Deveopment of vaginal mucosa: Dr Suporn's technique vs penile inversion?

[Teslagirl]

This is a question for those who have had a penile inversion and also for those who have had a scrotal skin technique like Dr Suporn does.
I've heard people say their vaginal lining eventually develops mucosal tissue. Is this the same for both techniques? Just intuitively it seems the inversion technique would be more likely to develop a mucosal lining.

[Jenna Marie]

Again, as a Brassard patient, it seems to be true for me. I haven't had it tested, but the skin in there is now soft, moist, light pink, and even feels "ripply" the way a cis vagina does. (None of which was true before!)

That said, I have explicitly mucosal tissue on my inner labia and clitoral hood - it started life as urethral lining - and there *are* some differences; the labial tissue is slicker and smoother and definitely lubricates a bit. But there are different types of mucosal tissue (cis labial skin is also different from vaginal), so I'm comfortable with it as it is.

[mrs izzy]

It's funny how so many have no clue that the inversion is the same as Suporn.

Each might add a twist but they are basically the same.

The penis skin is only used on the outside and to the entrance, after that is the split skin scrotal skin graft.

McGinn, Leis, Bowers all do the same with there own twists. Many more I am sure.

So mine is always wet, just not as viscous as a cis but if over aroused before it adds just enough.

Anyway it comes down to who you feel comfortable with. Everyone will give you the best they can and if and this is the key you take care of it post it will reward you back.

[Lisatrans69]

I too did not have 'genital correction' surgery with Dr. Suporn, but by a well known surgeon, now close to six years ago. My vaginal mucosa, as with the rest of my vagjay, now seems perfectly normal, natural (as I feel and believe my correct genitals, my breasts, female body, etc. should be, as least that is my feeling.

Having been diagnosed young, I did have the advantages of puberty delaying meds, etc, when I was 'corrected' in having a vajay at 18. I finally felt complete - or more so, until life only got better and better...until, my recent break-up with the man who helped my lose my V virginity later still 18, a freshman in college.

Hearts, Lisa

P.S. Having begun posting recently, (still not full member, but trying) I would welcome some post-op, or nearly any female member as a friend for chatting, or advise for me. Thanks, Lisatrans69

[Teslagirl]

It's funny how so many have no clue that the inversion is the same as Suporn.

Each might add a twist but they are basically the same.

The penis skin is only used on the outside and to the entrance, after that is the split skin scrotal skin graft.

McGinn, Leis, Bowers all do the same with there own twists. Many more I am sure.

So mine is always wet, just not as viscous as a cis but if over aroused before it adds just enough.

Anyway it comes down to who you feel comfortable with. Everyone will give you the best they can and if and this is the key you take care of it post it will reward you back.

You're saying they're the same? That's not in my knowledge. A penile inversion is where the penile skin is used to line the vagina, (with no supplementation) and it always has been since McIndoe invented it. If these surgeons don't use penile inversion, why do they call it that?

[GendrKweer]

Suporn pioneered the half-thickness scrotal skin graft while using the penile material for labia. Dr Chet does the same essential surgery now, but he was not the first to do it. These are not "penile inversions" and anyone calling them that is in error.

[Jenna Marie]

I don't know if anyone does "pure" penile inversion anymore, then. I'm not aware of any of the well-known surgeons who *never* use a skin graft when necessary, for one thing.

Brassard calls it "penile inversoin" because that's the primary source of the vaginal vault, but he definitely does add both scrotal and perineal grafts to supplement as part of his standard method, plus additional skin grafts if someone has little donor material.

(Brassard's own web site states that the typical op involves "a skin graft from the scrotal sac at the end of the penile skin tube." http://grsmontreal.com/anglais.html Look under "GRS male to female.")

[Zumbagirl]

Again, as a Brassard patient, it seems to be true for me. I haven't had it tested, but the skin in there is now soft, moist, light pink, and even feels "ripply" the way a cis vagina does. (None of which was true before!)

That said, I have explicitly mucosal tissue on my inner labia and clitoral hood - it started life as urethral lining - and there *are* some differences; the labial tissue is slicker and smoother and definitely lubricates a bit. But there are different types of mucosal tissue (cis labial skin is also different from vaginal), so I'm comfortable with it as it is.

I agree. As a post-op of 11 years it would be difficult to tell now, if there was ever such a thing as a standard vagina.

[mrs izzy]

You're saying they're the same? That's not in my knowledge. A penile inversion is where the penile skin is used to line the vagina, (with no supplementation) and it always has been since McIndoe invented it. If these surgeons don't use penile inversion, why do they call it that?

Sorry to say yes.

There is so many misconception now days on doctors techniques. Most everyone does the inverted penis technology type of surgery.

The penis skin that is turned inside out is where the name comes from. The inner section of the penis skin will not knit easy with the inner so they been doing the split skin scrotal skin inside. Thus had stopped prolapse as a more normal complication.

So I had a penis inversion with a scrotal skin grafted fir my neo vagina. The penis skin was used on the outside to line my labia and urethra split and added to make the inner labia and hood lining.

So yes the west is the same as the east except if you go have the colon type of neo vagina.

Sorry.

Just go to who you feel is the best. That's it all in a nut shell.

[Vicky]

I am an oddball here in that my surgery was done by Marci Bowers.  Her technique did turn my penis inside out in several ways, and used scrotal tissue deep inside my vagina for depth purposes, she also uses the urethral mucosa for the labia minora and clitoral hood areas and at 21 months, I can do dilation without lube, but it is not as comfortable as with the goo.  I am moist inside my vagina and it has developed a female smell to the area. 

