AUAUniversity: For more 2019 Surgical Videos, visit: Gideon Blecher , Giovanni Chiriaco* , Andrew Christopher , and David Ralph Abstract INTRODUCTION AND OBJECTIVES: Total penile reconstruction (TPC) is challenging, with surgical goals including an acceptable cosmetic and functional phallus, with restoration of sufficient penile length for social integration. This video highlights the complete process of TPC utilizing the radial artery free forearm flap (RAFFF). METHODS: RAFFF phalloplasty creates a cosmetically acceptable phallus with tactile and orgasmic sensation, incorporated neo-urethra enabling urinary and/or ejaculatory drainage, whilst ensuring length and rigidity to enable penetrative sexual intercourse. RAFFF stages include: 1) Phallus formation with neourethra and microvascular transfer to the recipient site; 2) Glans sculpture utilising the modified Norfolk technique; 3) Penile implant insertion. Each stage is perfor
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