Your interest in the FtM phalloplasty procedures provided by the surgical specialists of the Sava Perovic Foundation is appreciated. The Foundation is led by Dr Rados Djinovic (JIN-O-VICH), Chairman, Professor Perovic's right-hand man for most of the past decade. He is already one of the world's best urogenital reconstructive surgeons.
Through the Foundation created a number of years ago, Professor Perovic ensured urological surgery will continue to advance greatly in the years ahead and more people than ever will get the high quality surgical solutions to their health problems that they deserve..
FtM SRS + Total Phalloplasty surgeries are currently fully booked months in advance. PLAN AHEAD. Establish that you are a suitable candidate and book your appointment well in advance to avoid delays and disappointments.
The number of Perovic Total Phalloplasty procedures done per year has been reduced substantially to make room in the schedule for patients needing other types of surgery.
Dr Djinovic also leads the Sava Perovic Foundation Surgical Team. He is taking Perovic techniques, teachings, procedures and surgical philosophy to the next level in the decades ahead.
Surgical results or not merely as good as in the past — they are better than ever and require fewer hours in surgery than ever. The crowning achievement of Sava Perovic was Dr Rados P Djinovic.
All the patients of the Sava Perovic Foundation Surgical Team enjoy an outstanding rate of successful surgeries and an equally impressive lack of complications in addition to the best permanent surgical results available anywhere.
However, only about 5% of our surgical procedures are related to MtF or FtM transsexuals and transgender sex change.
We must share our time equally among patients with all types of urogenital problems because we have more patients and more people need our help than ever before.
Priority is given to patients who have done all they can do to prepare for the surgery they want and have read everything relevant that we have published about it. This and the other related pages of our site on this topic listed in the menu proactively answer all questions about these particular surgical procedures.
For that reason your only remaining questions should be:
- are you a suitable candidate?
- when can you get the surgery?
- exactly how much will it cost you?
Our international case manager, Richard, is happy to promptly provide answers to any questions NOT already answered here or from any of the pages to which we have provided links here.
Read the information we have already provided before asking any questions.
All inquiries will get answers. All questions will be answered eventually.
But patients we can help fastest and easiest because they have done all they can to help themselves will be put in the fast lane. We will attend to everyone else as soon as possible.
Cost depends on the exact surgery package you need. Getting all SRS from Dr Djinovic at the same time reduces:
- total surgical time;
- total recovery time;
- number of times under anesthesia;
- amount of time under anesthesia;
- total risk;
- total cost, particularly transport costs; and
- total transition time — 7 hours instead of months or years.
Note that there are about 15 articles on FtM sub-topics and several of them are on other pages of our site, not here. Those are available through the menu system.
Perovic Metoidioplasty
The Sava Perovic Foundation Surgical Team are the world's leading MtF & FtM SRS surgeons. Dr Djinovic can complete the transition from female to male in one surgery, including: 1) trans-vaginal hysterectomy (no visible scars); 2) oophorectomy; 3) vaginectomy; 4) metoidioplasty; and 5) scrotoplasty, including testicular prosthesis, in seven hours of surgery.
Read about Perovic Metoidioplasty in detail here. 
This package of surgeries requires 3-5 days recovery in hospital with 7-10 days total time in Belgrade. A patient can drive a vehicle after about seven days, return to work in 10-14 days, play sports after approximately 14 days and have non-penetrative sex after 30 days.
“Urethral advancement” is only a preparation for Perovic Total Phalloplasty surgery but is an important standard component of Perovic Metoidioplasty.
A number of patients get metoidioplasty and, as shown in the video below, years later decide that Total Phalloplasty is more appropriate for their evolving personal life. It is important to read the articles to which we just linked above. We do not repeat that info here.
The main differences between Perovic Metoidioplasty and Perovic Total Phalloplasty surgery is:
- the size of the resulting neophallus;
- the ability to have sexual intercourse;
- the need for MLD donor site grafting;
- the need to prepare the donor sites thoroughly before surgery;
- Total Phalloplasty surgery Stage One costs about 37% more than Metoidioplasty;
- Total Phalloplasty surgery has three stages.
With a penile prosthesis implant (Stage Three), a Total Phalloplasty surgery neophallus can be used for penetrative sexual intercourse as often and as long as desired. Stage Two urethroplasty gives the penis fire hose point-and-shoot capability which is much more than merely the ability to urinate standing.
