Figure 1.

Preoperative, intraoperative of free scapular flap (FSF) phalloplasty and follow-up photographs. (A) Preoperative scapular flap design. (B) the “tube-in-tube” technique. (C) The scapular flap was raised. (D) The vascular pedicle was cut off and prepared for phallus creation. (E) The inner flap was exposed and sutured to form the urethra. (F) The outer flap was wrapped around the neourethra to form the shaft. (G) In the early phase of this study, the penile prosthesis was inserted routinely and immediately before flap anastomosis. (H) Vascular anastomosis is complete. (I) Preoperative design of the recipient site. (J) Six months after the first stage of phalloplasty. (K) Standing urination after urethral anastomosis.