So, unfortunately, Cetrulo hasn't published about phalloplasty specifically. This makes me wonder if he will publish about these first few patients.
Based on his existing and most recent publications though, he has done a lot of work with flap reconstruction. Much of his work was for burns and other skin loss. His experience with this means that his patients are more likely to have reennervation and blood flow to the skin used for the neophallus. Which means, unlike some others we've seen, a better outcome healthwise, as it will heal better. This is better for preventing dehiscence and necrotization.
For what it is, that neophallus doesn't look that bad. Minus the disgusting hair. We've definitely seen much worse. And at least this patient doesnt have the horrifying leg or arm scars.
I can only guess at his methodology. But he relies on two common and successful surgical procedures - abdominoplasty and the pedicle flap.
It sounds like the first step is vaginectomy only. A pretty serious surgery that makes sense to do alone.
The second step is then the abdominoplasty and construction of the pedicle. During this surgery it seems like he does a partial abdominoplasty, but instead of removing the skin and fat he uses it to create the neophallus. This is why it's so high - it's meant to stay attached so that it can maintain blood flow and sensation, which makes healing much easier. She said no hair removal, which scared me because of those disgusting urethral hairs we've seen... But then I realized that he doesn't create the urethra at this stage.
Then he does the first stage scrotoplasty and urethral lengthening through the meta. I imagine he works with a urologist on the UL and probably uses a buccal graft. I only think that because his techniques are better in every area (and
). I imagine the scrotoplasty addresses any aesthetic things left from the vaginoplasty, and moves the labia into the optimal position.
Then, he performs a second skin removal in the abdomen/pannus area, in which he will stretch the skin down and across to position the neophallus. This should put it in the correct position. From here he would extend the urethral length through the neophallus and attach the nerves from the genitourinary area, burying the meta.
Then finally he would do the second stage scrotoplasty which would improve size and appearance, and probably use testicular implants.
Her weird hips are just how the fat and tissue looks after the abdominoplasty. This happens often and is corrected with Lipo. Ideally he would use a laser or ultrasound assisted method to sculpt the fat into a more masculine shape, and add emphasis to the abdominal muscles. He might also probably lipo or sculpt the phallus more to make it look better.
If for some reason the phallus is still too high, there are smaller procedures that can be done quite easily to lower it (like those in my previous post about penis lengthening).
This should have a better outcome. While it will not look real, at least it will be healthier in the long run. Function is another story, but I would assume better urinary outcome at least.
From an experimental point of view, this how we would ideally develop an actually good/reponsible method for ftm phalloplasty. This is not considering other issues they have mentally or the physical effects of medications and hormones, which can cause their own problems as we know.
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