Case ReportA True One-Stage Nonmicrosurgical Technique for Total Phallic ReconstructionMutaf, Mehmet MD; Is̨k, Dağhan MDı; Bulut, Ömer MD; Büyükgüral, Berker MD Author Information From the Department of Plastic and Reconstructive Surgery, Gaziantep University, Gaziantep, Turkey. Received December 14, 2005 and accepted for publication January 21, 2006. Reprints: Mehmet Mutaf, MD, Universite PTT Subesi, PK.6, Gaziantep, Turkey. E-mail: [email protected]. Annals of Plastic Surgery 57(1):p 100-106, July 2006. | DOI: 10.1097/01.sap.0000208991.22264.b5 Buy Metrics Abstract A new nonmicrosurgical technique for one-stage total phallic reconstruction is presented. In this procedure, an innervated anterolateral thigh (ALT) flap including the medial half of the fascia latae is combined with a sartorius perforator flap. Both flaps are elevated together as an island chimeric flap based on the lateral circumflex femoral vessels and tunneled to the recipient area. The neourethra is created with thin and hairless skin of the sartorius perforator flap, while the ALT flap is used to construct the shaft and glans of the neophallus. The rigidity was provided with a penile prosthesis covered with a neotunica albuginea created with vascularized fascia latae for the first time in the literature. The lateral femoral cutaneous nerve of the ALT flap is coapted to the pudendal nerve to provide erogenous sensibility. Here, a 15-year-old male in whom this new procedure was used for one-stage total phallic reconstruction is presented. Two years of follow-up revealed that an esthetically acceptable and functional neopenis with a nonhairy competent urethra, erogenous sensitivity, and a proper rigidity was achieved with no complication. This new technique, namely, the “Istanbul on the thigh” flap, is a one-stage, safe, and timesaving technique which fulfills all essential goals of phallic reconstruction but does not require microsurgical equipment and expertise. Moreover, the donor scar is located at an unexposed area, easy to conceal. Although more clinical experience is needed, this new procedure seems to be a useful alternative in phallic reconstruction. © 2006 Lippincott Williams & Wilkins, Inc.