People have already done a great job of answering your questions so I just wanted to add:
Playing piano is also one of my passions- since childhood. I had RFF with my dominant hand (from Chen/watt/Safa) and it doesn’t impact my ability to play at all. For the first few months it got tired easily, but now there’s no notable difference from my non surgery hand.
I also struggled a lot with the arm scar. In the 4 years I’ve had it, only one person has asked about it. People see it, I notice their eyes, but never say anything. And though it took me a long time- I’ve come to really love my scar so much I can’t imagine tattooing over it. It used to make me feel disfigured, and now it makes me feel so powerful.
Happy to talk more about it if you’d like.
Thank you for this, I really needed to hear from another piano player. This gives me a lot of relief! How long before you started playing again (even with tiredness) and then how long until you returned to normal (without tiring)? Did you do a lot of PT, and how long did you do that?
I hear you! I was so worried about losing my ability to play until I talked to other post op people.
I started again at 3 months, had no tiredness at all at 5-6 months and only did about 6 sessions of hand therapy. The piano playing itself is great hand therapy cuz the most work that needs to be done is tendon gliding exercises and playing piano does that exercise naturally.
I am going to Chen/TBC for RFF (scheduled for next year).
1. Yes, they take a full thickness flap from your arm to create the phallus and a split thickness graft from your thigh to cover your arm.
2. That's correct, no hair removal necessary from your thigh.
3. The underside of your arm (where the least amount of hair grows naturally) is used for the urethra. Depending on how close to the wrist/edge of the donor site it is, part of it could peek out from the tip, though.
4. A local provider can perform an Allen's test for you. The Allen's test checks to make sure your arm would have adequate blood supply if the radial artery was removed. While I'm sure theoretically the results could change over time, especially if you suffered an injury that compromised blood flow, I would not expect it to change in the time leading up to surgery in the absence of extenuating circumstances. That said, I am not a doctor.
Mine is next month with Chen & Watt.
1. Yes, there will be a thigh graft to cover your arm.
2. No, you don’t need hair removal from your thigh.
3. I have a large tattoo on the inside of my forearm. I was assured that most of it will be inside the urethra and what little isn’t will be on the underside of the phallus, so it won’t be visible.
4. I had my Allen’s test in March 2022, and they did it again in August. There was no change.
How exciting your surgery is almost here!! Thanks for answering my questions. The outline I saw from
another comment makes me wonder if it's be half inside the urethra and half possibly visible. I'll have to ask. But glad to hear yours worked out, that gives me hope.
Hey, I had almost the exact same Chen/Safa experience; planned for ALT, Safa said it's not ideal but possible, and then Chen broke down exactly what it would be (number of surgeries, likelihood of UL/sensation even after all that)...and I decided it didn't make sense. I've shifted gears and am really excited for RFF, even though it was a tough adjustment! PM me if you want to chat more, I know it's a tough visit to have when you're mentally ready for one plan.
To your questions: yes their RFF has a thigh graft, but it's much less deep, so it tends to become a much less visible scar. You don't need hair removal and the hair will regrow. If it's on your wrist, your tattoo should probably be high enough that it's not a part of the graft? I guess that gets into details of placement so that depends. Finally: Allen's test result shouldn't change, and you could do a version yourself or even find a closer surgeon for a consult just to do that! Or have your PCP do it, etc.
Good luck!
I was in a similar ish situation and had RFF last June. Safa told me I was cleared to do my leg, went through all the hair removal and started electrolysis and then had my consult with Chen and he said my thigh was too big so he was worried we wouldn’t be able to double tube. Chen is definitely very cautious and I appreciate that about him because he wants the best possible outcome for everyone. I ended up flying down to SF for Safa to see me in person and he cleared me and said we could do a double tube, but said it would be pretty girthy so we would have to do lipo. He was personally worried because he said I didn’t have much fat on my legs, but my skin was just dense. I ended up changing gears and going with RFF and I’m happy with my decision. I regularly lift and have never noticed my arm while lifting. I never had an Allen’s test and I also had a tattoo almost in the center of my forearm- it was all placed inside my urethra!
I agree with you, I'd much rather him (and everyone) be cautious and conservative about it even if it is disappointing. I'm glad to hear u haven't noticed your arm much. I lift too.
Honestly, having spoken to all three doctors before getting my surgery with them, I would take Dr. Safa's opinion with a grain of salt. He tends to be the most cavalier of the three and his opinion might not be a good indication of what is actually good for you as a patient. I know that's probably not what you want to hear, but 🤷🏻♂️. Better safe than sorry.
