Bottom Surgery Debacle?

[November Fox]

Hi guys,

Just wanted to get your opinion on this.

I know many transmen who will get top surgery and then spend years hesitating whether or not to get bottom surgery, meta or phallo. Both have their positive and less positive sides.

I´m hesitant about meta because I would rather be a bit larger, but also hesitant about phallo because I feel it´s too far from the real thing. Perhaps if I had phallo I would change my mind, but I can´t just test-run it for a while (sadly).

So I was wondering, for guys that have been hesitating, what their thoughts are on this. Whether some of you ended up taking a decision and what made you make that decision.

[CursedFireDean]

Since I haven't had bottom surgery yet, I don't know how much my opinion helps, but I've been thinking a lot about bottom.

I personally won't get meto just because my lower growth would be extremely unsatisfactory for me and I'd still find myself packing. It wouldn't do much to alleviate the dysphoria I experience. I don't even know if I'd have the length to pee standing up and if I can't even do that, there's no point for me.

As for phallo, I think about it a lot. One of my main concerns is that I don't want extremely noticeable scarring. I wouldn't be comfortable with forearm procedure because of how often my forearms are visible. I know I scar well, but the length of time it takes for them to heal to that point is something I don't think I could handle. I also have forearm tattoos that I wouldn't want to part with. As for other types of phallo, I know my weight is wrong for some and unrealistic for me to get that small. I still need to do more research on others. Ultimately however, I know I'm young and that medical technology is advancing, particularly with things like stem cell research. I know the possibility of having my own dick from my own cells is a very long way off (I've seen an estimated 5-10 years for cismen and 15-20 for transmen but honestly who knows) but I have time to wait. I also have only seen and heard of phallo resulting in a circumsized appearance and if I could manage an uncut one day, that would be amazing. I'm young enough that I'm willing to wait- I'd rather wait and see where medical advancement goes than get it early and miss out on medical advancement later in my life. If I have to wait for the ability to get an erection naturally, I'd be willing to wait. I also don't feel comfortable with the replacement of the erection devices every 10 or so years, I want one surgery and to be done. Or I suppose in the case of phallo, the immediate series of surgeries and that's it.

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[CMD042414]

I am going into stage 1 phallo in two weeks but when I first started T 3 years or so ago I was hesitant. One thing I never wavered on was not wanting meta. I respect anyone who wants a meta and I love that they have that option! But for me I felt lile I've always wanted a full size penis. I want to penetrate and be with a woman and have her feel me. Sorry if that's graphic.

Phallo has come along and there are some surgeons that are absolute artists. No two cis dicks look alike. So I'm fine if my penis looks like a "phallo" at close examination. I will have a penis and testicles and I will be able to stand and pee. Its more than good enough for mw. The alternative would be my original junk or a procedure I don't want. We're probably decades away frpm the "real thing". I want to live my full life NOW. So that's my thought process.

[NothingHere]

I had originally thought I wanted meto because it had fewer complications, no 'telling' scars, and being constructed from analogous anatomy to natal penis I thought it would pass better/seem less like a surgical construction and I liked the thought of natural erections. I also had some misconceptions in terms of what phalloplasty could achieve. I was mostly sacrificing penetration (which was important but maybe not the most important).

I'm currently leaning towards phalloplasty. I began to have fewer negative feelings towards phallo after learning that nerves can regroup so you can get sensation in the phallus and, with microsurgery, even attain erotic sensation through the shaft (I had previously feared a numb tube that still relied on natal anatomy for any kind of sensation). But passing is important to me so I think the real turning point was when I was looking up post-op porn for more images of phallo and saw a comment from a gay man that it was "hot" but he doubted this was an "actual trans man" because phallo did not fit his expectation of trans genitals ( he'd clearly only heard of meto) and it struck me that despite the video showing an older surgery and being obviuosly surgically constructed to me- it wasn't to him.

I've also since spoken to a gay man with an erectile implant who said he doubted any of his partners noticed he used one and demonstrated they are not as difficult as they made out to be ( I swear some trans humor makes pumping a dick look like rocket science). Ive also spoken to a trans woman who regretted bottom surgery and opted for phallo to reverse it which cleared up some other concerns (like being constructed from non-genital skin it would feel like sew on addition and not an actual penis... Hearing from some one who had a dick that it isn't that way was reassuring).

I have few lingering concerns I still want to clear up before I commit but I am strongly leaning towards phallo currently.

[eyesk8rboi]

[[ commenting to keep up with new responses, don't mind me ]]

[CMD042414]

I had originally thought I wanted meto because it had fewer complications, no 'telling' scars, and being constructed from analogous anatomy to natal penis I thought it would pass better/seem less like a surgical construction and I liked the thought of natural erections. I also had some misconceptions in terms of what phalloplasty could achieve. I was mostly sacrificing penetration (which was important but maybe not the most important).

