A NEW DESIGN FOR THE RADIAL FOREARM FREE-FLAP PHALLIC CONSTRUCTION

One-stage phallic construction using the radial forearm free flap was originally reported in 1984. This potentially sensate, thin, minimally hair-bearing flap, whose design incorporated a vascularized urethra, provided significant advantages over previously described multistaged insensate phallic reconstructions. The original design, as described b y Chang and Hwang, is limited in size and has the propensity to develo p meatal stenosis. This article describes a new design of the radial f orearm flap for phallic construction performed on four patients. The t echnique described incorporates a centrally located neourethra in cont inuity with a neoglans. It eliminates the circumferential meatal sutur e line and, therefore, meatal stenosis without sacrificing phallic len gth.