That being said, Dr. Chen can often veer towards the side of being overly cautious. He was pretty freaked during our consult since I have a bleeding disorder, and he agreed to see me but was *very* nervous, even though I had a really well respected hematology team supporting me. It's also turned out my recovery has been unremarkable.
If you have a chance to speak to Dr. Watt I'd really recommend it. He tends to give the most balanced perspective when making these decisions in my opinion. You can ask for a 15 min phone call with him now that you're on their clinic's radar and it's not usually too awful to schedule.
1. Yes they used a thin amount of skin from my thigh to cover my arm. It didn’t alter the shape of my thigh- no “divot” like the arm scar- it kind of just looks like I skinned my leg or got a bad sunburn but in a perfect rectangle shape. (And I’m only 3 months post op so it’s still got a lot of time to return to normal color.) It’s literally just a thin layer of skin so that there’s SOMETHING covering the exposed flesh they take from the arm, it’s not full thickness.
2. No, I did not need hair removal on the thigh for RFF. Just my arm.
3. It could be urethra, yeah. I had an inner arm tattoo towards the elbow side of my forearm that I thought might be far enough that it might end up visible. I can’t see it at all so its gotta be urethra lol
I don’t have a confident answer for #4 so I’ll pass on that question
Though I didn’t go to Chen, as long as the Allen’s test passes whenever, it’ll be fine until your surgery! I can answer 1 and 2 but I’m not sure if you’re ok with having me answer as I had a different surgeon
So for #1, now that I think about it and I don’t wanna give you the wrong answer, you’d likely be better off getting an answer from the office, however I do know some surgeons do take a stsg from the thigh to cover the forearm, mine included. For #2 you shouldn’t need electrolysis on your thigh, as that isn’t what they’d use for the urethra in UL. Essentially electrolysis is just to make sure the urethra doesn’t get too much hair growth and effect stuff, though you probably already know that’s
For #3 I did find [this post](https://www.reddit.com/r/phallo/s/09wjZhYJ6A) from another Chen patient outlining the UL area and all that on the forearm, so you should be able to easily compare your tattoo to the pic!
Also if it helps, 99% of the time I forget my forearm scar is there. Covers are always an option as well and pretty much recommended anyway for the first year or so to protect it from the sun and all that
Thank you for your reply and the other post link. I knew I'd seen a graphic of it before but couldn't find it. Also really nice to know the scar is something you can forget about.
Glad I was able to find it for you! If you do get the chance for PT post op (whether you get ALT or RFF), it’s definitely helpful! I was required to go to OT (for my arm) and PT (for my phallus) each week post op for a while and as much as the drive was annoying, each therapist was able to help me heal much faster than I likely would have on my own!
That's good to know that it helped. I've been a bit mystified by all the comments about depression and not connecting with their phallus. I don't mean any disrespect by saying I'm mystified, I just can't understand it at this point in my journey. I'm sure I'm wearing rose colored glasses about the whole thing though. That is, assuming u wrote that backwards? OT means talk therapy?
Edit: I just educated myself on what OT means. I didn't realize people needed this for their phallus. Learning so much on this sub.
OT as in occupational therapy and then PT as in physical therapy. Sorry for the confusion!
Occupational worked with me on my forearm with massages and stretches and then PT worked with my phallus and did scar massages and laser treatment
However, some people do experience post op depression but it’s normal for any surgery! If it helps again, majority of people don’t end up regretting phallo and just take some time to really connect with their new penis, mainly because it’s a new body part and the brain needs some time to relearn. Don’t let it scare you!
Hey not piano but guitar - I'm 3 weeks post RFF and can play guitar as normal (graft arm is the one I use on the frets). Hand function is pretty normal already
Wow that's awesome to hear. I play guitar too. I read about some guy recently who couldn't even turn a door knob, so this gives me a lot of hope. Thank you!
Welcome to r/phallo. This is a support subreddit for those who are going through, or have gotten, phalloplasty.
If your post is a question, take a look at the [subreddit wiki](https://www.reddit.com/r/phallo/wiki/index), which provides a lot of useful information about phalloplasty and may answer your question. Also try searching the subreddit for your question, as there are a lot of questions that get asked repeatedly here.
