Author Topic: Metoidioplasty - June 2018  (Read 620 times)

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Offline Dex

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Metoidioplasty - June 2018
« on: August 05, 2018, 07:05:56 pm »
(Potential trigger warning for discussing genitals in their medical terms and for surgical/recovery talk)

Hello,
I’m not usually a big sharer but I’ve run into a few minor snags with my metoidioplasty recovery and decided to post. I’ve been searching for the things I’ve been going through online to find some guidance and haven’t found much. I figured if those that come behind me want some additional info, that perhaps I could be helpful. I’ll try to remember to continue to update this thread as I heal.

Some background: I have been on testosterone since 11/2013 (almost 5 years). I am married (we’ve been together 11 years and she’s always identified as straight) with three step kids and a career I’ve been in for 15 years. I’ve been fortunate to be able to afford my care (which is not covered by insurance) and to have a great support system of family, work family, and friends. I had top surgery in 2014 (with several minor revisions, and a hysterectomy/oophorectomy in 2016 (this was medically indicated due to my many many issues throughout my life with my reproductive organs).

However, my dysphoria completely focused on my genitals as the rest of my body came in line. It began to cause intimacy issues as well as just general happiness issues. We researched several doctors and I went through my priorities in bottom surgery. First and foremost, I wanted something that didn’t look at all like female genitals. Second, I wanted the vaginal opening completely gone. Third, I wanted to be able to maintain natural erections. Fourth, I wanted a fused, anteriorly placed scrotum. Fifth, and far behind, was being able to stand to pee. This last one, I was on the fence about. My third priority eliminated phalloplasty as my surgery of choice and I didn’t think I would feel comfortable enough to stand to pee in a crowded restroom. At the end of the day, I decided this wasn’t enough of a priority for me to proceed with urethral lengthening when factoring in the cost, recovery, and my long term needs. Do I wish I could stand to pee? Of course. Do I wish I’d been born with a penis in the first place? 100% yes. But it was not enough of a need for me to proceed with that portion.

My wife and I researched several doctors and decided to do a consult with Dr Crane in Austin. We did this consult in 7/2017.  After the consult we decided to proceed with Dr Crane. His office was very responsive and he was great in person at the consult. We ultimately decided to bring our kids with us since I would need to be in Texas about 3 weeks. My wife and kids stayed with me the first 2 weeks and my mom and sister flew out to stay with me the last week and to help me get home.

I can answer anyone’s questions about planning, travel, etc if needed.

I had my surgery on 6/15/18. Dr Crane performed the surgery with one of his partners Dr Santucci. I can’t say enough great things about my experiences with both.

Other than a tremendous amount of swelling (there are no words to prepare you for the amount of swelling you’re likely to face), initially healing went well. My new phallus had retracted behind the swelling (shedding the pressure bandage they put on) and only the head was visible. They said I had very favorable anatomy resulting in a large scrotum and decent sized phallus.

Unfortunately, by the second post op (starting at about a week post op), I began having some wound separation in my perineum. They instructed me on open wound packing and said to keep it packed, but that it would heal in. Over the next week, I did develop a few more open suture areas (under my scrotum and in the front of my scrotum where 3 sections of tissue come together). I began packing these other separations as well.

My phallus also remained retracted and hidden behind swelling (besides the head). The doctors assured me that the swelling will take some time to resolve.

I am now 7 weeks post op. My two smaller separations have healed in completely but the larger one (roughly two inches in length and 1 inch in depth originally) is still not filled in. I have continued to pack it. I have to change the dressings each time I go to the bathroom but I’ve continued to send pictures in and it does look clean and like it is progressing. I just wish it would be faster.

I began pumping at about week 4 to try to deal with the retraction. Currently, I can pump it out almost to my presurgical length (about 3 inches) but it immediately returns to hiding once the pressure is released. I’m hoping that with time and continued reduced swelling, it will progress and give me a more out/traditional hanging phallus.

If all else fails, I will have a stage 2. Currently, this is planned for spring 2019. I plan to schedule the formal date this week. I will be having a monsplasty/resection, buried penis correction, and scrotal implants in the second stage. I will be having my second stage with Dr Santucci who specializes in buried penis surgeries. I’m very much looking forward to this second stage as Dr Santucci thought I would be able to free up an additional inch of visible length leaving me with around 3 inches of visible penis by the end of both surgeries. If the retraction hasn’t resolved by then, they will also be able to correct that at that time.