I'm currently leaning towards phalloplasty. I began to have fewer negative feelings towards phallo after learning that nerves can regroup so you can get sensation in the phallus and, with microsurgery, even attain erotic sensation through the shaft (I had previously feared a numb tube that still relied on natal anatomy for any kind of sensation). But passing is important to me so I think the real turning point was when I was looking up post-op porn for more images of phallo and saw a comment from a gay man that it was "hot" but he doubted this was an "actual trans man" because phallo did not fit his expectation of trans genitals ( he'd clearly only heard of meto) and it struck me that despite the video showing an older surgery and being obviuosly surgically constructed to me- it wasn't to him.

I've also since spoken to a gay man with an erectile implant who said he doubted any of his partners noticed he used one and demonstrated they are not as difficult as they made out to be ( I swear some trans humor makes pumping a dick look like rocket science). Ive also spoken to a trans woman who regretted bottom surgery and opted for phallo to reverse it which cleared up some other concerns (like being constructed from non-genital skin it would feel like sew on addition and not an actual penis... Hearing from some one who had a dick that it isn't that way was reassuring).

I have few lingering concerns I still want to clear up before I commit but I am strongly leaning towards phallo currently.

The misconceptions are unfortunate and do the FtM community a huge disservice because it limits our options and keeps guys from getting something they desperately want and need, a functioning penis. In terms of what it looks like I have only ever heard other FtMs say negative things. Cis men and women, and MtFs wiill look at pictures of dicks and cannot point out the phallo at first glance for the most part. Everytime I show one to my cis female friends they are impressed.

And think about it anyone who is reading this and having trouble deciding, how often does someone see and examine your dick?! Like seriously. It drives me nuts (pun intended) when guys say I don't want an obvious this or that. Well how often do you plan on whipping it out and showing it to people? Most likely only when you have sex and if you're stealth there are tons of reasons to come up with. I am not stealth but if I were I would simply say I had to have a surgical procedure to fix it. Shoot, you might even be able to get sympathy and even more sex! And finally, cis men have phallo too. The funny thing is they are just grateful to have a chance at functioning genitals whereas we are extremely nitpicky.

[James80]

I am leaning toward meto with urethral lengthening, but it's too early to commit for me. I feel like I would never fully pass unless I could pee like a man. Yes, using an STP device is an option, but god, I just don't want to do that. It's too much complexity for something that (I feel) should be so simple.

Honestly, though, I would prefer to have a phalloplasty, but I'm a Type I diabetic and would not likely heal from a surgery that invasive nor do I think I could get a good doctor to perform one, even if I decided to take the risk. If anyone knows of a diabetic whose had a successful (still alive, has a dick) phalloplasty, I'd be grateful to know!

[FTMax]

I spent over a year researching, talking to post-op guys, and talking to surgeons before making a final decision. You can read both of my bottom surgery adventure threads to see my thought process during that period.

Everyone I talked to led me to believe that phalloplasty was the best option for me. But being honest with myself, assessing my own needs, looking at the financial aspects of it, figuring out the pros/cons of having surgery now versus waiting, and considering some other factors obviously led me to the opposite conclusion.

Bottom surgery is goal dependent. You have to be honest with yourself about what exactly you are looking for as an end result that will make you happy, with the understanding that there is a high degree of risk involved and that it may take a while to get to that final end point. All I wanted from surgery was an aesthetically male looking package, no vagina, and to pee out of my penis (ideally standing, but that wasn't a deal breaker). Ultimately I decided to have meta done based on those desires, with the added caveat that I was completely open to going back for phallo in the future if my needs changed or I was unsatisfied by my results.

For me, an added benefit of meta is that you have that room to be wrong. There is never a situation where a meta patient can't go back for phalloplasty at a later date if they aren't satisfied with their outcome, didn't make the right decision in the first place, or if their goals changed over time. But if you are unable (due to age, health, life circumstances, etc.) or unwilling to say that, I would cool your heels and really dig into what is going to make you happy in the long run. I consider myself to be lucky to be in a situation where I can afford to be incorrect about my decision, as someone who is young, healthy, and has a large disposable income. Not everyone has that luxury, so that's another thing you need to be honest with yourself about.

All that said: phallo has come a long way in a relatively short amount of time. There are new innovations that are popping up all the time. Complication rates are decreasing as more surgeons do these procedures and figure out what works best. I have yet to meet someone who is completely post op (complication free, not planning any additional procedures) who is unhappy with their decision to have phalloplasty. I know many meta guys who go on to have phallo for a variety of reasons, and I know many who are completely satisfied with what they ended up with. Almost everyone waffles back and forth about which procedure is right for them.