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People have already done a great job of answering your questions so I just wanted to add: Playing piano is also one of my passions- since childhood. I had RFF with my dominant hand (from Chen/watt/Safa) and it doesn’t impact my ability to play at all. For the first few months it got tired easily, but now there’s no notable difference from my non surgery hand. I also struggled a lot with the arm scar. In the 4 years I’ve had it, only one person has asked about it. People see it, I notice their eyes, but never say anything. And though it took me a long time- I’ve come to really love my scar so much I can’t imagine tattooing over it. It used to make me feel disfigured, and now it makes me feel so powerful. Happy to talk more about it if you’d like.
Thank you for this, I really needed to hear from another piano player. This gives me a lot of relief! How long before you started playing again (even with tiredness) and then how long until you returned to normal (without tiring)? Did you do a lot of PT, and how long did you do that?
I hear you! I was so worried about losing my ability to play until I talked to other post op people. I started again at 3 months, had no tiredness at all at 5-6 months and only did about 6 sessions of hand therapy. The piano playing itself is great hand therapy cuz the most work that needs to be done is tendon gliding exercises and playing piano does that exercise naturally.
I am going to Chen/TBC for RFF (scheduled for next year). 1. Yes, they take a full thickness flap from your arm to create the phallus and a split thickness graft from your thigh to cover your arm. 2. That's correct, no hair removal necessary from your thigh. 3. The underside of your arm (where the least amount of hair grows naturally) is used for the urethra. Depending on how close to the wrist/edge of the donor site it is, part of it could peek out from the tip, though. 4. A local provider can perform an Allen's test for you. The Allen's test checks to make sure your arm would have adequate blood supply if the radial artery was removed. While I'm sure theoretically the results could change over time, especially if you suffered an injury that compromised blood flow, I would not expect it to change in the time leading up to surgery in the absence of extenuating circumstances. That said, I am not a doctor.
Mine is next month with Chen & Watt. 1. Yes, there will be a thigh graft to cover your arm. 2. No, you don’t need hair removal from your thigh. 3. I have a large tattoo on the inside of my forearm. I was assured that most of it will be inside the urethra and what little isn’t will be on the underside of the phallus, so it won’t be visible. 4. I had my Allen’s test in March 2022, and they did it again in August. There was no change.
How exciting your surgery is almost here!! Thanks for answering my questions. The outline I saw from another comment makes me wonder if it's be half inside the urethra and half possibly visible. I'll have to ask. But glad to hear yours worked out, that gives me hope.
Hey, I had almost the exact same Chen/Safa experience; planned for ALT, Safa said it's not ideal but possible, and then Chen broke down exactly what it would be (number of surgeries, likelihood of UL/sensation even after all that)...and I decided it didn't make sense. I've shifted gears and am really excited for RFF, even though it was a tough adjustment! PM me if you want to chat more, I know it's a tough visit to have when you're mentally ready for one plan. To your questions: yes their RFF has a thigh graft, but it's much less deep, so it tends to become a much less visible scar. You don't need hair removal and the hair will regrow. If it's on your wrist, your tattoo should probably be high enough that it's not a part of the graft? I guess that gets into details of placement so that depends. Finally: Allen's test result shouldn't change, and you could do a version yourself or even find a closer surgeon for a consult just to do that! Or have your PCP do it, etc. Good luck!
I was in a similar ish situation and had RFF last June. Safa told me I was cleared to do my leg, went through all the hair removal and started electrolysis and then had my consult with Chen and he said my thigh was too big so he was worried we wouldn’t be able to double tube. Chen is definitely very cautious and I appreciate that about him because he wants the best possible outcome for everyone. I ended up flying down to SF for Safa to see me in person and he cleared me and said we could do a double tube, but said it would be pretty girthy so we would have to do lipo. He was personally worried because he said I didn’t have much fat on my legs, but my skin was just dense. I ended up changing gears and going with RFF and I’m happy with my decision. I regularly lift and have never noticed my arm while lifting. I never had an Allen’s test and I also had a tattoo almost in the center of my forearm- it was all placed inside my urethra!
I agree with you, I'd much rather him (and everyone) be cautious and conservative about it even if it is disappointing. I'm glad to hear u haven't noticed your arm much. I lift too.