Both Perovic Metoidioplasty and Perovic Total Phalloplasty retain the ability to have orgasms. Both enable you to urinate standing.
The musculocutaneous latissimus dorsi (MLD) donor sites (BOTH SIDES) should be professionally massaged for AT LEAST 1-2 months or more before surgery.
Download the iPOD (MP4) version of the MLD massage video here.
Or watch an online Flash version of the training video online here.
Good donor site preparation usually takes at least one month but Dr Djinovic recently said: “2-3 weeks of professional massage, 2x per day is usually a sufficient period.” (Note: professional and twice/day.)
Quality and frequency of the preparation of the donor sites determines how soon you can be properly prepared. Good donor sites (both sides) preparation is one of the primary keys to achieving an excellent surgical result.
Perovic Total Phalloplasty
The Sava Perovic Foundation Surgical Team can perform “Package F”: 1) vaginectomy; 2) trans-vaginal hysterectomy; 3) oophorectomy; 4) urethral advancement; and 5) scrotoplasty (including testicular implants) followed one week later by Total Phalloplasty Stage One — all during the same single visit to Serbia.
The first surgical session takes six hours with 5-7 days hospital stay. The second surgical session takes 9-11 hours and requires seven days hospital stay. The total length of time in Belgrade is two weeks. A patient can walk unaided after 2-3 days and can drive and work after two weeks.
All Total Phalloplasty Stage One surgical packages cost more than Euros 10,000. Exactly how much more depends on the SRS that is done preceding the FtM phalloplasty.
Surgical fees will increase in January 2012.
All photos available for publication are on this page or contained in the article(s) to which we link. When more become available, they will be found here. No need to ask us to send you more by email attachment.
Sex Change Reversal: MtF-FtM
Total Phalloplasty is the solution needed for MtF sex change reversal. Total Phalloplasty is also the solution needed to solve natal male micropenis syndrome.
Gender reassignment reversal requires strong, convincing, explicit, psychiatric evaluations from two or more experts in gender dysphoria which approve the reversal surgery.
Of course, the evaluations CANNOT be from the incompetent mental health professional who approved the totally wrong initial surgery.
The new evaluations MUST address the issue of how such a terrible mistake was made in the first place.
The new evaluations should explain how WPATH Standards of Care, carefully developed over decades by many highly qualified professionals, failed to protect the patient from mistaken and inappropriate gender change.
If you want superior quality results defined as near normal appearance and function the Total Phalloplasty is the solution.
Dr Djinovic performs the reversal based on authorization by reputable mental health experts who have determined it is in your best interest.
Total Phalloplasty cannot restore ability to procreate.
Complications & Revisions
About 7% of patients experience some complication with Total Phalloplasty surgery Stage One, all of which are naturally occurring. If minor surgical intervention is needed, it can be done when the patient returns to Belgrade for the next stage.
This procedure has a 100% success rate. However, one Australian patient suffered partial flap necrosis in mid-2008 due to a unique vascular drainage problem of his graft tissue.
He got corrective surgery in mid-2009 and subsequently wrote to the Sava Perovic Foundation saying: "I am very, very happy and very impressed with the result and appearance of my new penis. Your team is obviously gifted with this kind of surgery ... I am very appreciative of both Professor Perovic and Dr Djinovic for giving me the opportunity to redo the phalloplasty again, especially with waiving all of the fees associated with the recent surgery."
The Sava Perovic Foundation Surgical Team always does such revision surgery without fee.
Dr Djinovic is now able to identify this rare condition immediately upon removing the MLD flap. If this is encountered:
- the blood circulatory system of the flap will be enhanced;
- the flap will be returned to it's location at the donor site for six weeks or longer for improvement of its vascularity (flap autonomization); and the
- surgery will be postponed to a later date when the patient's body has improved the blood supply within the donor tissue.
Total Phalloplasty Stages Two & Three
Three months or more after Stage One, Total Phalloplasty surgery Stage Two (Urethroplasty) takes 3-4 hours of surgery. You must stay 2-3 nights in hospital and 5-7 days total time in Belgrade.
