Topic: Metoidioplasty - June 2018

[Dex]

(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!

[Ryuichi13]

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

[Dex]

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.

[Ryuichi13]

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

[Dex]

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

[Dex]

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!

[Ryuichi13]

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

[Dex]

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

[Dex]

Hello again everyone,
My second stage of my metoidioplasty is finally here!

We arrived in Texas yesterday and have spent the last day doing fun things. It’s been rainy but should be cleared up tomorrow for us to do some outdoorsy things prior to surgery on Friday.

I had my pre-op appointment where Dr S went over the plan and discussed any questions my wife and I had. He was patient and kind as always.

We discussed the opening where my urethra is (I elected to not do the urethral lengthening due to cost, complication risk, and recovery time) and decided it was best to leave It as is. As I’ve mentioned in other posts, it healed more open than I think would be the preference but as we discussed things, tinkering with it could create a worse problem of it being too small so we decided it was best to leave it.

We also discussed my retraction and he was able to feel where some tight bands of scar tissue are and he was confident we should be able to resolve that at this stage. He would like me to begin pumping once the incisions are healed in an effort to keep any scar tissue from settling back in. He said it’s not definitive that it for sure can prevent it but it certainly can’t hurt.

So the plan will be to fix that, do the monsplasty/lift, the buried penis repair to reduce the tissue alongside my phallus, and the insertion of the testicular implants.

Looking forward to (hopefully) this last step and getting on to recovery. I will keep everyone posted as things begin to heal!

[Ryuichi13]

OOH!  I can't wait to see the before and after pics! 

Are you going to post them on transbucket?  I'd love to be able to refer to them.  I've been debating on having a monsplasty, tbh, as part of having a meta.   

What kind of complications could there be with a UL?  What parts do they use to create them?  I thought they would use the inner labia lips or something like that to create the lengthening.  I take it I'm wrong?  I have to admit, I want a UL along with my meta, so I'm curious.

Ryuichi

[Dex]

I will try to find a way to post before and after. The way Dr S approaches the second stage meta is a little different and based on his experience with cis-males and buried penis. I’m excited because I think this approach will work very well for my anatomy. I had tried using transbucket with my phone after the first surgery and couldn’t get it to work but I will find a way!

The benefit of the monsplasty is that it will remove more of the tissue around the phallus and make it more visible. It also will pull things up a little bit more up and forward. He thought we could lift about 3/4 inch and that will make a huge improvement on placement of the phallus and scrotum.

With the UL, I will admit I’m more of an outlier with not getting it done. Would I love to be able to pee standing up, yes of course. But it wasn’t enough to outweigh the cons. My insurance doesn’t cover trans related care and adding the UL adds about $10,000 to the cost (typically). Complication wise, fistulas are common and stricture can occur as well. It’s all fixable. But I just didn’t want to deal with the potential and the continued/prolonged healing. It’s not ideal, obviously, but I’m at peace with that decision.

[Dex]

Hello!
The surgery went well this morning. The main pain I’m having at this point is the monsplasty incision area. It’s a pretty large incision so I’m not terribly surprised. But wow what a difference in how that area looks already, even with the post op swelling.

I may not have much to post initially but I wanted to let everyone know it was done and I’m on my way to healing! I’ll update as things heal. I have my only post op on Wednesday morning and will definitely post then. 

[Dex]

Just one quick update. I’m roughly 24 hours post op. Things are still going great! The swelling has definitely set in at this point so things are relatively sore. My large incision from the monsplasty is definitely the most sore, it feels like I overworked my lower abs on core day. But there is relatively little bruising and there is still hardly any swelling in that area. As someone that had a lot of mons tissue, I can’t get over how awesome it looks to have it flat.

The incisions for the testicular implants are at the very top of my scrotum. That is in an effort to keep the implants where they are and reduce the weight/tension on the incisions. I do have some bruising in the scrotum which is normal for having them dissected and the implants placed. The scrotum is where I’m experiencing the most swelling. I experienced a lot of swelling in my scrotum with the first surgery as well and Dr S said to expect about the same amount this time around.

For now, I’m taking it easy, icing regularly, and keeping up on my medications.

I’ll update as things change and as I get to my post op and head home!

[Perry]

Sounds like a successful surgery! Good luck with your healing.

Perry

[Dex]

Hello again!

Minor update. It’s about 5 days post op at this point. Subjectively, this surgery has been much much easier to heal from as compared to stage 1. I have far more energy, far less pain, and feel much much healthier than I did at this point last time. That is to be expected as the meta/scrotoplasty + vaginectomy is a major surgery and this one is minor, comparatively. But it’s still worth mentioning.  I have had to use hardly any of the pain medication. The monsplasty incision is hardly painful at this point as well.

