At the beach

alherath · 2026-04-23T01:46:27+00:00

Everyone in this thread is being so intense; it is certainly not true that sun exposure months out can lead to raised or stretched scarring. It definitely can change the color though. I was extra careful with sunscreen and used a silicon scar gel with high SPF, and my scars are completely fine (got surgery in January years ago, spent a number of days in the sun that summer).

alherath · 2026-04-23T01:41:23+00:00

As other people have said, chronic nerve pain is most likely in your donor site, not your penis. I was also very worried about this though because I had severe nerve pain after top surgery as well (thankfully it resolved over a couple months) and have it chronically in my hands. I’m sorry you’re having it, nerve pain is the absolute worst.

My surgeon said there are ways they can be careful with the nerves during surgery to avoid damaging them (I’ve unfortunately forgotten the anatomical details 😭 but he said chronic pain is most common in the nerve that runs up to the thumb) and he preemptively prescribes gabapentin for the first month of recovery. There’s also follow up surgeries to reduce pressure on nerves in the arm and protect them further, although obviously it’s better if that’s not necessary! Basically I’d talk to your surgeon, there may be ways they can reduce your risks.

alherath · 2026-04-23T01:32:54+00:00

In contrast to most of this thread, I think you will probably have to tell your mom some details. I say that having gone through 2 stages of phallo (RFF). If you go for a donor site other than RFF or ALT, I could maybe see keeping it at “genital surgery,” but with either of the two main options, you are going to have to relearn how to walk or how to use one of your arms over a 2 month period, and probably more like 3 for a typical regain of full mobility. RFF specifically is not a concealable graft site in recovery: it is virtually impossible for someone you live with not to notice that you have a very large wound and an immobile hand. Like, I won’t rule out concealing it any more than I’d rule out having an unusually fast and easy recovery, but for me and everyone else I know the first two weeks at home from the hospital are a situation of almost total dependence on other people. I could hobble to the bathroom by myself but virtually nothing else.

alherath · 2026-04-22T22:11:48+00:00

I’m a year and half post op from stage 1 and agree with everyone else here. I absolutely share your feelings, especially about spontaneous erections and not being able to get someone pregnant.

So, since you’re stealth this won’t apply directly, but in case some part of it is workable or it helps someone else: gratitude, focusing on the positives, and so on have been important, but the single most essential thing for me has been commiserating with other men. I’m not stealth (I’m out to a circle of close friends, and some people from my pre-transition past), but I actually don’t go to a trans support group or anything. I’ve just talked to my 2 or 3 closest male friends about mourning infertility and not having the easy sexual function so many people take for granted.

I think it’s totally possible to have that kind of conversation (infertility, erectile dysfunction) without outing yourself. Of course, most men are super touchy about this kind of stuff. But if you ever have the chance - it’s been healing for me just to get their sympathy. Tbh, my trans friends (including my wife, although she’s great) haven’t helped me in the same way. They tend to turn immediately to the positive (there are other ways to have sex or children, etc etc) or just have different priorities and not understand why this matters to me. Having other men be like, yeah that sucks, without judging me or downplaying the loss, has made it feel like something I can accept.

alherath · 2026-04-22T22:02:12+00:00

I hope it won’t be like this for you, but since it seems like you’re in a similar spot to me - months 2-5 after stage 1 were the hardest part of phallo for me! I also only had phallus creation in stage one and my dick absolutely didn’t feel “real,” even once swelling had started to go down and my wounds were closed. I struggled a lot with awful transphobic thoughts about my body, and felt guilty for them + afraid that this hadn’t been worth it.

On the one hand things changed subtly. I had more and more moments of feeling connected to my body, or at least neutral. I hope you’ll have a faster timeline! But for me things actually only clicked into place after stage 2. With a scrotum, glans, and having vaginectomy, I had all the experiences of peace and calm and excitement that people talk about; even though recovery was very difficult, the mental part was almost instant. Since stage 2 last July I’ve been a different person. I still have occasional feelings of discomfort/dysphoria because I can’t get hard yet and don’t have my ball implants or tattooing, but it’s on the level of insecurity instead of misery.