Personally, I'm happy with what I've got. It works great, looks great, I'm complication free, and I'm able to stand and pee. I currently don't see myself going back for phallo, but I feel much more comfortable with the idea of it now that I'm post-op. I don't think I would have been mentally ready for a phallo recovery at the time I had surgery, but I think I could do it now having gone through meta. If that makes sense.

[randomdude5]

I had thought about both phallo and meta. For me the main concern with phallo was the huge scarring on either the arm or thigh. I felt like people are becoming more aware of trans surgeries and feared someone might see that scar and automatically think oh that guy is trans. I knew I would never want to go out in a t shirt again if I had forearm phallo, but with meta I just felt like I'd still feel incomplete in a way.

For me it was a matter of priorities. I looked into MLD phallo and the main negative I read was that the sensation wasn't as good as other phallo types. For me, I know I wouldn't be satisfied with meta and could not deal with RFF or ALT scarring, and that was more important than having 100% sensation to me. Ended up opting for the MLD, had first stage up to now and do not regret it in the slightest. Even after only 1 stage my family doctor back home was impressed with the result. Totally feels like my own too and not just a tube of skin. It really is just comparing the pros and cons of each and getting the one that you feel will give you what you want out of surgery. For me anyways, anything was better than what I had before so even if the phallo doesn't come out perfect, it is still an improvement.

[SaerJoe]

I spent over a year researching, talking to post-op guys, and talking to surgeons before making a final decision. You can read both of my bottom surgery adventure threads to see my thought process during that period.

Everyone I talked to led me to believe that phalloplasty was the best option for me. But being honest with myself, assessing my own needs, looking at the financial aspects of it, figuring out the pros/cons of having surgery now versus waiting, and considering some other factors obviously led me to the opposite conclusion.

Bottom surgery is goal dependent. You have to be honest with yourself about what exactly you are looking for as an end result that will make you happy, with the understanding that there is a high degree of risk involved and that it may take a while to get to that final end point. All I wanted from surgery was an aesthetically male looking package, no vagina, and to pee out of my penis (ideally standing, but that wasn't a deal breaker). Ultimately I decided to have meta done based on those desires, with the added caveat that I was completely open to going back for phallo in the future if my needs changed or I was unsatisfied by my results.

For me, an added benefit of meta is that you have that room to be wrong. There is never a situation where a meta patient can't go back for phalloplasty at a later date if they aren't satisfied with their outcome, didn't make the right decision in the first place, or if their goals changed over time. But if you are unable (due to age, health, life circumstances, etc.) or unwilling to say that, I would cool your heels and really dig into what is going to make you happy in the long run. I consider myself to be lucky to be in a situation where I can afford to be incorrect about my decision, as someone who is young, healthy, and has a large disposable income. Not everyone has that luxury, so that's another thing you need to be honest with yourself about.

All that said: phallo has come a long way in a relatively short amount of time. There are new innovations that are popping up all the time. Complication rates are decreasing as more surgeons do these procedures and figure out what works best. I have yet to meet someone who is completely post op (complication free, not planning any additional procedures) who is unhappy with their decision to have phalloplasty. I know many meta guys who go on to have phallo for a variety of reasons, and I know many who are completely satisfied with what they ended up with. Almost everyone waffles back and forth about which procedure is right for them.

Personally, I'm happy with what I've got. It works great, looks great, I'm complication free, and I'm able to stand and pee. I currently don't see myself going back for phallo, but I feel much more comfortable with the idea of it now that I'm post-op. I don't think I would have been mentally ready for a phallo recovery at the time I had surgery, but I think I could do it now having gone through meta. If that makes sense.

Well hi guys--SaerJoe back again 3.5 years post-op from top surgery with Dr Peter Raphael of Plano, Texas and 3 years on T.  It seems this site has lost my original profile and while this name has no significance to me, I've opted to retain it should I be able to find my old posts! 

I want to thank FTMax for his comments here.  After reading "Hung Jury" (anyone else read it?) and having spent over 3 years now wearing adhesive-based prostheses (T2 Prosthetics Berlin, Germany), I'm considering more permanent "tackle."  FTMax hits the major points right on the head as far as a man needing to be completely goal oriented in this process.  I also am thinking along the same lines from what I've learned that meta can be an end in itself, yet not necessarily, giving us options to go further if we wish (and the budget holds out).  We can always have the option to go back for phallo as techniques continue to improve.  It's nice to hear from someone who's gone through this same series of thought processes and articulates so well.

