Phalloplasty Arm and Skin Graft Healing | 5 Years Post-op

Five years ago, I had a skin graft taken from my arm, as part of the first stage of my phalloplasty surgery. One of the worries of forearm phalloplasty, concerns how the arm recovers and the outcome of the scarring. In this blog, I will reflect on the healing of the graft and function of the arm over these 5 years.

Radial Forearm Free Flap Phalloplasty (RFF Phalloplasty)

For anyone new to my content and to phalloplasty, I will briefly explain before diving in. The first stage of RFF involves taking a portion of the skin from the forearm, to create the penis and the new urethra.

This graft is double thickness, which means it takes both skin and fat. Nerves and veins are also harvested

A replacement graft is then taken from beneath each buttock cheek, to replace on the arm. Effectively then, I got a bum lift at the same time. Sounds pleasant, but oh my goodness it was the most painful thing in the world!

It’s been a long road healing from this incredibly invasive surgery, but the human body is incredible at what it can achieve. Now, at 5 years post-op, my arm has recovered wonderfully.

Return of Arm Function Over 5 Years

In terms of the function of the arm and hand, the early days post-op were scary. Initially, I couldn’t bend my arm straight at all, it was physically impossible. My fingers were also tight and difficult to move and my thumb was numb. I was also not allowed to move my wrist, so as to not compromise the newly grafted skin from my buttocks that had been replaced on the arm.

These initial limitations were very unnerving, but of course expected.  Part of the early physiotherapy involved gentle straightening the arm over time until it returned to normal. I also had lots of finger and hand exercises which I made sure to do regularly. Finally, once the graft was passed its early healing stage, I could exercise the wrist too.

With the help of time and these exercises, the movement of the arm and hand returned relatively quickly. By six months post-op, all feeling and use of the hand came back and my arm movement returned to normal.

Limitations at 5 Years Post-op

At 5 years post op, I do still notice the tiniest fraction of strength loss in the hand, but I am someone who has always had very week grip. My fine motor grip is also a little weaker than it once was, but not enough to affect my daily life.  I do also notice some weakness in my wrist, mainly on weight bearing when doing press-ups. I think this is largely because the graft skin is tight around my wrist, whereas with normal skin there would be some give. But that being said, I do yoga, I do press-ups, and I manage these fine.

Return of Sensation of the Arm Graft Over 5 Years

Although the numbness in my fingers and thumb disappeared, the numbness in my arm remains. When I or someone else touches my graft arm, I can feel pressure, but very little touch sensation. I can feel some slight tingly touch in some areas, and some touch is a little displaced, meaning I feel the touch elsewhere. Approximately, I would say that I have about 80% numbness across the graft.

I have been asked if the numbness bothers me. Perhaps it should because it is a sad thing that I cannot feel my partner’s touch on that arm. However, for me, the price of a numb arm for a functioning penis is one I am very happy to pay.

Saying that though, I did not realize in the beginning, that my arm would feel this way. It wouldn’t have changed my decision, but it would have been nice to know. So, I always remind people now of the likelihood of this happening as it is an important loss to process in this surgery. I talk a lot about processing the losses and gains in this surgery because I think it is an important part in the outcome, in terms of our expectations.

How The Graft Arm Feels

I have also been asked how the arm itself feels from an experiencing point of view. It is an odd feeling to describe. It is as if I have a snug long-sleeved t shirt on. It’s not painful, but I am aware that it feels as if something is on my arm all the time.

Skin Quality of the Arm Graft at 5 Years Post Op

The skin quality of my graft is really good. However, the skin is prone to getting quite dry. Grafted skin needs additional moisture and I apply moisture a few times a day. I’m vigilant about this because I am not getting any younger and I do not know how well my graft will age. I share some of my favorite scar care products in a recent blog.

Aging of the skin graft was actually a question from someone recently, and the truth is I do not know. The trouble is, that phalloplasty is still a young surgery so there are not many older trans people with this scar. I expect like all skin, it will get drier and lose its elasticity, so staying hydrated and keeping the skin moist will help. I am also very careful to protect my arm in the sun. Where possible, I cover the arm in the sun or use complete sunblock on it even during the winter. You can see the progression of the graft from the first stage to now, in the video below.

Scar Outcome of The Arm Graft at 5 Years

I was lucky to have a graft that healed very well. The scar outline is obvious but faded. The skin itself is fairly even in color. I have now, however, had my graft tattooed. I had originally thought I would do this, to help disguise the scar.

Healing of the Replacement Grafts

It’s also worth noting, because this rarely gets spoken about, how my replacement grafts have healed. The skin to replace on the arm, (here in the UK) is taken from underneath your bum cheeks. They take two skin grafts from underneath both buttocks. These go from hip to just between the groin and are about a couple of inches wide. They then bring that skin up to meet your bum cheeks, so you effectively get a bum lift.

The buttock grafts were the most painful part of surgery for me. Having 100-ish staples in your bum, is not pleasant! It also took a long time to heal, because of where it is. My scar lines are still not quite as white as I would like them to be, but it healed well. It used to be tight, but over the last couple of years it has got a lot more relaxed. The scar lines will go white in time and of course they are not visible. You can only see them when I bend over a bit, and then my partner Chris says it looks as if my bum is smiling.

A lovely vision to leave you with!

I hope that was helpful. As always if you have any questions, please do pop them below, I always love your comments!

Helpful Phalloplasty Resources

I have written a book detailing the entire process of phalloplasty from decision-making to completion. More info here.

A list of additional phalloplasty videos and blogs can be found in my content index If you would like to ask any questions or request some blogs or videos you would like to see, please send me a message.

I have additional video resources, showing a completed phalloplasty result on my Ko-fi page.

For any trans people exploring surgery options, or going through surgery, I offer email support and mentoring on a pay-what-you-can-afford basis. I am always happy to help.

Hello! My name is Finn and I have a passion for creating honest content, that inspires personal growth and promotes well-being.

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