Skip to main content

How to Prepare for Your Phalloplasty Surgery

If you’re considering getting phalloplasty or bottom surgery, it’s important to know what to expect. We’ve made this guide for all patients who are considering phalloplasty.

Before your surgery, there are a number of things you’ll need to do to prepare. Carefully review this guide to prepare for your procedure.


This document has information and/or instructional materials developed by the University of Utah Health’s Transgender Health team for the typical patient considering or undergoing phalloplasty. It may include links to online content that were not created by University of Utah Health’s Transgender Health team and for which the Transgender Health team does not assume responsibility.

Information in this document does not replace medical advice from your health care provider because your experience may be different than the typical patient.

Talk to your health care provider if you have any questions about this document, your condition, or your treatment plan.

Hair Removal Before Your Surgery

Some patients get hair removal before their phalloplasty surgery. During your consultation, we’ll help you decide whether you should have hair removal. It will depend on the part of your body.

Lifestyle Changes Before Surgery

Keep in mind that patients with a body mass index (BMI*) greater than 35 are at a higher risk for wound healing problems and complications after surgery. However, we understand that BMI is not a perfect measure of your overall health. We will discuss how your weight may affect you and the potential benefits of losing weight before surgery. If our team decides that weight loss is the best pre-surgical option for you, we will refer you to our weight management program.

You’ll also need to quit smoking.

If you are actively smoking at the time of your consultation, we will perform a cotinine urine/blood test six weeks before surgery. You must have a negative test, or we will reschedule/cancel your surgery.

Hysterectomy & Oophorectomy

Before having phalloplasty surgery, you’ll need to have surgeries for hysterectomy and oophorectomy (removal of your ovaries). You’ll need to have these surgeries at least eight weeks before your phalloplasty surgery.

We won’t perform a hysterectomy or oophorectomy during your phalloplasty surgery.

Consultation for Phalloplasty

During your consultation, you’ll meet our surgeons and staff. You may meet one of our plastic surgery resident MDs (doctors). All of our staff have completed Transgender Sensitivity Training to educate and inform our team, and make your experience the best it can be.  

Please let us know if you have any concerns during your appointment (from registration at the front desk, to your consultation, to your parking). We want to improve wherever we can.

During your consultation, your surgeon will review and discuss your history, including when:

  • you first knew you were a transgender individual,
  • how long have you been living in the gender role that is congruent with your identity,
  • when you started hormones, and
  • who your mental health and primary care providers are.  

Your medical and surgical history will be reviewed (past medical problems, surgeries you have had, medications you take, allergies you have to medications/latex/adhesives/foods, smoking status). 

Your surgeon will also ask about any risk factors for blood clotting issues (past deep vein thrombosis or pulmonary embolism), or bleeding problems (like hemophilia), or family/personal history of problems with anesthesia.  

You will be given a hospital gown/robe to wear. This allows your surgeon to perform a physical exam and allows you to cover any parts of your body that are not being examined. The gown helps us respect your privacy, but still be able to examine your body (it also keeps you warm!). 

Specifically, the exam will involve the standard heart and lung exam, as well as looking at your arms, abdomen, genital area, and legs. This is a very comprehensive exam with the goal of finding the best surgical options for you, and identifying any potential issues that may make one surgical option better than another. 

For example, the surgeon will perform an Allen test on your forearms. This involves applying pressure over the two arteries that supply your hand, and then sequentially letting go of each artery.  This test looks at the blood flow to your hand and can show if your whole hand is getting blood from each of these two arteries. If your hand gets blood from both the radial and ulnar arteries, a radial forearm phalloplasty is a potential option for you.  

Your abdomen will be examined for scars, hernias, and rashes. 

We’ll also look at your groin and leg pulses to get a sense of the blood flow to your legs. 

Your surgeon will also examine your clitoris, labia minora, and majora (the outer part of the vaginal area), and vagina.  

You and your surgeon will discuss the best surgical plan for you.  

With your written permission, we may also take pre-operative photographs. Photographs help us document any findings from your exam that will influence your surgical plan.

Preparing for Your Phalloplasty


Eating a high protein diet in the month leading up to your surgery is generally a good idea. Your body uses protein as a building block for healing.

Albumin is a protein your body makes, and a marker of how good your nutrition has been over the last month. An albumin level of less than 3.5 grams per deciliter (g/dL) can be a sign of malnutrition. If this is your situation, you may want to talk in depth with a nutritionist to help your overall health and healing.  

Also, a daily multivitamin is also a good way to make sure your body has all the elements needed for healing.


You’ll need to get these labs before your surgery:

  • Complete Blood Count (CBC)
  • Comprehensive Metabolic Panel (CMP)
  • Type and screen

Surgery Day: What to Expect

How Long Does Phalloplasty Surgery Last?

Your surgery can take six to eight hours, or more.

Your home support team will be able to stay in the surgical waiting room, and can give their contact information to the waiting room receptionist there. Our receptionist will contact your home support team when your surgery is over.

The surgery waiting room phone number is 801-585-2280.