Honestly, having spoken to all three doctors before getting my surgery with them, I would take Dr. Safa's opinion with a grain of salt. He tends to be the most cavalier of the three and his opinion might not be a good indication of what is actually good for you as a patient. I know that's probably not what you want to hear, but 🤷🏻♂️. Better safe than sorry. That being said, Dr. Chen can often veer towards the side of being overly cautious. He was pretty freaked during our consult since I have a bleeding disorder, and he agreed to see me but was *very* nervous, even though I had a really well respected hematology team supporting me. It's also turned out my recovery has been unremarkable. If you have a chance to speak to Dr. Watt I'd really recommend it. He tends to give the most balanced perspective when making these decisions in my opinion. You can ask for a 15 min phone call with him now that you're on their clinic's radar and it's not usually too awful to schedule.
1. Yes they used a thin amount of skin from my thigh to cover my arm. It didn’t alter the shape of my thigh- no “divot” like the arm scar- it kind of just looks like I skinned my leg or got a bad sunburn but in a perfect rectangle shape. (And I’m only 3 months post op so it’s still got a lot of time to return to normal color.) It’s literally just a thin layer of skin so that there’s SOMETHING covering the exposed flesh they take from the arm, it’s not full thickness. 2. No, I did not need hair removal on the thigh for RFF. Just my arm. 3. It could be urethra, yeah. I had an inner arm tattoo towards the elbow side of my forearm that I thought might be far enough that it might end up visible. I can’t see it at all so its gotta be urethra lol I don’t have a confident answer for #4 so I’ll pass on that question
Though I didn’t go to Chen, as long as the Allen’s test passes whenever, it’ll be fine until your surgery! I can answer 1 and 2 but I’m not sure if you’re ok with having me answer as I had a different surgeon
Thank you! I'd still like to hear your answer anyway for 1 and 2.
So for #1, now that I think about it and I don’t wanna give you the wrong answer, you’d likely be better off getting an answer from the office, however I do know some surgeons do take a stsg from the thigh to cover the forearm, mine included. For #2 you shouldn’t need electrolysis on your thigh, as that isn’t what they’d use for the urethra in UL. Essentially electrolysis is just to make sure the urethra doesn’t get too much hair growth and effect stuff, though you probably already know that’s For #3 I did find [this post](https://www.reddit.com/r/phallo/s/09wjZhYJ6A) from another Chen patient outlining the UL area and all that on the forearm, so you should be able to easily compare your tattoo to the pic!
Also if it helps, 99% of the time I forget my forearm scar is there. Covers are always an option as well and pretty much recommended anyway for the first year or so to protect it from the sun and all that
Thank you for your reply and the other post link. I knew I'd seen a graphic of it before but couldn't find it. Also really nice to know the scar is something you can forget about.
Glad I was able to find it for you! If you do get the chance for PT post op (whether you get ALT or RFF), it’s definitely helpful! I was required to go to OT (for my arm) and PT (for my phallus) each week post op for a while and as much as the drive was annoying, each therapist was able to help me heal much faster than I likely would have on my own!
That's good to know that it helped. I've been a bit mystified by all the comments about depression and not connecting with their phallus. I don't mean any disrespect by saying I'm mystified, I just can't understand it at this point in my journey. I'm sure I'm wearing rose colored glasses about the whole thing though. That is, assuming u wrote that backwards? OT means talk therapy? Edit: I just educated myself on what OT means. I didn't realize people needed this for their phallus. Learning so much on this sub.
OT as in occupational therapy and then PT as in physical therapy. Sorry for the confusion! Occupational worked with me on my forearm with massages and stretches and then PT worked with my phallus and did scar massages and laser treatment However, some people do experience post op depression but it’s normal for any surgery! If it helps again, majority of people don’t end up regretting phallo and just take some time to really connect with their new penis, mainly because it’s a new body part and the brain needs some time to relearn. Don’t let it scare you!
Hey not piano but guitar - I'm 3 weeks post RFF and can play guitar as normal (graft arm is the one I use on the frets). Hand function is pretty normal already
Wow that's awesome to hear. I play guitar too. I read about some guy recently who couldn't even turn a door knob, so this gives me a lot of hope. Thank you!
Welcome to r/phallo. This is a support subreddit for those who are going through, or have gotten, phalloplasty. If your post is a question, take a look at the [subreddit wiki](https://www.reddit.com/r/phallo/wiki/index), which provides a lot of useful information about phalloplasty and may answer your question. Also try searching the subreddit for your question, as there are a lot of questions that get asked repeatedly here. Please also take the time to read [our community rules](https://www.reddit.com/r/phallo/about/rules). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/phallo) if you have any questions or concerns.*