Goals for me?  Standing to pee would be amazing, although it's not a requirement.  For me, a HEALTHY, sensate and sexually functioning member would be most important.  I've known my wife for 36 years; we've been together for 19 (married in NYS for 5) and, well, she's an unabashed "straight" woman I met in college at our tender age of 17.  Now 54--well--we still have it in for each other, and I'd surely like to keep us both happy in that department, and I'm sure we'll be fine either way.  Given this, she is totally respectful and happy with whatever I choose is best for me.  I'm a lucky guy.

Are any guys on this forum familiar with Dr Raphael and his Centurion process?  I was very pleased with him with the top surgery, and have done some reading on his Centurion process, but was also considering a doc I'd read about from Serbia (Belgrade) that is now performing these surgeries in NYC.  Thoughts, comments welcome.    SJA

[FTMax]

I spent over a year researching, talking to post-op guys, and talking to surgeons before making a final decision. You can read both of my bottom surgery adventure threads to see my thought process during that period.

Everyone I talked to led me to believe that phalloplasty was the best option for me. But being honest with myself, assessing my own needs, looking at the financial aspects of it, figuring out the pros/cons of having surgery now versus waiting, and considering some other factors obviously led me to the opposite conclusion.

Bottom surgery is goal dependent. You have to be honest with yourself about what exactly you are looking for as an end result that will make you happy, with the understanding that there is a high degree of risk involved and that it may take a while to get to that final end point. All I wanted from surgery was an aesthetically male looking package, no vagina, and to pee out of my penis (ideally standing, but that wasn't a deal breaker). Ultimately I decided to have meta done based on those desires, with the added caveat that I was completely open to going back for phallo in the future if my needs changed or I was unsatisfied by my results.

For me, an added benefit of meta is that you have that room to be wrong. There is never a situation where a meta patient can't go back for phalloplasty at a later date if they aren't satisfied with their outcome, didn't make the right decision in the first place, or if their goals changed over time. But if you are unable (due to age, health, life circumstances, etc.) or unwilling to say that, I would cool your heels and really dig into what is going to make you happy in the long run. I consider myself to be lucky to be in a situation where I can afford to be incorrect about my decision, as someone who is young, healthy, and has a large disposable income. Not everyone has that luxury, so that's another thing you need to be honest with yourself about.

All that said: phallo has come a long way in a relatively short amount of time. There are new innovations that are popping up all the time. Complication rates are decreasing as more surgeons do these procedures and figure out what works best. I have yet to meet someone who is completely post op (complication free, not planning any additional procedures) who is unhappy with their decision to have phalloplasty. I know many meta guys who go on to have phallo for a variety of reasons, and I know many who are completely satisfied with what they ended up with. Almost everyone waffles back and forth about which procedure is right for them.

Personally, I'm happy with what I've got. It works great, looks great, I'm complication free, and I'm able to stand and pee. I currently don't see myself going back for phallo, but I feel much more comfortable with the idea of it now that I'm post-op. I don't think I would have been mentally ready for a phallo recovery at the time I had surgery, but I think I could do it now having gone through meta. If that makes sense.

Well hi guys--SaerJoe back again 3.5 years post-op from top surgery with Dr Peter Raphael of Plano, Texas and 3 years on T.  It seems this site has lost my original profile and while this name has no significance to me, I've opted to retain it should I be able to find my old posts! 

I want to thank FTMax for his comments here.  After reading "Hung Jury" (anyone else read it?) and having spent over 3 years now wearing adhesive-based prostheses (T2 Prosthetics Berlin, Germany), I'm considering more permanent "tackle."  FTMax hits the major points right on the head as far as a man needing to be completely goal oriented in this process.  I also am thinking along the same lines from what I've learned that meta can be an end in itself, yet not necessarily, giving us options to go further if we wish (and the budget holds out).  We can always have the option to go back for phallo as techniques continue to improve.  It's nice to hear from someone who's gone through this same series of thought processes and articulates so well.

Goals for me?  Standing to pee would be amazing, although it's not a requirement.  For me, a HEALTHY, sensate and sexually functioning member would be most important.  I've known my wife for 36 years; we've been together for 19 (married in NYS for 5) and, well, she's an unabashed "straight" woman I met in college at our tender age of 17.  Now 54--well--we still have it in for each other, and I'd surely like to keep us both happy in that department, and I'm sure we'll be fine either way.  Given this, she is totally respectful and happy with whatever I choose is best for me.  I'm a lucky guy.

Are any guys on this forum familiar with Dr Raphael and his Centurion process?  I was very pleased with him with the top surgery, and have done some reading on his Centurion process, but was also considering a doc I'd read about from Serbia (Belgrade) that is now performing these surgeries in NYC.  Thoughts, comments welcome.    SJA

I've spoken to 2 guys who had centurions with Dr. Raphael and both are happy with what they ended up with.

