Stock Photo - Photo essay at Lyon hospital. Department of urology. Phalloplastie, operation of plastic surgery to create a phallus, required to complete a change of sex, following a hystéro_ovariectomie.This takes place in two steps. Here step 2. Step 1: it´s the creation of a neo_penis from a fragment of skin taken from the arm. The skin, the nerves, the veins and the arteries are taken from the not dominant arm to constitute the urethra, the acorn and the penis. The vaginal cavity is blocked and the big lips are used for the scrotum. The nerves which innervate the clitoris are protected, they will innervate the penis, in order to keep an orgasmic capacity after the intervention. Step 2: after the penis found its sensibility, testiculaires implants and implant are added to make an erection possible on demand. Here, intubation of the patient.