First Stage Phalloplasty | A Guide to Recovering at Home


The first stage of radial forearm free flap phalloplasty is the most recovery intensive. Not only does it take many weeks to heal, but there are also multiple affected areas. Therefore, recovery can feel like very hard work. However, with the right preparation beforehand, you can adapt your home and make things a lot easier for yourself. In the following blog, I share the things that I found helpful in my own recovery after first stage phalloplasty.

Returning Home after First Stage Phalloplasty

Returning home from the hospital, although initially feeling like a relief, can also feel scary when we realise how limited we are. For example, in having the graft taken from one arm, you will be limited in your daily tasks such as eating, washing and dressing. If you have skin from the buttocks taken to replace on the arm graft, you will also be unable to sit or lie comfortably. Even just getting around your home, negotiating stairs and so on, will be a challenge for at least the first six weeks. However, there is a lot you can do to prepare your home beforehand, to make the process of recovering at home, less daunting and more comfortable.

Adapting Your Home

Making a few simple changes to your home will make the world of difference in all your daily tasks.  Here are my top recommendations for ways to adapt your home for your post-surgery needs.

Soft Toilet Seat

Negotiating the toilet after first stage phalloplasty is a painful nightmare. Investing in a soft toilet seat, which also adds some height, makes the whole thing so much easier. This has been a great investment throughout all my surgery stages.

Adjustable Back Rest

Trying to prop yourself up with one hand is almost impossible. It’s hilarious for others to watch as we flail around like a beached whale (see some of my videos!) but not so fun for us. I invested in one of these back rests and used it through all my surgeries. It’s adjustable in height and doesn’t move, unlike pillows. It’s fab!

Safety Gate to Keep out Pets

If you have pets, it’s a good idea to limit their ease of access to you, at least for the first few weeks. An enthusiastic dog in your lap is not what you want right now! Using gates to keep them out of your bedroom/lounge is a sensible option.

Walkie Talkie

Yes, you can text your partner/friend to ask them to bring you a cuppa but it’s likely easier to use a walkie talkie and most definitely an improvement on shouting!

Automate Your Home

You could also the excuse of surgery to invest in some smart home gadgets such as the Alexa. With a couple of these in your home, you can communicate between rooms, turn on lights, turn on the TV, play music, call people and so much more, simply by using your voice!

Sitting and Sleeping

Gel or Memory foam cushion

Your freshly stapled bottom will thank you for buying a comfort cushion! I don’t know what I would have dome without one of these as it made sitting so much easier. Even after the staples, it helped loads, to reduce pressure after sitting for a while and soothe my sore bits.

V-Shaped Support Pillows

These are a surgery staple for me, they are so comfortable and good for helping you stay upright and supported. They are great to make sleeping more comfortable too, especially when paired with the adjustable backrest.

Body Pillow

In the early weeks after your surgery, you will only be able to sleep on your back or slightly propped up. When you start to be able to use a different position, this body pillow is amazing. I am a side sleeper, I do not manage to sleep well on my back, despite several surgeries I have never got used to it. As soon as I am able to go on my side I do. With this body pillow, you can protect the area between your legs and position your body and arm comfortably.

Looking After your Arm after First Stage Phalloplasty

Protective Sling

The Hospital should hopefully send you home with a padded sling to protect from knocks and bumps. A sling is also necessary to elevate the arm and help to eliminate swelling. Check beforehand what you will be sent home with and if you need to, buy something for your recovery at home.

An Arm Hanger

It is important to raise your arm whilst you sleep too, to again reduce swelling and to protect it from knocks while you sleep. You can rig up something to hang your arm from, (which I did with a hammer and nail and hung it off my bookcase at night) Or alternatively you could hire a drip or bed stand. Here in the UK, you can hire all sorts of things from The Red Cross.  

Managing Tasks with One hand

This takes some getting used to, but I promise you will surprise yourself in how you adapt! The following tools helped me loads.


They say the simplest things can be the most helpful and it is true! Buy some large pegs, you will be surprised how many uses they have. I used them to clip bread to a board so I could butter it, to hold a piece of paper still so I could write, to keep my leads from running off. They are rather handy!

Grabber Tool

A grabber tool will become your best friend! It takes so much effort and pain to move. A dropped item on the floor feels like a climb to Everest. This handy grabber tool is great for picking things up off the floor and for grabbing stuff that’s hard to reach.

Shoe Horn

I would suggest you buy slip-on shoes, it will be a while until you can do up laces, however, even getting on slip-on shoes can sometimes be a challenge and a shoe horn will make this so much easier

Personal Hygiene – Washing and Showering

I found washing and showering to be the most challenging aspect of stage one phalloplasty, because of being so physically limited. Not only is your arm out of action, but you also cannot let your penis hang free for at least the first four weeks. With one hand in a sling and one holding your penis, you are therefore pretty limited in what you can do.

If you don’t have a partner, consider asking/paying/bribing/begging a friend to assist you to make showering safer and less challenging. Showering is just about do-able on your own but I would try to avoid this if you can. The following tools are useful when it comes to keeping clean.

Shower sleeve

You must not get the graft on your arm wet for a few weeks. Therefore, having something to keep it dry while you shower, is vital. By covering your graft arm with a water protector, that’s one less thing to worry about. Then, you can also use your sleeve protected arm to rest your new penis on while you shower if you don’t have the hand of someone else.

