in the scrotum. When you press the pump, fluid moves into the implant, making the penis firm. Afterward, the fluid goes back to a small reservoir and the penis becomes soft again.
NON-INFLATABLE
These are bendable rods placed inside the penis. They’re always firm but can be bent into different positions. These implants are easier to use but may not look as natural when the penis is soft.
WHY PENILE IMPLANTS MAY BE RECOMMENDED AFTER PHALLOPLASTY
After phalloplasty, many people are happy with the appearance and function of their new penis. These surgeries often allow someone to urinate while standing and feel sensation in the area. However, one of the challenges is that the neophallus usually doesn’t get firm enough on its own for penetrative sex. [4]
Special Considerations for Trans Patients
Penile implants for trans men and nonbinary individuals are different from those used in cisgender men. Because the neophallus is made using skin and tissue from another part of the body (like the arm or thigh), it doesn’t have the same internal structure as a penis someone was born with. This means the implant must be placed more carefully to avoid injury or complications. [5]
Many surgeons now use implants specifically designed for the neophallus, which can improve safety and outcomes. Choosing a surgeon with experience in gender-affirming care is important for this reason.
THE SURGICAL PROCESS
Getting a penile implant is a step that many people take after phalloplasty. The process involves several stages, from the consultation with your surgeon to recovery and healing after the surgery.
What to Expect Before, During, and After Implant Surgery
Before surgery
You’ll meet with a surgeon who is experienced in gender-affirming procedures. During this consultation, you’ll discuss your goals, which implant type is best for you, and the overall process. Your surgeon will also explain any potential risks and answer any questions you have. It’s important to be clear about what you want and ensure you feel comfortable with the plan. You may also need to have some tests done to make sure you’re in good health for surgery. [6]
During surgery
The surgery is usually done under general anesthesia, so you won’t feel any pain during the procedure. The surgeon will make a small incision, typically in the scrotum or the lower abdomen, and then insert the implant. This can take a few hours, depending on the type of implant and the complexity of your surgery. After the implant is in place, the incision will be closed with stitches.
After surgery
You will be monitored as you wake up from anesthesia. Expect some pain and swelling in the first few days, which is normal. Your surgeon will give you guidelines for pain management and care instructions for your incision site. You may need to avoid any physical activity for a while to let the area heal properly.
RECOVERY TIMELINE AND TYPICAL HEALING PROCESS
The recovery time can vary, but here’s what you can generally expect:
- First week: You’ll likely need to take it easy and follow your surgeon’s instructions carefully. There may be some swelling and bruising, but this should gradually decrease over time. Pain can usually be managed with prescribed medications.
- First month: You may need to avoid sexual activity or heavy physical exertion for about 4-6 weeks. The implant may still be in a soft state, and it’s important to let your body heal properly.
- 3-6 months: Full healing can take several months. You may gradually return to sexual activity once the surgeon gives you the green light. During this time, you may also be taught how to use the pump (for inflatable implants) and how to care for the implant long-term.
RISKS AND POTENTIAL COMPLICATIONS
While penile implant surgery is generally safe, there are some risks involved, just like with any surgery. These include:
- Infection: The area around the implant can become infected, which is why it’s important to follow all aftercare instructions closely. Your surgeon may prescribe antibiotics to reduce the risk of infection. [1]
- Implant failure: In rare cases, the implant can malfunction or break. Inflatable implants, in particular, have mechanical parts that may wear out over time. If this happens, you may need another surgery to replace or fix the implant. [1]
- Pain or discomfort: Some people may experience pain or discomfort after the surgery, especially when using the implant for the first time. This can often be managed with medication, but if the pain continues, it’s important to consult your surgeon.
- Scarring or changes in appearance: There may be some scarring around the incision site, though it usually fades over time. The appearance of the neophallus may change slightly with the implant, and it may not feel exactly like a natural penis.
While these risks exist, the vast majority of people who undergo penile implant surgery have positive outcomes, especially when they work with an experienced, gender-affirming surgeon.
CHOOSING THE RIGHT SURGEON AND CLINIC
Choosing the right surgeon and clinic for your penile implant surgery is one of the most important steps in your journey. You want to work with professionals who are experienced, compassionate, and who understand your needs.