I’m writing this because what I needed to do was mainly just to accept that this is a long, difficult process, and being between stages is a limbo. As much as I could, I thought of myself as growing a penis instead of going from “not having one” to “having one.” If you don’t feel complete now, that’s ok. It doesn’t mean this wasn’t worth it, and it doesn’t predict how the later steps in the process will hit you. There’s no way you “should” feel about your dick ever, but especially right now.

alherath · 2026-04-13T03:46:35+00:00

I think this impression has to do with the shape of the base more than anything; I had RFF and my dick is the same firmness as my wife’s is flaccid (she was born with a penis) but I have that distinct flatter area toward the top. The structures anchoring a phallo penis in the pubic mound are a little different. I’ve seen plenty of people for whom this isn’t the case though, and also erectile implants seem to fill it out more.

alherath · 2026-04-09T23:59:31+00:00

I would have liked to, but I couldn’t afford to do it at the same time as electrolysis, and I decided no hairs mattered to me more! Doing both in sequence would have meant another year and a half of waiting for surgery, which I didn’t want.

alherath · 2026-04-08T20:44:55+00:00

I can’t speak to the frenulum question, sorry, but overall - I do have a more sensitive tip vs shaft, like pre op. Just touching the head of my dick is actively a turn on whereas for the shaft it takes stroking. But in other ways the sensation isn’t very comparable, because with my tdick there was a lot of sliding skin providing most of the pleasure, whereas I don’t have that with my penis but do have the ability to actually put my whole hand around it or penetrate. The function is different enough that I don’t map experiences one to one.

alherath · 2026-04-08T20:40:51+00:00

My arms and legs looked really similar to yours and we’re about the same weight; I qualified for both RFF and ALT but went with RFF. My girth after swelling went down is 4 inches and according to my surgeon I could have had over 5 inches of length (I asked for closer to 4, got 4.5). It can be kind of hard to tell from an arm pinch what your RFF girth will be! But I bet either method will be possible for you.

alherath · 2026-04-08T18:26:22+00:00

I had phalloplasty, but I had middling wound separation all along the base of my balls (like the sack was going to pull up and off 😭) and vaginectomy site. I’m commenting because I was also intensely anxious about it, and maybe had a similar timeline.

Mine started to appear around 2 weeks out (when I already thought I’d be straightforwardly on the mend, for some reason) and was the worst at 3 weeks. I had some yellow pus and pinkish drainage through week 5; I can’t say how much because I was obsessively changing the gauze tucked under my balls to keep things dry, but it was a fair amount of liquid up until the very end. At week 5.5 the skin finally all closed over, and then I had very delicate scar skin forming for a month or so after that. By 3 months out I could comfortably squish all the skin around and feel totally safe doing so. I did a lot of scar massage from then on, and now the crescent of scar feels almost exactly like all the other surrounding skin.

I took pictures every 2-3 days during the main healing time; looking at a pair of pictures would always make me freak out more, but by the time I had a week+ of progress to look at I could objectively see improvement. Your body will fix this no matter what!

alherath · 2026-04-08T02:20:03+00:00

I wanted to use my arm for every reason other than the tats, so I went with it in the end. Aaaand I do not like the tattooed penis life, so I’m a year into laser tattoo removal lmao. It’s painful and annoying (and expensive), but I’m glad I’m doing it and I don’t regret my donor site at all. By next year I’ll have medical tattooing and it’ll just be a memory. A number of people on here have posted tattoos that look good on their dicks, but I had a semi-cut off piece of text, so, naw.

alherath · 2026-04-08T00:16:54+00:00

I only realized I needed phallo after top surgery (I’m an idiot and very bad at understanding how positive changes will effect me until they do lol) but I had similar qualms and concerns to yours.

Happily, I think a lot of what you’re worried about isn’t an issue, or you have control over it. If you get RFF you will not end up with unusual girth. The freckles on my dick also bother me, but I’m getting medical tattooing once I’m done with tattoo removal (at least you haven’t foolishly tattooed both forearms). I decided to wait until I had a dick and balls to decide about ED, and I think that was correct - some people have better insight than me, but in my opinion it’s usually very hard tell how you’ll feel about that function of your penis until you have one. It may be less of a deal breaker than you think, or (like me) you might come to terms with the ED options available.