I think that catches us up to today. I have been most concerned about the retraction and the wound separation. Other than pilonidal cyst forums, I couldn’t find anything about either. So I hope this will be helpful for someone else someday. I’ll try to remember to update as I heal so this thread has a conclusion eventually!

Offline Ryuichi13

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Re: Metoidioplasty - June 2018
« Reply #1 on: August 26, 2018, 11:39:28 pm »
I just found this thread today, and I'm very interested in how you are healing currently.  I'm taking it there's no place you have any pictures posted like transbucket, is there?

I'm currently considering a meta with a UL, and possibly a vaginectomy with an anterior scrotum placement later on down the line.  I too want the ability to have my own natural erections, and standing to pee is an option I'd like to have as well.

But first, I need my top surgery.  Being older (I'm 56, heading towards 57), I'm more worried about getting my top surgery done first, but it doesn't hurt to start my research for bottom surgery as well.

Ryuichi



Offline Dex

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Re: Metoidioplasty - June 2018
« Reply #2 on: August 27, 2018, 11:57:16 am »
I haven’t posted pictures yet, no. I actually have never posted any pictures of any of my surgeries though I wouldn’t be opposed to sharing privately and potentially sharing on transbucket once I’ve healed a bit more.

I’m beginning to feel more optimistic about my healing. I am just over 10 weeks post op at this point. I’ve continued pumping daily for about 15 minutes a day at about 10 psi of pressure. I’m seeing increased length while pumping and it remains more “out” until the erection subsides. Flaccid, I’ve seen about 1/4-1/2 inch improvement in visible length. So I’ll continue pumping. I’m not entirely confident it will resolve before my second surgery but pleased that I get some visible length with natural erections now. Certainly enough for my wife to work with (which has been amazing, btw). Despite the retraction, I am lightyears more comfortable with my body and no longer am “stuck in my head” during sexual encounters with my wife. This has been freeing for both of us and we are having the best sex of our marriage.

The wound separation in my perineum continues to heal. I saw the surgeon who did my chest surgery (who is local and he offered to help however he could) and he recommended I stop packing for now since he didn’t think it was providing benefit any longer. That has been about 5 days since then and I’ve already noticed an improvement in the depth of the wound. It seems to be healing from the back forward and I’m feeling improvement on a daily basis.

Other than still not swimming nor doing any running (because I don’t want to upset the healing in my perineum), I’m back to all my normal activities at this point. I have no pain and no swelling with being up and around. I can stand as long as I’d like without discomfort.

Sex is great, sensation is fantastic, orgasms are wonderful. Blow jobs are a beautiful thing lol.

I’ve scheduled my second (and last) stage for 4/26/19. I’m very much looking forward to having the implants put in. I have enough scrotum to be visible through underwear even without implants but I’m really looking forward to how that will look visually when filled out with the implants.

Chest surgery was my highest priority as well. I was like a size F before top surgery. It was definitely the biggest visual dissatisfier I had and I’m very happy with the contour of my result. I did have a couple of small revisions (they were done in office under local anesthetic). I did that at about 5 months on T. Then had a hysterectomy at about 18 months on T as I had PCOS and endometriosis since I was 15 and still had pain. Since I was on T, and found a great OB/GYN, they agreed to take everything out and it was covered by insurance due to my past history. Genital reconstruction was my last step. It’s one that’s not as visible to the outside world but became increasingly critical for me. It really began to impede intimacy with my wife. It really has been amazing to get close to the end of my active change part of my journey.

Happy to answer any questions you have.

Offline Ryuichi13

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Re: Metoidioplasty - June 2018
« Reply #3 on: August 27, 2018, 06:37:45 pm »
Honestly, the idea of wound separation is one of the things that scares me the most about bottom surgery.  I know that , being older, I might take longer to heal, but also, I'm definitely not as active as you sound like you are.  I have a low pain threshold, and the idea of any kind of open wound that doesn't heal and being in pain terrifies me.  But for the sake of wanting to look like the man I should have been born as when I look down or when I pee, I'm willing to take the risk.  Any pics you feel comfortable showing me would not only be kept private (of course), but could help alleviate my fears some.  The choice is, of course, up to you.

I heard that pumping can/may not be beneficial.  It sounds like its working for you.  I'm now giving second thoughts about pumping after I have my meta, but as that's a couple years in the future, I'll have plenty of time to do more research on it.  Thank you for the info on it!