Importance of Working with Experienced, Affirming Surgeons
When considering a penile implant, it’s important to work with a surgeon who has experience in gender-affirming surgery. An affirming surgeon will understand the specific needs of trans men and nonbinary people and will have experience performing bottom surgeries, including penile implants. These surgeons know how complicated gender-affirming procedures can be and want to help you in a way that is respectful and welcoming.
An experienced surgeon will also know how to handle potential complications that may arise in neophallus surgery, such as tissue healing, sensation, and implant placement. This ensures you receive the best care possible and feel comfortable throughout the entire process. Working with a surgeon who makes you feel safe, respected, and understood is key to achieving the results that align with your goals.
Questions to Ask During a Consultation
Before committing to a surgery, it’s important to have an open and honest conversation with your surgeon. Here are some key questions to ask during your consultation:
What is your experience with penile implants for trans men and nonbinary patients?
Understanding the surgeon’s experience with gender-affirming surgeries will help you feel confident that they are familiar with your unique needs.
What type of penile implants do you recommend, and why?
Ask about the different types of implants (inflatable vs. malleable) and why they believe one might be more suitable for your anatomy and goals.
What are the risks associated with this surgery, and how do you handle complications?
It’s important to know the potential risks, such as infection or implant failure, and understand how the surgeon manages these risks.
What can I expect during the recovery process, and how long will it take to fully heal?
Ask for a clear outline of the recovery timeline, what to expect during the healing process, and what kind of follow-up care is involved.
How do you ensure that I’m emotionally and mentally prepared for this surgery?
A good surgeon will also discuss emotional preparation and support, ensuring that you’re ready both physically and mentally for the procedure.
Affirming Healthcare providers
Making decisions about your body and your transition is a deeply personal journey, and it’s important to remember that you have the right to choose what feels best for you. Whether you’re considering a penile implant after phalloplasty or simply exploring your options, know that you have the power to make choices that align with your own goals and desires.
It’s also important to work with affirming healthcare providers who understand your needs and provide care that respects your identity. Surgeons who specialize in gender-affirming procedures can help you explore all the options available to you, answer your questions, and guide you through the process in a compassionate and supportive manner. They will work with you to find the best solution that matches your goals for both physical and emotional well-being.
If you’re ready to explore the possibility of a penile implant or have more questions, don’t hesitate to reach out to Align Surgical which specializes in gender-affirming care. We offer consultations where you can discuss your options in a safe and welcoming environment. Your healthcare team is there to support you every step of the way. Remember, your transition is yours, and you deserve to have the information and care that helps you feel empowered and at ease with your choices.
Contact us to learn more about penile Implants or any other procedures you may be considering. Whether you’re exploring options after phalloplasty, scrotoplasty, or any other gender-affirming surgery, we’re here to provide you with compassionate care and expert guidance.
BY DR. MICHAEL SAFIR, MD
Dr. Michael Safir, MD is a board-certified reconstructive urologist specializing in genital gender-affirming surgery for transgender individuals. Based in Los Angeles, Dr. Safir holds a rare subspecialty certification in Female Pelvic Medicine and Reconstructive Surgery (FPM-RS), making him one of the few urologists in the world with advanced fellowship training in both male and female genitourinary reconstruction. He earned his undergraduate and medical degrees through the Honors Program in Medical Education at Northwestern University, where he also completed his urology residency. Dr. Safir went on to complete fellowships in Male Genitourinary Reconstruction at UCSF and Female Reconstructive Urology at UCLA, training under renowned surgeons Dr. Jack McAninch and Dr. Shlomo Raz. He has served as Section Chief of Reconstructive Urology at New York Medical College, a Clinical Instructor at UCLA and UCSF, and President of the Los Angeles Urological Society. Dr. Safir is board-certified by the American Board of Urology, a Diplomate in FPM-RS, and an active member of the World Professional Association for Transgender Health (WPATH). With deep expertise in procedures such as phalloplasty, scrotoplasty, and gender-affirming penile implants, Dr. Safir is known for providing safe, affirming, and personalized care to transmasculine patients across the country.
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