Getting up and moving around does increase swelling substantially and that has been the most uncomfortable part of the surgery. The swelling in the phallus, in particular, has been the most uncomfortable. I’m sure because of all the nerve endings in there.

It’s not been pretty to look at lol. It’s pretty black and blue in both my scrotum and my phallus. The bruising in the mons area has not been that bad.

However, I’m seeing the swelling reduce pretty quickly on a day to day basis. It’s already reduced quite a bit from its peak Saturday/Sunday.

It’s been nice that it hasn’t been super uncomfortable because I’ve been able to do some things like go to lunch or dinner with my wife and go to Endgame yesterday. Today is my travel day home so I’m already quite uncomfortable but then I’ll be home and will be able to rest fully.

I did have my post op with Dr S this morning. He said everything looked great. He felt I had about a medium amount of swelling and he was really happy with how things looked to be healing. He said I had no sign of infection with the implants which is great and likely won’t be an issue but is still one thing I should be on the lookout for over the near week. I had a few questions for him that I’ll detail below:

If my phallus retracts again, are there options to correct it at that point or is it kind of an “is what it is” situation?
-He said that he was able to remove some of that scar tissue and he didn’t feel there would be any retraction once the healing goes down. However, if for some reason it still doesn’t heal out, he felt this would be a very minor procedure that he could correct. He mentioned that really any area I’m not happy with the contour post healing would be something he could tweak if needed. He didn’t feel this was something I would likely need based on how it looks now but he did say it was an option if I felt it necessary.

I had heard of other patients using viagra or cialis post op. Was that something he thought might be beneficial? Also, at what point post op should I try pumping?
- he said there isn’t really any study that shows that either viagra or cialis definitely helps anything. The same goes for pumping. It’s just not well studied. However, he said they are in the category of “could help, can’t hurt”. For that reason he didn’t see any reason to not give it a shot. He wrote me a script for low dose cialis to use for the next few months and said I could start pumping around week 3 or after the incisions are healed over.

When am I considered “out of the woods” for bad healing with the implants as it relates to necrosis?
- he said if I were going to have any tissue death due to blood flow constriction with the implants that I would have signs of that already like blackening skin or scabbiness in areas he wouldn’t expect it (ie - not an incision). I didn’t have any of that so he felt I was out of the worry zone for that particular complication

Is there anything I should be careful of position wise or anything during healing to help prevent injury or movement of the implant?
- no karate (he said laughing). But nothing in normal activity should cause any issues

Do the implants ever need replacement or do they degrade over time?
- no. Should be good for the rest of my life

Is there anything I can or should do to help the swelling subside (compression/massage/etc)
- no. They could do compression but it’s uncomfortable and not very high yield results wise. It can also increase the likelihood of tissue death due to potentially restricting blood flow in that area. Therefore, they don’t do any kind of wrap on the scrotum post surgery. Ice will continue to help with discomfort as the swelling subsides over the next few weeks.

That was all the questions I had. He mentioned again that he thinks I’ll be very happy with the outcome. He felt I was top 10% for phallus size and had a very large scrotum to work with so he thinks the final outcome will be great aesthetically. It’s hard to see that right now with the swelling. My wife keeps telling me to be patient and relax about it lol but, I will say, he can tell me I’m hung as often as he’d like lol.

I think that’s all for now! Should be boarding our first flight toward home shortly and I’m very excited to sleep in my own bed tonight.

Let me know if anyone has any questions and I will try to commit to posting at least weekly during the initial healing.

Dex

[Dex]

Hello,
Just wanting to keep things current.

So far, so good on the healing. I’m just shy of 2 weeks post op at this point. There is not much to report as compared to last week.

My travel day home was about as miserable as I expected but not nearly as bad as my first surgery. I spent most of the next day in bed with ice.

I found out early this week that my short term disability insurance would cover me through 5/23 which was a huge relief for me. It will give me the extra two weeks (after what my vacation time would have covered if I’d had to use it) to heal more fully before returning to work.

All my incisions are holding together very nicely and I’ve not had any unexpected healing problems or other issues.

There have been no signs of infection thus far.

Swelling continues to be the main issue, though it is reducing slowly. My scrotum, especially, seems to be making progress on the swelling much faster than last time.

Pain-wise, I have almost no pain unless something is pressing on that area. I’ve been continuing to ice at least twice a day and that definitely helps discomfort of the swelling.

Almost all the bruising has subsided. There is still a slight yellowish discoloration in the pubic area from the inflammation but that is expected this close out from surgery.