Three months or more after Stage Two, Total Phalloplasty Stage Three (Penile Prosthesis Implantation) takes three hours of surgery, requires you to stay 2-3 nights in the medical facility and 5-7 days total time in Belgrade.
Penile Prostheses Implants
Cost of the penile implant prosthesis is NOT included in the surgical fee because it varies according to brand, model, type and size that the patient chooses. Penile implant prices are set by the manufacturers, not the surgeons, and vary country-by-country. And, the cost of the prosthesis is paid directly to the manufacturer, not the Sava Perovic Foundation.
There is no maximum amount of time you can wait to between Total Phalloplasty surgery Stage 1 & 2 or Stage 2 & 3 but the minimum is 90 days between each.
Stages Two and Three are optional but you must decide your plan before starting Stage One. There is no limit on how long you wait after each stage before you get the next.
The two most recent Total Phalloplasty patients who just competed Stage Three and completed all stages together said: “I believe my friend and I have the best, functioning, aesthetically pleasing phalluses after any kind of surgery on the planet, and potentially in other galaxies as well.” [Both men are married so you can image how thrilled their wives must be as well.]
The 3-component, AMS 700 CX with MS pump inflatable penile implant with the InhibiZone Antibiotic Surface Treatment which impregnates antibiotics into the tissue-contacting surfaces of the penile prosthesis is recommended by Dr Djinovic but sometimes the LGX | Ultrex is not. Information from the manufacturer is available here.
The recommended AMS Ambicor (2-component penile implants) is the penis implant Dr Djinovic would choose for fixing erectile dysfunction if he ever developed it. It costs about 23% less than any of the 700 series AMS penile implant prosthesis models.
Semi-rigid (malleable) AMS 650TM and 600M TM AMS penile implants cost a quarter of the price of inflatable implants.
The semi-rigid Promedon Tube implant of Argentina costs about 38% less than AMS semi-rigid implants and is also highly recommended. An independent study of (natal male) patients using the Promedon Tube reported:
- Successful sexual intercourse: 90.4%
- Prosthetic infection: 0%
- Non-specific pain (subsided spontaneously, no intervention): 24%
- Prosthesis too short complaint: 32.5%
- Retarded ejaculation: 10%
- Unsatisfactory penis appearance complaint: 9.6%
- Crural cross-perforation: 4%
- Hematomas: 1.6%
- Penile hypothesia [reduced sensation] (subsided spontaneously, no intervention): 0.8%
In some Stage 3 cases, there is no option and a semi-rigid implant is medically indicated and must be used first. After a period of time it can be replaced with an inflatable one.
During the past four decades, Dr Perovic developed many secret “tips and tricks” while doing more than 20,000 operations. Those “tips and tricks” used by Dr Djinovic mean:
- complications are extremely rare;
- the ones that occur are very minor;
- patients get aesthetically pleasing surgical results;
- surgical results are extremely functional.
Upgrading, Revising or Correcting Surgical Results of Others
If you want Dr Djinovic to “upgrade” with urethroplasty and a penile prosthesis implant an FtM phalloplasty done by someone else somewhere else, you are not asking for Perovic Total Phalloplasty Stage Two and Perovic Total Phalloplasty Stage Three.
You need a unique solution and that requires an evaluation by the surgeon.
To have Dr Djinovic evaluate your surgical results to determine if he can upgrade, correct or revise them:
- submit your medical history;
- send us a batch of sharply focused photos showing your penis from all angles in good light. Do NOT send them as email attachments. Send them to us using the method explained on our web page on that topic;
- send measurements of your current penile length and girth in both flaccid and erect state. You can simulate “erect” state by pulling/stretching it to what you consider normal. Be reasonable, be realistic — and don't injure yourself.
With that information, Dr Djinovic will:
- evaluate your case;
- let you know whether he can help you; and
- quote a firm, exact price for the surgical package.
Only a few FtM phalloplasty procedures (other than Perovic Total Phalloplasty) result in a neophallus with sufficient vitality, large enough, and with sufficient vascularization to accommodate an inflatable prosthesis.
Most FtM phalloplasty procedures are not designed for upgrades of functionality in the future.
Sometimes they can be upgraded but sometimes it proves too much for the penis. It varies case by case.
Perovic Art of Urogenital Surgery
+1-216-220-4220