Dr. Miro (who did my surgery) only stops in to Mt. Sinai in NYC to teach. He is not performing surgeries there. If you like his results and are looking for something similar stateside, you could go to Dr. Ting at Mt. Sinai who he trained.

[Jacqueline]

Well hi guys--SaerJoe back again 3.5 years post-op from top surgery with Dr Peter Raphael of Plano, Texas and 3 years on T.  It seems this site has lost my original profile and while this name has no significance to me, I've opted to retain it should I be able to find my old posts! 

I want to thank FTMax for his comments here.  After reading "Hung Jury" (anyone else read it?) and having spent over 3 years now wearing adhesive-based prostheses (T2 Prosthetics Berlin, Germany), I'm considering more permanent "tackle."  FTMax hits the major points right on the head as far as a man needing to be completely goal oriented in this process.  I also am thinking along the same lines from what I've learned that meta can be an end in itself, yet not necessarily, giving us options to go further if we wish (and the budget holds out).  We can always have the option to go back for phallo as techniques continue to improve.  It's nice to hear from someone who's gone through this same series of thought processes and articulates so well.

Goals for me?  Standing to pee would be amazing, although it's not a requirement.  For me, a HEALTHY, sensate and sexually functioning member would be most important.  I've known my wife for 36 years; we've been together for 19 (married in NYS for 5) and, well, she's an unabashed "straight" woman I met in college at our tender age of 17.  Now 54--well--we still have it in for each other, and I'd surely like to keep us both happy in that department, and I'm sure we'll be fine either way.  Given this, she is totally respectful and happy with whatever I choose is best for me.  I'm a lucky guy.

Are any guys on this forum familiar with Dr Raphael and his Centurion process?  I was very pleased with him with the top surgery, and have done some reading on his Centurion process, but was also considering a doc I'd read about from Serbia (Belgrade) that is now performing these surgeries in NYC.  Thoughts, comments welcome.    SJA

Hi SaerJoe,

Welcome back. Thanks for sharing and bringing up some good questions.

I took a look around and found posts that quote you but your posts and your account seems to be gone. That would seem like it is deliberate. Not sure. So while there are quotes of your posts, it would be a long laborsome task to grab those and try to recreate a sort of history.

A few things have changed, since you left. One of them is posting the following to newly posting members:

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[SaerJoe]

thanks a million, Jacqueline.  I understand the drill--and make no presumption of privacy.  Again---thank you, and most of all for running a very tight ship! 

SJA

[SaerJoe]

I've spoken to 2 guys who had centurions with Dr. Raphael and both are happy with what they ended up with.

Dr. Miro (who did my surgery) only stops in to Mt. Sinai in NYC to teach. He is not performing surgeries there. If you like his results and are looking for something similar stateside, you could go to Dr. Ting at Mt. Sinai who he trained.
[/quote]


Thanks so much FTMax.  I've got good friends, neighbors in fact, that are traveling to that area, and I wouldn't be averse to going to Belgrade for this gentleman, if you feel his skilled hands are worth the travel.  Thoughts? 

[FTMax]

I've spoken to 2 guys who had centurions with Dr. Raphael and both are happy with what they ended up with.

Dr. Miro (who did my surgery) only stops in to Mt. Sinai in NYC to teach. He is not performing surgeries there. If you like his results and are looking for something similar stateside, you could go to Dr. Ting at Mt. Sinai who he trained.

Thanks so much FTMax.  I've got good friends, neighbors in fact, that are traveling to that area, and I wouldn't be averse to going to Belgrade for this gentleman, if you feel his skilled hands are worth the travel.  Thoughts?

I went to Belgrade partially because it was my least expensive option and partially because Miro is the most experienced surgeon I was considering. If I had to make the decision again, I would go back to him again. I will probably be headed back sometime in the next six months for a few small revisions, and if I ever decide to go back for phallo in the future, I would go back to him for that as well. I've never received bad care here in the US, but the care I received in Serbia was light years better. It's turned me into a huge proponet for medical tourism.

I have insurance, but it's a high deductible policy that doesn't include travel benefits. So I would've spent $10k for surgery here plus whatever flights and hotel expenses I had for the 2 trips I would've needed to make to get the same procedures done by an American surgeon. I would've had to spend another $10k if for some reason I couldn't get both stages done in the same premium period. I was able to go to Belgrade and get everything I wanted in a single stage for under $15k. My revisions will be free. My only expense will be getting myself back to Belgrade and potentially apartment rent if I decide to stick around for a few extra days.

So I guess it really depends what kind of money you're willing to spend and whether or not you have insurance here?