My phallus is still pulled back somewhat due to the swelling. Starting next Friday, I can begin pumping to try to prevent that from staying that way once it’s all healed up.

I began taking the cialis once every 3 days last week. I haven’t noticed too much from that but the most recent dose was this morning and I’m beginning to notice it is much easier for me to become aroused. Sensitivity to my phallus is beginning to come back as well, which is nice, but the doc said no intimacy for at least 3-4 weeks post op. So I’ll have to wait it out til then.

I can’t really think of any other changes to report for now.

I’ve been very happy with the outcome so far. It looks great as compared to before. My main concern will be the phallus healing in instead of out again. I’ll be happy once I can begin taking action on that and hopefully getting it to heal correctly.

I’ll report more in a week and a half or so!

[Dex]

Hello!

It’s been a bit so thought I’d drop a brief update.

I’m 5 weeks post op at this point. I did return to work as planned on 5/24. The first day was pretty rough with increased swelling and discomfort but I was able to rest almost all of Sunday and Monday and I saw a drastic decrease in swelling after that.

The swelling in the monsplasty area had been increasing almost every day from week 2 to week 3.5ish and then stayed pretty steady after that. Unfortunately, the swelling sits right at about waistline and below so that made the switch to jeans from athletic shorts a tough one.  It is still pretty sensitive around that area but I am fortunate that I have an office job, a desk that allows me to sit or stand, and plenty of ability to get up and move around when I become uncomfortable.

My scrotum has been continuing to become less swollen though and that is looking great. As the swelling comes out, the shape of my scrotum is looking more and more natural. I’m excited to see how it looks once my incisions soften up a bit and things relax even more.

All my incisions are doing well. I’ve not had any of the wound dehiscence I had last time. I do sometimes struggle to absorb the stitches so I have had a few push out through the incision line but that is something that happens to me almost any time I have a skin related surgery (top surgery resulted in the same thing). It’s a minor inconvenience at worst and I think I’m pretty much through that stage at this point. I’ve begun massaging the incision lines when I’m laying in bed at night in an effort to help them soften up sooner. I’m hoping this massage will also help with the softer residual swelling I still have. I anticipate the swelling will stick around somewhat for at least another 2 months or so. It is similar to top surgery in that regard (the monsplasty portion).

I did start pumping but had a few spots on my incision that didn’t look fully healed over so I had backed off on that and plan to pick it back up over the weekend.  Even without pumping, I’m beginning to see more of the phallus out which is reassuring. I’m hopeful that pumping in addition to the reduction in swelling will help as much be visible as possible. Truthfully, I don’t care as much about flaccid length. I don’t plan to be walking around in the gym naked or anything like that. I just want to make sure as much as possible will be out while erect for obvious reasons.

Speaking of that, my wife and I became active again at about week 4. So far, so good on that front lol. It’s not quite as “out” as it was post healing with the last surgery but things are still very tight from inflammation and healing. I’m sure this will only improve. Sensation, for whatever reason, seems to be even better than it was before this last surgery. I’m not sure why that would be since nothing was changed with the phallus really at all. Perhaps because more of the shaft is accessible now with the monsplasty portion? Perhaps because I feel better about it psychologically because it looks, already, much better than it did before? I don’t know, maybe a combination of many things.

In any case, I think that’s all for now. I’ll update again in a bit with further healing progress.

[mm]

Dex, so glad for you to have good results.  As you say as the swelling goes down everything will get even better.  Your explanation of having better sensations is probably correct, you good such nice results and can relax now and enjoy yourself.

[Dex]

Hello again!

I am just over 10 weeks post op now. I’m going to try to update in categories to organize my thoughts and provide consistency.

Swelling -
Things are still changing shapewise but the majority of the swelling is gone. I have some residual soft swelling in my scrotum toward the bottom but have virtually no swelling on the sides, front, and back.
The side incisions where  the buried penis repair was performed are still slightly swollen but not much.
The monsplasty area still has some soft swelling above and below the incision line. The incision line is still firm but I’ve been continuing to massage it and I am noticing it soften up over time. For me, it is typically about months 4-6 where that firmness starts to come out and the rest of the swelling disappears. So far, I seem to be on track or ahead of schedule on that healing as compared to previous surgeries.

Implants -
My testicular implants both settled in just fine and I have not had any issues with protrusion or infection. They sometimes like to rotate around which is fine, it doesn’t hurt or bother in any way. If I notice one is rotated when I go to the bathroom, I just rotate it back lol.

Pain -
I’ve not had any pain for some time. I am currently pain free in all areas

Sutures -
As is the usual for me with any skin related surgery, I had some sutures push out through the incision line (both the monsplasty area and the buried penis area). This occurred around weeks 7-8ish. I’m used to this happening and once the suture pushes out, it heals over quickly and doesn’t take long to finish healing.

