Musculocutaneous latissimus dorsi flap for phalloplasty in female to male gender affirmation surgery

Djordjević, Miroslav L.; Bencic, Marko; Kojović, V.; Stojanovic, Borko; Bizic, M.; Kojić, S.; Krstic, Zoran; Korac, G.

doi:10.1007/s00345-019-02641-w

Cited by 45 publications

(52 citation statements)

References 21 publications

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“…The free radial forearm flap (RFFF) and the anterolateral thigh pedicled or free flap (ALT) are, by a considerable margin, the most common donor site choices currently. The latissimus dorsi (LD) myocutaneous flap [32,33] and the superficial circumflex iliac artery flap (SCIP) [34,35] are used at select centers. The free fibula osteocutaneous flap [35][36][37] and the lower abdominal pedicled flap [29,38] are used less frequently.…”

Section: Phalloplastymentioning

confidence: 99%

“…In considering other flaps, most, as already mentioned, are used preferentially in single centers, used infrequently, or mainly of historical interest. Djordjevic et al [32] have advocated phalloplasty using the latissimus dorsi myocutaneous flap. Advantages include the reliable donor site anatomy, the inconspicuous donor site that, with adjacent tissue rearrangement, can be closed primarily, and the large amount of tissue available.…”

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confidence: 99%

“…Advantages include the reliable donor site anatomy, the inconspicuous donor site that, with adjacent tissue rearrangement, can be closed primarily, and the large amount of tissue available. The authors also speculate that a reinnervated latissimus muscle can aid phallic rigidity and allow penetrative intercourse, although data to confirm this are lacking [32] . Significant disadvantages, however, The ALT is based on the lateral femoral circumflex system [48] .…”

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confidence: 99%

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Phalloplasty: understanding the chaos

2020

Plast Aesthet Res

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Wide variation in overall strategies and surgical specifics for masculinizing genital surgery has created a "phalloplasty chaos" that is confusing to both surgeons and patients seeking gender confirming surgery. The purpose of this article is to review masculinizing genital confirming surgery, or "phalloplasty", focusing on specific goals and categorizing each component of the surgical process. Experienced surgeons from several highvolume centers review and categorize the commonly employed strategies and techniques for gender confirming phalloplasty, including the permutations of approaches to cutaneous flap for phallic construction, the sequence and staging of procedures, and strategies for urethral construction. There is no clear advantage or reduction in complications associated with particular sequences of urethral and phallic reconstruction. Because no single technique or staging strategy has proven superior for gender confirming genital surgery, it is paramount that surgeons are knowledgeable of all available options and the associated advantages, disadvantages, and risks.

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Section: Phalloplastymentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Phalloplasty: understanding the chaos

2020

Plast Aesthet Res

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“…This has ushered in the current era of phalloplasty for the treatment of gender dysphoria, where the focus is on achieving the best possible phallus reconstruction while minimizing overall morbidity. While many donor sites have been explored and are still currently utilized, the radial forearm and the anterolateral thigh are the most commonly used in phalloplasty surgery for gender dysphoria [6][7][8][9] [Figures 1 and 2]. Current techniques and surgical staging vary widely between institutions and individual surgeons, thus making it difficult to draw conclusions regarding the frequency and extent of complications.…”

Section: Introductionmentioning

confidence: 99%

Partial flap loss in transgender phalloplasty using the anterolateral thigh or forearm - a systematic literature review

2020

Plast Aesthet Res

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Aim: In this study, we systematically review the current literature regarding partial flap loss (PFL) for the two most commonly performed types of phalloplasty, the radial forearm and the anterolateral thigh flaps. The primary purpose is to synthesize the available information to clarify anatomic location, etiology, extent of flap loss, and management thereof. Second, we utilize this information to inform strategies to mitigate the risk of PFL. Methods: A systematic review of all abstracts published on phalloplasty on PubMed was performed. Abstracts were reviewed by two senior authors who included all studies discussing flap-related outcomes after radial forearm free flap (RFFF) phalloplasty or anterolateral thigh flap (ALT) phalloplasty for the treatment of gender dysphoria. Primary variables collected include: flap type, PFL rate, anatomic location, extent of and management of PFL.

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“…Six [3][4][5][6][10][11][12] major studies (implant n > 40) have been published on this topic, most of them being relatively small volume (implant n < 247, mean patient n = 97), retrospective, with high heterogeneity in terms of implant models, techniques and outcome measures [3][4][5][6][10][11][12] (Table 1).…”

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confidence: 99%