I've never really been "stuck in my head" when it comes to sex, but I have to admit, I'm looking forward to what it'll be like after my meta and after I heal.  Yet another reason why I want to have one done.  Again, thank you for that info. :) 

I"m still up in the air when it comes to a scrotoplasty, as I want my junk placed in front, and not between my legs.  I've seen pics of ones placed between the legs, and they just don't look right to me.  I want mine to be out in front like they are on natal men.  I wan to be able to sit down and not have to worry about crushing them when I put my legs together...at least, no more than a natal man would worry.

My chest is around a D or DD size, I"m not exactly sure since its literally been decades since I wore a bra.  I've only been binding for the last few years, but before then, I'd wear t-shirts tucked into my pants, even when wearing a t-shirt over top.  I'm currently waiting for my partner to have his hip replacement operation before I really start checking into my top surgery, as I want to be able to help him recover from it first before its my turn to go under the knife.

I still have my female parts, but since I'm post menopausal, I'm not terribly worried about them.  When I decide to have my meta done, if my insurance will cover it, I'll more than likely have most of it removed to reduce any chance of cancers...and so that I will no longer have to have gyno appointments.  the idea of no longer having to need gyno and mammogram appointments is also a huge motivation for me to have these things removed once and for all.

Thank you so much for sharing me this information, its really helping me decide what types of surgeries to plan for in the future, and what to expect.  Of course I also know that YMMV, but hearing others' stories help me know what I can expect to some degree.

Feel free to PM me pics, or if you post them on transbucket or anywhere else, feel free to send me links.

Again, thanks!

Ryuichi



Offline Dex

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Re: Metoidioplasty - June 2018
« Reply #4 on: August 28, 2018, 04:02:02 pm »
I’ll try to PM you pics. I’m at a work conference this week so I’ll try to do that tonight.

With regard to the wound separations, to be honest, they are pretty painless. I don’t have any pain at all and other than the initial separation, they were pretty non painful. Wound packing can be uncomfortable when changing dressings but it was more like a brief sting when removing the dressings and not at all very bad. My largest one is definitely finally closing up completely. I’m seeing progress by the day which is great and a huge relief to me.

So far pumping has been working well for me. It’s mentally relieving to see it “out” when it’s been retracted but I do believe it is helping correct the scar tissue retraction slowly. If nothing else, it makes me feel like I’m doing something, lol. I know it will be fixed (at worst) with my second surgery so I’m trying to not stress over it too much.

Scrotoplasty, yes.... absolutely. This is one of the reasons I chose Dr Crane. He does a rotational flap reconstruction of the labia majora. This results in a hanging, anteriorly placed, fused scrotum. Implants will be inserted in the second surgery but it already looks great. I had very generous anatomy, which helps. It is not at all between my legs and will be pulled even more forward with my second surgery when I have the monsplasty. You retain the ability to ride a bike and it looks very “natural”. I also did not want it between my legs, just because of comfort. And I love the feeling of having something hanging where it should be.

I definitely get the chest struggles. Top surgery was incredibly freeing. I get having to wait for other things, though. I’m 35 and have had 2 hip surgeries due to injury already. My wife and I have 3 kids (ages 16-11) so all of my surgeries have had to fit into that timeframe.

I wasn’t expecting my hysterectomy/oophorectomy to be very impactful transition wise other than not needing paps anymore. However, I found psychologically that it was VERY impactful. I felt more whole knowing those parts were no longer there.

As you said, overall results will for sure be a “YMMV” situation. In fact, docs won’t even be able to tell you your final outcome until post surgery since they just don’t know what you have available to free up until they get in there and start working.

Let me know if you have any other questions, I’m happy to help.

Dex

Offline Dex

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Re: Metoidioplasty - June 2018
« Reply #5 on: October 02, 2018, 02:19:52 pm »
Hello again!

It’s been a little over a month since my last update. I’m trying to remember to update this, even if it’s not of any immediate use.

Since my last update, I’ve confirmed the date of my second (ideally last) surgery on 4/26/19 with Dr Santucci. I’m excited and anxious to get it over with. Excited because I think I’ll be even happier after that surgery with the aesthetic outcome and anxious because I’m beginning to hit surgery fatigue and just want to be done and move on. As with the first surgery, it will not go through insurance and will be paid for with cash. That means that, while expensive, I at least won’t have the hurdles to jump with insurance. I’ll only need to be in Texas about one week so it’ll be cheaper travel-wise.