[Monkeymel]

The truth is out there somewhere Scully

As techniques have been pioneered and changed over time, and experiences shared between surgeons at congresses - it is most likely that most good surgeons are using the same techniques especially on recent girls. But surgeon egos keep different naming conventions.

Surgeons who do less operations or use older techniques may still call things pure penile inversion. I know someone who was really short changed by her surgeon 4-5 years ago. Mainly due to inexperience. But she is still mainly happy

[Teslagirl]

Suporn pioneered the half-thickness scrotal skin graft while using the penile material for labia. Dr Chet does the same essential surgery now, but he was not the first to do it. These are not "penile inversions" and anyone calling them that is in error.

Yes we agree. My original post was about mucosal development in PI surgeries, and I have always been told that the difference between Suporn and the North American surgeons was that the Americans use penile inversion techniques whereas Suporn uses (as you say) the half-thickness scrotal skin graft. Now I'm being told both the American surgeons and Suporn  use more or less the same technique, and I'm confused as to the difference. Please can someone definitively clear this up? Are they the same? Is it just that Suporn uses an extra sensate area (the "Chonburi organ")?
Or is it as another poster to Susan's said, that though Suporn's dilation regime is brutal at first, much later it is possible to have sometimes long periods between dilations without losing depth or width whereas the North American surgeons have a more gentle initial dilation regime but it must be maintained regularly for life to avoid losing depth and width. Is this another difference? As Jack Webb used to say in Dragnet "Just give me the facts, ma'am"!

[suzifrommd]

My surgeon (Dr. Rumer, studied under Dr. Lies) seemed to think that I will not develop mucosal membranes inside.

That being said, when I feel around in there, the texture is similar to a (dryish) cis gender woman's and it's always pretty moist. Moisture is getting there somehow.

[Julieb1]

Dr sanguan uses full thickness scrotal grafts so what happens to them ?


Julie x

[Vicky]

I am a Dr. Bowers patient, and my actual mucous tissue area is my labia minora and clitoral hood since that is where my urethral mucosa tissue from my penis was utilized so that I had a single surgery experience.  My discharge instructions from Dr. Bowers clearly stated that in time (around 3 - 6 months) that I would develop vaginal typical "flora" that thrive in a warm moist environment and that would give my vulva and vagina a feminine smell and would produce "SOME" additional moisture internally.  It does not say that I will actually get mucous tissue there per se, only that my vaginal tissue will become moister, which is very true.  I can dilate without gel lube if I have to, but do not like to.  On the other hand, my lube it about a tenth of the amount I used in my early days of dilation. 

I would personally like to know about this "gentler" dilation technique that I was supposed to have had came from since in the early days it did not feel gentle at all. In the early healing days, so dilations left me crying from pain.  It is "recommended" that I have intercourse or do a dilation every day now, but it has gotten where 2 in 72 or 1 in 48 does just fine.  I found in my earliest days that to get a Soul Source dilator with its bent tip in comfortably , that I had to twist or rotate it at certain points to avoid an ouchy place.  It is more fun that way, and you experiment with the nice feeling places sooner.

The people I know who have Suporn's "Chonburi organ" seem no happier with what happens than I am with what I have experienced.  This unique structure is salvaged tissue that is supposed to have more sensitivity in it.  There is really no way I can think of to "prove or disprove" his brag about that since each person is going to have different healing and outcome for a wide variety of reasons. I do not see finicky neurological testing on individual nerve connection in terms of quantity ever being done, and my own healing over many months played all sorts of tricks on me nerve wise.

Certainly faith in your doctor can improve your outlook over what does happen, but misplaced faith, or just your physiology, can dash the feelings in a moment at some point down the road.  There are no ultimate FACTS on the surgical differences, it is much to much subjective.

[Apple]

There has been a scientific study done to see whether the transformation of the skin into a mucosa happens, using histological sections, and the answer is unfortunately no. Those cases that looked most similar to actual mucosal vaginal tissue were in fact irritated skin. See here:
http://www.ncbi.nlm.nih.gov/pubmed/17992150

[GendrKweer]

I have to say, Apple, I always suspected as much. To my knowledge, only stem cells can change into other cell forms (or rather, become a cell form).... Muscle tissue cannot change into nerve tissue, so it stood to reason that skin cells couldn't change into mucous-producing cells no matter their transplant location or type.

[Jenna Marie]

That study had 9 people in it... I analyze this sort of thing for a living, and that's not nearly enough to draw a solid conclusion. Suggestive, yes, but it'd have to be replicated with a much larger sample size (and I'd like to know the confounding factors, which are generally not mentioned in an abstract).

Essentially, it's controversial, and there have been studies showing both answers. This paper cites 4 studies showing that neovaginas do have "quasi-mucosal" tissue (as do cis vaginas, it's not truly mucosal there either) :

http://www.gendercare.com/library/italiano_paper1.html

My personal suspicion is that there are conflicting answers because there are conflicting *realities* : some women see more change than others, just as issues of healing and scar formation are individual as well. I also found a study showing that neovaginal skin is capable of harboring the normal flora of the vagina, but presumably it's more likely (and easier) if there is, shall we say, a "donor" handy to get things started.  So perhaps those whose vaginal flora are closest to typical will also see the greatest changes in the skin to adapt? Pure speculation there, though.

[Apple]

I guess the transformation could be more probable with skin grafts (Suporn) (as opposed to pedicled skin flaps - PI), since in a graft, new blood vessels need to grow into the grafted tissue, so there is quite a lot of stuff happening. The pedicled skin flaps are quite self-sufficient, so not much change is happening to them.

Anyway, I'm sceptical towards the idea. Extremely obese people often have folds of skin which are almost permanently "inside". Yet no changes in tissue type happen to them, as far as I know.