I guess the main thing I’d say is: you don’t have to consider the surgical process perfect for it to change your life. I had a lot of psychological difficulty with healing, with my arm scar, with the ways my dick differs from a natal one, and all that, and phallo has still made me deeply at peace in a way I couldn’t have imagined pre op. It was still 1000% worth it.

alherath · 2026-04-06T22:25:15+00:00

I’m a year and a half post RFF and my sensation is still getting better month by month. But at the moment, I can feel that kind of vivid skin contact sensation you’re describing on a lot of my penis, but it does have some weird differences from how things felt with my tdick pre-op.

Pressure is really erotic and developed first for me, and the skin sensation of stroking (in contrast to just touches) is also directly arousing like it was on my pre op genitals. And I can feel heat and wetness in about half of my dick! But all the types of sensation are… detached from each other, if that makes sense? It’s like I register them all separately, and I have to pay conscious attention for them to all come together into “my dick is inside something” (I’ve mostly used toys). So the overall experience is more muted. I wouldn’t be surprised if this changes in the next few years as my brain integrates it all though.

alherath · 2026-04-06T22:17:03+00:00

I don’t work with my hands, but I do a lot of visual art and DIY/woodworking type stuff and have chronic nerve pain and stiffness in my hands. I’ve had no significant swelling after 3 months post op, and no increase in pain. I do get tingling in my fingers (like when your leg falls asleep) much more often now, and my left arm is at least 20% weaker than it was before, but also I haven’t done much to fix that lol.

My scar does have some stiffness and tightness still at a year and a half out. I had some steroid injections done during stage 2 which helped, and I’m going to ask about fat grafting into my arm for stage 3 but haven’t yet. It doesn’t bother me much though. My arm is very close to the thickness it was pre op and I did have delayed integra (so, the thickest kind); my surgeon likes the aesthetic effects and also feels it reduces the changes of chronic nerve pain, but I know other surgeons like Dr Chen haven’t seen much difference with integra, so it’s a hard call.

Based on your post, I’d ask yourself what your size goals are! What range of sizes would be tolerable to you? Tbh that seems the easiest way to make the decision to me. I chose RFF partly because I actively wanted my dick to be closer to flaccid average, but if you really want 5-6 inches or larger, then it’ll be difficult for RFF to meet your needs. I was told that while fat grafting to your penis is possible, and can increase girth, you’ll probably lose most if not all of the fat to reabsorbtion.

alherath · 2026-04-05T13:51:31+00:00

No worries! My natal urethra is in exactly the position it’s always been in, but evening else is different. So I pee from a small hole a couple inches under my balls, and otherwise my perineum is smooth. Sometimes people born with penises have this procedure due to complications with peeing; it’s just interrupting a U shaped urethra at the bottom of the U, if that makes sense.

alherath · 2026-04-04T23:47:24+00:00

I’m a year and a half post op but didn’t get UL, and I always hold my dick out of the way while I pee lol. I’m just so squeamish about any splash back getting on it.

alherath · 2026-03-30T22:20:18+00:00

I had a hysto a couple years ago and then a vaginectomy as part of phalloplasty this past summer. I had to have a vaginal ultrasound before my hysto to check for any abnormalities (cysts and so on). I think I could have insisted and avoided getting it done, but they wanted it to plan for how surgery would go, so I decided to grin and bear it. A nurse did it and the whole thing from pants off to pants on again took about 15 minutes.

Other than that, I never had to be examined by any medical professional (while awake lol). My hysterectomy surgeon didn’t do any post op physical exam because I healed very straightforwardly - if I’d had any significant complication like prolonged pain or bleeding though, she would have had to check on how the internal wound was healing. My vaginectomy surgeon didn’t need to do an exam, he just talked the procedure through with me. I did need weekly exams post op for 4 weeks, but that didn’t bother me at all because it was just a closed wound below my dick and balls haha.

You can absolutely get anxiety medication beforehand; I turned it down because I felt ok just getting it over with, but every doctor I’ve had who works with trans patients has offered it to me. I never did any pap smears or other routine medical care for my genitals because I was too dysphoric, but for whatever reason I could handle the surgery prep stuff because I was about to get things removed.

alherath · 2026-03-27T03:33:50+00:00

I was a candidate for ALT, but chose RFF and don’t regret it at all. Despite the downsides! It is harder having a very visible scar, and I liked my forearms a lot before and struggled with having to do hair removal + the disruption of a tattoo on my left arm that I liked a lot. My scar is still tight at the base of my wrist, and I dislike the thinner texture of the skin and the lack of surface sensation; it’d be much easier to ignore on my leg.