[SaerJoe]

Thanks so much FTMax.  I've got good friends, neighbors in fact, that are traveling to that area, and I wouldn't be averse to going to Belgrade for this gentleman, if you feel his skilled hands are worth the travel.  Thoughts?


I went to Belgrade partially because it was my least expensive option and partially because Miro is the most experienced surgeon I was considering. If I had to make the decision again, I would go back to him again. I will probably be headed back sometime in the next six months for a few small revisions, and if I ever decide to go back for phallo in the future, I would go back to him for that as well. I've never received bad care here in the US, but the care I received in Serbia was light years better. It's turned me into a huge proponet for medical tourism.

I have insurance, but it's a high deductible policy that doesn't include travel benefits. So I would've spent $10k for surgery here plus whatever flights and hotel expenses I had for the 2 trips I would've needed to make to get the same procedures done by an American surgeon. I would've had to spend another $10k if for some reason I couldn't get both stages done in the same premium period. I was able to go to Belgrade and get everything I wanted in a single stage for under $15k. My revisions will be free. My only expense will be getting myself back to Belgrade and potentially apartment rent if I decide to stick around for a few extra days.

So I guess it really depends what kind of money you're willing to spend and whether or not you have insurance here?

Those are some great points, FTMax.  I do have insurance, and am just looking in to what is covered.  I know our deductible is $5K; not sure about travel expenses, and of course, that coverage is likely domestic, right?  My main concern is experience in the surgeon.  Experience is the most critical factor in a surgeon.  I've put an email to his center in Belgrade; we'll see what happens.  I suppose I could also look in to Dr Ting as you suggested, as NYC is just a 4-5hr drive from home.

I know this is likely a dumb question, as I'm not quite certain yet through all my reading.  Is urethral extension required with phallo?  Just a crazy thought in my head, as that it seems among the greatest concerns seem to be issues regarding infection and complications of that part of the procedure.  I'd forgo that aspect for better results otherwise (implants; sensation).  I also understand (one article I'd seen) that nearly 79% of phallo guys experience incontinence or inconsistencies in voiding.  These are q's I'll surely talk over w a doc, but was just curious.

[JHeron]

Since I haven't had bottom surgery yet, I don't know how much my opinion helps, but I've been thinking a lot about bottom.

I personally won't get meto just because my lower growth would be extremely unsatisfactory for me and I'd still find myself packing. It wouldn't do much to alleviate the dysphoria I experience. I don't even know if I'd have the length to pee standing up and if I can't even do that, there's no point for me.

As for phallo, I think about it a lot. One of my main concerns is that I don't want extremely noticeable scarring. I wouldn't be comfortable with forearm procedure because of how often my forearms are visible. I know I scar well, but the length of time it takes for them to heal to that point is something I don't think I could handle. I also have forearm tattoos that I wouldn't want to part with. As for other types of phallo, I know my weight is wrong for some and unrealistic for me to get that small. I still need to do more research on others. Ultimately however, I know I'm young and that medical technology is advancing, particularly with things like stem cell research. I know the possibility of having my own dick from my own cells is a very long way off (I've seen an estimated 5-10 years for cismen and 15-20 for transmen but honestly who knows) but I have time to wait. I also have only seen and heard of phallo resulting in a circumsized appearance and if I could manage an uncut one day, that would be amazing. I'm young enough that I'm willing to wait- I'd rather wait and see where medical advancement goes than get it early and miss out on medical advancement later in my life. If I have to wait for the ability to get an erection naturally, I'd be willing to wait. I also don't feel comfortable with the replacement of the erection devices every 10 or so years, I want one surgery and to be done. Or I suppose in the case of phallo, the immediate series of surgeries and that's it.

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I've thought about waiting for the medicine to be available quite a bit myself, but I gotta tell you dude I decided I don't want to waste the best years of my life late 20s - 30s waiting to feel complete <----(by that I mean my ideal body not anybody else's, course transition means many things to many people). As of right now I'm firmly planning on getting phallo and whenever it becomes possible to get my own bio penis made form my cells and whatnot I'm certain I'd just opt for replacing my phallo with it.

[FTMax]

Thanks so much FTMax.  I've got good friends, neighbors in fact, that are traveling to that area, and I wouldn't be averse to going to Belgrade for this gentleman, if you feel his skilled hands are worth the travel.  Thoughts?


I went to Belgrade partially because it was my least expensive option and partially because Miro is the most experienced surgeon I was considering. If I had to make the decision again, I would go back to him again. I will probably be headed back sometime in the next six months for a few small revisions, and if I ever decide to go back for phallo in the future, I would go back to him for that as well. I've never received bad care here in the US, but the care I received in Serbia was light years better. It's turned me into a huge proponet for medical tourism.