Activity level -
Since about week 5, I’ve been back to normal activity levels. I’ve been working full time and have had lots of activities the last month. I ran a 5k OCR at week 6, had a weekend camping trip/bachelor party for my brother week 8, stood up in his wedding week 9, and spent a week at our off-the-grid cabin last week. I was able to split and stack wood, ride the 4 wheeler, go swimming, etc without any issue.

Pumping -
I have been pumping though not as diligently as I should be. I probably average 2-3x a week. I have noticed that while pumping, I am getting more length and it remains “looser” to pull out for a day or two after pumping. It does still pull in a fair amount when not under vacuum, however. The other issue I’m running into is that I’m kind of between the midsize and large pump cylinder. Width wise, the midsize fits the best and provides the best suction. However, the length I have is getting close to being too big for that cylinder. The large size is slightly too wide currently. I can get a seal but I don’t get the length pull as much. I am able to get about 3 inches out in the vacuum, but it quickly retracts to about 2 inches once the vacuum is released. Regardless, I am trying to get more consistent in hopes it will stay out more. I have to remember I’m still only 10 weeks out and I’m trying to not get frustrated with it. I do think some swelling is still playing a part.

Sensation and intimacy -
This part has been pretty amazing. I love how it feels with more being exposed. Particularly when I pump, it is pretty great size and length wise. We have been able to resume all our normal intimate activity. Trying to not get too detailed here but BJs feel/look amazing. Having everything look normal (even if small) is a huge turn on. This last week, we tried a bit of penetration. After pumping it is much easier than without pumping. I am able to achieve enough penetration (with and without pumping) to have her feel it (minimally) and I am able to achieve climax. It does take some experimentation with positioning. Our bed is really high off the ground so that does make it difficult to get a 90 degree angle (which would offer the most penetration length wise). However, we were definitely able to make it work. And... wow... it’s been incredible. I feel so whole being able to express love physically in that way. Even though it’s not mind blowing size wise, we’ve had lots of discussions about it since we’ve been trying things and my wife assured me that while it’s not going to get her to climax, it feels really good to her and feels “right”. She doesn’t climax from penetration alone anyway, regardless of size. Anyway... probably TMI, but it is has been an amazing experience and I love how it feels.

Overall -
Feeling great about things! Hoping to get more consistent length without the pump by continuing to pump and loosen things up in there. The look of it is fantastic. I love having a bulge in underwear and when sitting. I am feeling much less self conscious about myself as a whole and even swam at a public beach with no shirt on for the first time in my life. That has nothing to do with this surgery directly but this last surgery has had a huge impact on my overall well being.

Emotions -
This last part has been a bit of a paradox for me and is not transition related specifically. I’ve come to a point in my life (at 36) where I’ve been pushing for something, always. Career, family, home ownership, transition related changes, etc. Career wise, I’m a director of IT in a large system and well respected by my leader and my colleagues. I have a successful, rewarding, and wonderful marriage with 3 kids that are beginning to have their own lives as late and mid teenagers. I have a home I’m proud of. I’m 5.5 years into testosterone and have completed all surgical options available to me at this juncture... I went back to school and got a degree. I’m happy. I’m secure. But yet, I feel some lacking in not having something to push for. So, I need to find a new project to take on, I just haven’t figured out what that is yet. It must be the farmer blood in me that just can’t sit still and needs to constantly be pushing. It’s an affliction many in my family suffer from lol. So while I’m enthusiastic, happy, joyful even over the results of this last surgery, once that wore off and I’m just into the “living” of things, I don’t think I realized just how much having something to strive for has meant to me. I’ve never been at a point in my life where I wasn’t striving for something more. So... that is the last part I’m working through and that is not trans-related at all but more mid-life related. I don’t like to be comfortable lol being comfortable stifles growth. But I do need to also learn to just relax once in a while and enjoy the moment.

Thanks for sticking with a long update! I don’t think much will change in the near term but I’ll check back in with updates on a few weeks!

Dex

[mm]

Thanks so much for your update, so informative for me.
Swelling, great it is decreasing and you see and feel how everything will be long term
Implant, didn't realize you need to rotate and move them around to have them in the right place
Activity Level, must be nice to be active again and knowing the surgeries are behind you
Pumping, everyone seems to say one need to pump regularly to get good results, sounds like you are seeing some nice results
Sensation and intimacy, seems to be coming along nicely, you both are getting great feeling of being close and your new penis is working as you would like.
Emotions, will continue to change as your like moves on

Thanks again and keep letting us know how you are doing