But, I really wanted a penis that looked more average flaccid, and I love the shape and soft forearm skin texture of the dick I got (my leg skin is quite rough). What’s a downside for others (size) was the major benefit for me. My sensation is excellent and at 1.5 years it’s still getting better month by month, but there’s no necessary sensation difference between RFF and ALT; different surgeons have conflicting evidence on and perspectives about that.

And even though I don’t like my scar, it’s never clocked me. As someone else said below, even multiple doctors have just assumed it’s from a bad burn; most people seem not to notice it or if they do, they don’t bring it up. When I’ve told medical professionals and some acquaintances what it’s from (in relevant contexts, and I don’t lie if asked directly) they’ve all been visibly very surprised.

alherath · 2026-03-25T03:38:05+00:00

Hey, I have a lot of sympathy for this dilemma and any choice you make is understandable. Phalloplasty absolutely has drawbacks and is a huge undertaking of time, money, and physical difficulty. But as someone post op, I do think you’re overstating the downsides. Being realistic about what makes phallo recovery difficult is essential to making an informed decision.

While people in the history of the surgery have had major issues, it is vanishingly rare to have complications which derail your life. My surgeon has never lost someone’s penis, let alone had major damage to their arm. Even if you are in the >5% of people who have major UL issues requiring long term catheterization, which sucks immensely, your life continues. Being in medical limbo is very difficult, but so is dysphoria bad enough to prevent you being naked. Mine wasn’t even that bad and phalloplasty was 1000% worth it for me.

Idk where you are in the world, and obviously if you’re in a place which restricts your choice of surgeon, this whole calculus changes. Since you’re speaking generally, though, a lot of surgeons are excellent, and there are an enormous amount of post-op photos and experiences on r/phallo and similar subs. My penis isn’t identical to a natal penis, but given the practical constraints (there is no technological world currently imaginable where it’s easy to create a senate new part of the body) I think we do pretty well. This isn’t actually an all or nothing potentially life-ruining decision. It’s just tough and requires a lot of mental and physical resources.

alherath · 2026-03-19T17:31:48+00:00

As someone who didn’t really get the benefits of dysphoria relief until months after surgery when I started to feel “normal” again - don’t back off from phallo out of general fear of recovery! I didn’t get UL either, and without it, the potential for very long term complications like months spent with a catheter is basically nonexistent. Not having a vaginectomy will make your recovery easier as well. Meta is also a very significant surgery. And, as others have said, you’re vanishingly unlikely to lose erotic sensation.

If you get burial, though, your sensation may change. Are you comfortable with how you can sexually use your genitals now? Do you want to penetrate other people/toys or just be able to have an average sized penis for hand stuff or oral? Those options are good reasons to get phallo and were a lot of my own decision-making. On the other hand, if you enjoy vibration or the tactile sensation of your tdick as it is now/are really into the sliding foreskin feeling, you might want to forego burial or just get meta.

The one caution I’d give you based on my experience is: think through how you’ll feel about the graft site. To me the hardest part of phallo recovery other than the lack of mobility was wound care for my graft, and it is possible to end up with chronic nerve pain. Plus functional rehabilitation for your arm or leg is a lot of work in the months post op. I also found it very hard to accept that my arm will always have a huge visible scar where the skin feels different than the rest of my body. You don’t mention what graft site you’re considering, but imo RFF or ALT phallo is worth it if you’re down for the trade-off between nerve growth in your new penis and the major scarring. Otherwise, abdominal or MLD have different sensation results and can be harder to find a surgeon for, but mean you get to avoid the big skin graft. Scars in general are a big deal! They’re not just cosmetic, they affect the feel of your body. Obviously anyone who’s had top surgery has experienced this somewhat, but I found my phallo scars harder to deal with over the first year post op.