Wet Wipes

Showering every day is exhausting, even with help from someone. Therefore, for those times in-between, and to keep things fresh, wet wipes will be your best friend! I know they are not great for the environment, but when needs must, this is the way forward. Make sure to choose ones that are fragrance-free and gentle.

Dry wipes

Dry wipes are fantastic for many different things. They are much more hygienic than flannels to wash with and can be used to hygienically dry areas around wounds after showering too.

Avoiding Infection after First Stage Phalloplasty

Infection is one of the biggest problems in lower surgery and accounts for lots of complications. As well as following the suggestions for washing and bathing, the following will also help you to lower your infection risk.

Antibacterial Hand Gel

Make sure to have a few bottles of antibacterial gel dotted about your home. Keep bottles in the bathroom, beside your bed and where you sit during the day. Don’t be afraid to insist your visitors use it too! Unfortunately, our friends can be huge carriers for germs! Pump bottles are the easiest to use with one hand.

Bed Protectors

Bed protectors are great to lie on in bed and sit on in chairs. They help to protect wound areas and keep things hygienic. Also, they are especially good when you just want to sit or lie naked and let the air get to everything to aid healing. Another use for them is to sit on them and wash while avoiding soaking your bed or chair. You can get washable bed protectors, but for sake of ease get the disposable ones

Flushable Wet Toilet Wipes

Trying to wipe your bum successfully with one had is very difficult! Using wet, flush-able toilet tissue makes it easier and keeps things clean and hygienic too.

Eating and Drinking

Eating well is vital for good healing and recovery, however, it can be a challenge with one arm and limited movement. If you have a loving partner or friend who is willing to cater for you whilst your arm is out of action, then feel lucky! You can skip this section and instead buy them flowers/chocolate etc!

Pre-Cook and Freeze Bulk Food in Advance

If you can, it is best to batch cook simple wholesome food in advance that you can defrost and reheat. Make sure to use containers that are airtight, suitable for the freezer, and suitable for the microwave.

Stock Cupboards with Freeze-Dried Foods

Buy lots of freeze-dried meals that are quick and easy to prepare. For example:

  • Instant noodles
  • Cup-a-soups
  • Microwave meals
  • Tinned soups
  • Powdered milk/coffeemate

Use a Meal Delivery Service

If you have spare cash you could try a meal service for a few weeks. They are not just for the elderly and you would be surprised at the quality of most of them

lap Tray

You won’t be able to put anything directly on your lap for some time. Therefore make sure to get a tray with legs that extend, so that you can use it to go over your lap. These lap trays have fantastic multi-uses, not only to use to eat when in a chair or in bed but also to use with your laptop. Pair it with the anti-slip mat to help keep things still for one-handed use!

Plate/Cup Non-Slip Mat

Chasing a plate around whilst you attempt to cut your sausages with one hand gets to be a tad annoying! A non-slip mat keeps your plate/mug/bowl still making one-handed eating and drinking much easier!

Keeping Yourself Entertained

Stage one Phalloplasty has the longest recovery time and also is the most intensive healing. For this reason, you will find yourself with an extended time stuck indoors. You will go stir crazy, you will likely push your loved ones and friends to breaking point! Therefore, to avoid cabin fever, and alienating friends, prepare beforehand and think of things you like to do which are possible with one hand and limited movement. Here are some ideas.

Buy a kindle

If you like to read and you haven’t already, buy a kindle. This makes reading with one hand much easier. If you get one that’s back-light, you will be able to read in bed without disturbing your bed partner.

Buy an Entertainment Package

It is a really good idea to invest some money into an entertainment package. You have so many options for additional TV channels, movies, games and a lot of this are pay monthly, meaning you do not have to lock into a contract. A simple and cheap way to give you more viewing options is with a device such as the Amazon Fire Tv Stick. With one of these, you can watch all the main channels on demand and have the option to subscribe to an additional service such as Netflix. Pair it with amazon prime and you get access to books, TV films and music.

Keeping Active after First Stage Phalloplasty

Hire a Wheelchair

You will not be running marathons for some time, however, its important to keep mobile and to gradually increase your activity. Keeping active helps with healing and also with pain management.

Hiring a wheelchair was one of the best things I did. Neither myself nor my partner at the time could drive, so it was necessary to get to the doctors. However, it was also helpful to get me out and about because I could walk for a bit and then sit for a bit. Do team it up with the soft cushion I mentioned earlier to protect from bumps!

I hired mine from The Red Cross. They only asked for a donation and provide an amazing service. I suggest googling what is around your area as you may be able to hire one cheaply as I did.

Buy a Mini Bike

A minibike was a purchase on a whim that may have initially seemed daft but actually was a great help. Just to be able to sit and do some light peddling helped to keep me active. Once my arm stated to recover I also used it to peddle with my arms to strengthen my arm too.

Good Luck With Your Surgery!

I really hope that these are helpful to you. Do let me know if you use any of my suggestion and what you think. Or, if you have had lower surgery yourself and have used something helpful not added here, I would love you to let me know! Creative pictures of ways people have managed to do things, suspend their arm etc, always make me smile!

If you are yet to have your surgery, do check out my essential guide of what to take with you to hospital. And for additional blogs about gender transition and surgery visit my Gender Transition section.

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