I have insurance, but it's a high deductible policy that doesn't include travel benefits. So I would've spent $10k for surgery here plus whatever flights and hotel expenses I had for the 2 trips I would've needed to make to get the same procedures done by an American surgeon. I would've had to spend another $10k if for some reason I couldn't get both stages done in the same premium period. I was able to go to Belgrade and get everything I wanted in a single stage for under $15k. My revisions will be free. My only expense will be getting myself back to Belgrade and potentially apartment rent if I decide to stick around for a few extra days.

So I guess it really depends what kind of money you're willing to spend and whether or not you have insurance here?

Those are some great points, FTMax.  I do have insurance, and am just looking in to what is covered.  I know our deductible is $5K; not sure about travel expenses, and of course, that coverage is likely domestic, right?  My main concern is experience in the surgeon.  Experience is the most critical factor in a surgeon.  I've put an email to his center in Belgrade; we'll see what happens.  I suppose I could also look in to Dr Ting as you suggested, as NYC is just a 4-5hr drive from home.

I know this is likely a dumb question, as I'm not quite certain yet through all my reading.  Is urethral extension required with phallo?  Just a crazy thought in my head, as that it seems among the greatest concerns seem to be issues regarding infection and complications of that part of the procedure.  I'd forgo that aspect for better results otherwise (implants; sensation).  I also understand (one article I'd seen) that nearly 79% of phallo guys experience incontinence or inconsistencies in voiding.  These are q's I'll surely talk over w a doc, but was just curious.

Coverage is likely to be domestic. The only caveat some policies have is for emergency coverage in a foreign country. I have heard that there are policies out there that cover international surgeries, but it is likely not something you already have.

Travel benefits seem to be hit or miss. The general rule of thumb if it is covered is that they will reimburse you for expenses if you have to travel to see a surgeon due to a deficiency in local options, which is generally the case for bottom surgery. This usually includes airfare/ground transportation and a daily rate for accommodations. Might also include food expenses.

Urethral lengthening is never required. If you don't opt for it, they just leave your urethra where it is. If you had a scrotoplasty, it would end up under your balls.

I would say the 79% statistic is false or outdated. A lot of people have short term issues with their lengthened urethras, but these typically heal within 6 months on their own, or involve really small secondary procedures to correct. I can count on one hand the number of guys I've met who have incontinence issues.

I generally tell people to go into surgery expecting to have some kind of complication. If you're having urethral lengthening, don't expect that it's going to be perfect right out of the gate. My complications meant having a suprapubic catheter in for 10 weeks total, but now everything works great.

[SaerJoe]

Those are some great points, FTMax.  I do have insurance, and am just looking in to what is covered.  I know our deductible is $5K; not sure about travel expenses, and of course, that coverage is likely domestic, right?  My main concern is experience in the surgeon.  Experience is the most critical factor in a surgeon.  I've put an email to his center in Belgrade; we'll see what happens.  I suppose I could also look in to Dr Ting as you suggested, as NYC is just a 4-5hr drive from home.

I know this is likely a dumb question, as I'm not quite certain yet through all my reading.  Is urethral extension required with phallo?  Just a crazy thought in my head, as that it seems among the greatest concerns seem to be issues regarding infection and complications of that part of the procedure.  I'd forgo that aspect for better results otherwise (implants; sensation).  I also understand (one article I'd seen) that nearly 79% of phallo guys experience incontinence or inconsistencies in voiding.  These are q's I'll surely talk over w a doc, but was just curious.


Coverage is likely to be domestic. The only caveat some policies have is for emergency coverage in a foreign country. I have heard that there are policies out there that cover international surgeries, but it is likely not something you already have.

Travel benefits seem to be hit or miss. The general rule of thumb if it is covered is that they will reimburse you for expenses if you have to travel to see a surgeon due to a deficiency in local options, which is generally the case for bottom surgery. This usually includes airfare/ground transportation and a daily rate for accommodations. Might also include food expenses.

Urethral lengthening is never required. If you don't opt for it, they just leave your urethra where it is. If you had a scrotoplasty, it would end up under your balls.

I would say the 79% statistic is false or outdated. A lot of people have short term issues with their lengthened urethras, but these typically heal within 6 months on their own, or involve really small secondary procedures to correct. I can count on one hand the number of guys I've met who have incontinence issues.

I generally tell people to go into surgery expecting to have some kind of complication. If you're having urethral lengthening, don't expect that it's going to be perfect right out of the gate. My complications meant having a suprapubic catheter in for 10 weeks total, but now everything works great.

Thanks for the response, FTMax.  I'm using the Tapatalk app now, so forgive me if this reply shows up in some strange place!