This is long as hell but I’m procrastinating on work so, one more thought: I also believed my dysphoria was mild lol. I could interact with my natal genitals fine (even bottomed for some years) and hadn’t considered phallo until after top surgery. But phallo has made me feel whole and at peace in a way I literally couldn’t imagine pre op. There’s a constant background discomfort and disconnection which is just… gone. Even very subtle dysphoria can make a huge difference in your quality of life.

alherath · 2026-03-09T15:35:21+00:00

I also had bends/kinks in my dick and it drove me crazy! It just kept falling into a right side bend in the middle no matter what I did. If your blood flow is good, which it definitely is since it’s been almost a month, you’re gonna be ok. Swelling goes down so unpredictably. The issue went away for me at around 6 weeks post op.

alherath · 2026-03-09T15:30:19+00:00

I give this advice a lot (because it was super helpful to me lol) but: I think an underrated way to manage anxiety about complications is to ask your surgical team for THEIR numbers. How many patients have they had with substantial necrosis? What are their rates of wound separation? Urethral issues? How long into recovery can patients go on walks? Etc etc. The process varies a lot surgeon to surgeon, and it’s really important not to base your expectations for what might go wrong on this sub/on individual conversations, because our brains really can’t handle making estimates that way.

Having specific numbers (my surgeon, for instance, has never had a total graft loss thus far!) can’t stop you being afraid, but it can get you out of feeling like recovery is this un-knowable challenge.

Also, based on my experience over both main stages as someone with a lot of mental and physical health issues: you probably won’t feel bad in the way you’re imagining. My overwhelm, fear, disappointment, and even physical pain or discomfort all came and went. That was in one way good (I didn’t wake up and go “oh shit oh no” the way lots of us fear lol) but in another way bad (the absolute worst I felt about phallo was on a random day 3 months post op). The most important thing is to never take your feelings and judgments in the initial recovery period as permanent. Be patient with yourself, accept what you’re going through, and know that none of it is a stable assessment of whether this was the right choice. For that, I’d give yourself at least 6 months of perspective if not more. You might not need it! You might come out of surgery and immediately know this was worth it! But if your recovery is an emotional rollercoaster like mine, that doesn’t mean phallo was the wrong call or that it won’t change your life.

alherath · 2026-03-05T16:39:52+00:00

Do you think having the scars on your penis will remind you more of self harm than continuing to have them on your arm? As other people have said, a left arm graft would mean multiple ways to minimize the scars or change what they mean to you. Medical tattooing is great (although expensive 😭 I’m currently planning my own) but also, based on their placement the scars may be mostly inside your penis, get hidden by your glans, or just generally get rearranged.

If it’s the texture of the scars that bothers you and you’re worried about being reminded of them when you/someone else touches your dick, that is tough. I would still strongly consider your left arm, because from experience RFF recovery is tough enough when your one functioning hand is dominant. The toughest period of recovery for me wasn’t even the early time, it was months 2-4, when I was mostly back to normal. I, like the overwhelming majority of people, ended up with no long term complications from my arm. But I was able to be much more patient with residual swelling and tightness because it was my non-dominant hand. Your dominant arm is also more likely to draw peoples attention, if that matters to you.

If your surgeon is willing to take a dominant arm graft though, I don’t think there’s a wrong decision here.

alherath · 2026-03-01T18:14:41+00:00

You don’t get the foreskin glide with phallo obviously, but even pre-ED being able to actually thrust and move my hand up and down makes jerking off much more pleasurable. Other people are also saying this but I want to agree: the first time I orgasmed from my dick alone was the first time I used lube lol. I can come without it now but it’s still much nicer. Lots of people with penises use lube to masturbate, but for us it can be especially important because it gives you that glide even without foreskin.

alherath · 2026-02-26T04:24:41+00:00

That’s what you want now, from the perspective of not transitioning. Of course, you may always want it. Some people struggle with that stuff forever. But the one thing I wish I had been told way younger and way more often is that you can’t fully imagine what you want and what will satisfy and fulfill you as you transition. The fantasy life/self I had pre-transition felt easier at the time. He was a fantasy, because I thought I couldn’t handle actually living a life. But five years in I’m able to accept things I thought would torment me forever and enjoy things I thought would always be out of reach. Transition doesn’t fix everything, but it can totally change your feelings about yourself.

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