On the healing front, I’m now about 15.5 weeks post op. I seemed to hit another plateau with the large wound separation in my perineum. It seemed to be making progress and then stalled out again. Since I elected to keep my native urethral location, I think this has contributed to its hesitance to close up (since its not supposed to be closed up fully). I’ve also noticed that as time goes on, hair grows around the wound (of course) and while I’ve been shaving weekly to keep this down, I invariably miss one or two hairs and they end up growing out and laying in the wound. I think this is also contributing to it not closing up since something (hair) is disrupting the healing process. A couple days ago I got really creative with positioning and mirror work and since then, I once again feel like it’s starting to close up. The overall trajectory has been positive but I admit it’s been increasingly frustrating that I’m just not done with this part of the healing. I sent more pictures to Dr Crane’s office and they’ve recommended monitoring another few weeks and still holding back on exercising. I did have a 5k I signed up with with my oldest two kids a while back and I did end up doing the 5k, but slowly. I’m anxious to just get back to normal but I am feeling more positive now that I’ve had some noticeable healing again.

The retraction still remains as well. I haven’t been pumping as diligently as I should be. But I have been doing it at least 2-3 times a week. I am still continuing to see more length while pumping and when erect naturally, more is standing out from my body. But flaccid length does not seem to be budging much. I am resigned to thinking it may not be corrected before my next surgery. I’ll continue to pump, even if it’s just to feel like I’m doing something to try to fix it, but if it doesn’t resolve then it will be fixed in my last surgery. When pulling my phallus straight out, I can feel a very tight band of something on the underside of it holding it back to my body but I don’t know if it’s some kind of ligament that reattached or if it’s scar tissue. Regardless, I’ll stay the course and hope for the best but I really only have 7 months left max and it has not interfered with sexual pleasure at all.

Sensation-wise, things continue to get even better. My scrotum still gives me some “nerve zingers” as I call them from time to time but I’m regaining sensation in that tissue as well as beginning to get even more increased sensation in my phallus, which is great :)

I think that’s all for this update. I’ll try to update again in at least a month or so... thanks!

Offline Ryuichi13

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Re: Metoidioplasty - June 2018
« Reply #6 on: October 03, 2018, 01:24:53 am »
I'm glad to hear that you're healing pretty well.  If things change, feel free to let us know!

Good luck with your healing and surgery!

Ryuichi



Offline Dex

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Re: Metoidioplasty - June 2018
« Reply #7 on: January 09, 2019, 03:55:03 pm »
Hello everyone!
Since I was responding to another post, I thought it might be good to do an update on my general thread.

I’m just shy of 7 months post op at this point (29.5 weeks to be exact).

Of the things that were slow to heal, all of them are still issues, unfortunately.

While my two smaller wound separations healed up fully and completely (more on that below), the larger separation in my perineum is still open. At this point, I believe it healed over with skin like tissue instead of pulling together and closing up. The good news is it’s clean, healthy, and not weeping or acting like an open wound at all. It doesn’t hurt. It’s mostly just irritating especially while urinating though I’ve found a position where it doesn’t spray all over. This has been the biggest issue for me currently as it’s just aggravating. With that being said, I’ve gone on with my life and am back to all normal activities. I had a phone consult with Dr S a few weeks ago to discuss it. Mostly I wanted to make sure this was something they could fix at the same time as the rest of my planned procedure in April. He said it was and we talked through a few more items ahead of my next surgery and I came out of that conversation feeling good about things.

Second main issue I experienced was the retraction of the neophallus. I haven’t re-read through all my previous posts but I think I mentioned how I can feel the bend/kink in it when it’s erect. So I know there is more in there than is visible. I, admittedly, have not been very diligent with pumping (for a variety of reasons, one being it’s kinda painful with pulling on the tight band of tissue). However, I know this will be resolved with my next surgery as well and I’ll just need to keep an eye on things post surgery to ensure the retraction doesn’t form again. Though, not as much is getting shifted around in the second surgery so I should be less likely to reform that scar tissue.

Speaking of scar tissue, my scrotum has no swelling in it at all anymore and hasn’t for some time. The incision lines have softened up pretty well and where I had the two smaller wound separations is hardly noticeable, even from a scar perspective. I’m feeling good about my healing and am starting to get excited about the next step.

With all that being said, I am still extremely happy with my surgery. I love not being completely self conscious about that part of my body and I am thoroughly enjoying intimacy with my wife.

I think that’s most of my updates for now. I’m not sure if I’ll have much more ahead of my next surgery in April since I think things are pretty stable for not but I’ll try to update as things come up.

Dex

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