I appreciate the feedback regarding incontinence--that's good news.  Honestly (sorry if it's too personal), I don't have any designs on an uncomfortably large member, as in wearing the T2 prosthetic for 3 years I've battled with how to minimize the size of it in the shorts.  Normal to slightly on the smaller size -- would be just fine with me (us), and if that helps w urethral lengthening, then maybe I'd consider it.  That's good information about going in with the assumption--that you'll have complications or at minimum, some sort of set back.  All the more reasons to get healthy and stay that way--after. 

My quandary, now in my early 50's--is long term.  The whole medicalization reality is something I grapple with.  I generally don't care for surgery and all the issues that anesthetics etc bring as time goes on.  I did see my endo/internist today, and notified her that I am considering the surgery.  Onward with the research.  After reaching out by email yesterday, I've not yet heard back from Dr Miro, nor Mt Sinai as yet.  Dr Raphael has responded.  Do you know if he also does phallo?


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[FTMax]

Those are some great points, FTMax.  I do have insurance, and am just looking in to what is covered.  I know our deductible is $5K; not sure about travel expenses, and of course, that coverage is likely domestic, right?  My main concern is experience in the surgeon.  Experience is the most critical factor in a surgeon.  I've put an email to his center in Belgrade; we'll see what happens.  I suppose I could also look in to Dr Ting as you suggested, as NYC is just a 4-5hr drive from home.

I know this is likely a dumb question, as I'm not quite certain yet through all my reading.  Is urethral extension required with phallo?  Just a crazy thought in my head, as that it seems among the greatest concerns seem to be issues regarding infection and complications of that part of the procedure.  I'd forgo that aspect for better results otherwise (implants; sensation).  I also understand (one article I'd seen) that nearly 79% of phallo guys experience incontinence or inconsistencies in voiding.  These are q's I'll surely talk over w a doc, but was just curious.


Coverage is likely to be domestic. The only caveat some policies have is for emergency coverage in a foreign country. I have heard that there are policies out there that cover international surgeries, but it is likely not something you already have.

Travel benefits seem to be hit or miss. The general rule of thumb if it is covered is that they will reimburse you for expenses if you have to travel to see a surgeon due to a deficiency in local options, which is generally the case for bottom surgery. This usually includes airfare/ground transportation and a daily rate for accommodations. Might also include food expenses.

Urethral lengthening is never required. If you don't opt for it, they just leave your urethra where it is. If you had a scrotoplasty, it would end up under your balls.

I would say the 79% statistic is false or outdated. A lot of people have short term issues with their lengthened urethras, but these typically heal within 6 months on their own, or involve really small secondary procedures to correct. I can count on one hand the number of guys I've met who have incontinence issues.

I generally tell people to go into surgery expecting to have some kind of complication. If you're having urethral lengthening, don't expect that it's going to be perfect right out of the gate. My complications meant having a suprapubic catheter in for 10 weeks total, but now everything works great.

Thanks for the response, FTMax.  I'm using the Tapatalk app now, so forgive me if this reply shows up in some strange place!

I appreciate the feedback regarding incontinence--that's good news.  Honestly (sorry if it's too personal), I don't have any designs on an uncomfortably large member, as in wearing the T2 prosthetic for 3 years I've battled with how to minimize the size of it in the shorts.  Normal to slightly on the smaller size -- would be just fine with me (us), and if that helps w urethral lengthening, then maybe I'd consider it.  That's good information about going in with the assumption--that you'll have complications or at minimum, some sort of set back.  All the more reasons to get healthy and stay that way--after. 

My quandary, now in my early 50's--is long term.  The whole medicalization reality is something I grapple with.  I generally don't care for surgery and all the issues that anesthetics etc bring as time goes on.  I did see my endo/internist today, and notified her that I am considering the surgery.  Onward with the research.  After reaching out by email yesterday, I've not yet heard back from Dr Miro, nor Mt Sinai as yet.  Dr Raphael has responded.  Do you know if he also does phallo?


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Size, as far as I have ever been told, has no bearing on UL success or complication rate. You would think the complication rate would be greater with phallo because you have that much more lengthened urethra to deal with, but all the surgeons I've spoken with cite almost identical urethral complication rates in their patients who have meta vs. those that have phallo. Size is more of a concern for blood flow and necrosis.

Miro will probably take a few days to respond. If you haven't heard anything back in a week, send another email. He's a busy guy so your message might've gotten buried. I've never talked to anyone at Mt. Sinai so I'm not sure how responsive they are to emails.

Last I checked, Dr. Raphael was only doing meta. If you wanted to stay local to that region, Dr. Crane is operating in Austin now.