I am having penis surgery and need a ticker

[trannyboy]

So, it is time for a countdown on my bottom surgery. I really don't know how it works though. Stage 1 of the surgery is on July 30, Stage 2 is mid August depending on healing and Stage 3 will be at the end of September again depending on healing. The first surgery is to completely isolate the clitoral tissue, basically a met but much further dissection. After the initial surgery I will have two surgeries in August under epidural and sedation where they will use a pedicle technique to relocate the new penis to a proper position (no longer over the vagina. Once all this has healed and I am ready to travel I will go to Dr Perovic to have a urethra connection, glans enlargement, mons reduction, liposuction, LD muscle graft, testicles and scrotum surgery.  So there it is, my surgery and if it all goes well I will have very minor scarring and a functioning penis with normal appearance. I was unable to solve the sperm issues but I have found methods to have semi-normal precum and depending on the individual an ability to cum with orgasm.

So now what and how do I get my ticker?

->-bleeped-<-boy

[joannatsf]

Congratulations and good luck!  I hope you have succesful surgeries.  I just have one question; what's a ticker?  The last I heard it was heart and I assume you already have one of those

[Drik]

Wow.
good luck!

[Elwood]

Bloody hell. Um, just hold on, buddy. Any surgery is hard, but this one sounds really extensive.

If it turns out well... that's the light at the end of the tunnel for me, haha. All the surgeries I've seen look pretty... ech. So yes, stay healthy and hydrated... that's important to making surgical results safe and predictable.

[Sandy]

So now what and how do I get my ticker?
->-bleeped-<-boy

Tickers are web timers that count down until the event.  Usually Tink sends them out.  Here is one for you T-boy.  Sorry I couldn't find one more macho...  It sounds like you may need three of them though...




-Sandy

[trannyboy]

Claire- Umm a ticker on this board is one of those things at the bottom of people's post who are having surgery shortly and it counts down the time until surgery. Or at least I think it is called that... In terms of my heart meh, I have one but I could use to trade it for a shiny new one if you are offering.

This surgery will make the radial arm phallo archaic but it is intensive and the docs won't give me a date for stage 2 and 3 because it all is going to depend on me. I am doing some pretty extreme steps to get ready for surgery including but not limited to a healthy diet, working out, scrotal and penile saline infusion to stretch the original skin of the penis and sack to ensure there will be enough to cover the new penis, topical DHT treatment and massage.

After stage 1 we have to have healthy tissue to graft it higher and will require a nerve graft from the leg. Until stage 2 my penis will actually be resting in front of the vagina. We hope by doing the surgery in stages we can ensure that the grafts take. I will lose sensation for between 6 months to 2 years because the nerves will be cut but my surgeon has a very high success rate for people with bladder and prostate cancer and is confident that I should regain full function.

thanks for the well wishes

Posted on: July 07, 2008, 11:10:16 AMwoohoo I got a ticker or at least someone has a ticker in my name;)

[Jamie-o]

Congratulations ->-bleeped-<-boy!  It sounds as if this is very different from what one usually reads about.  Can you tell us where you initially got the info on this surgery?  I'd love to read more about it.

[Elwood]

I want a ticker that says when I'm gonna die. 

Aaaaanyway... good luck, sir. I'm not horribly comfortable with calling you ->-bleeped-<-boy... sounds like being trans is some sort of superhero thing...

Jamie-o is right. It is an intriguing procedure. I don't think I'd look into for myself, but it'd still be interesting to learn about.

[Sandy]

Aaaaanyway... good luck, sir. I'm not horribly comfortable with calling you ->-bleeped-<-boy... sounds like being trans is some sort of superhero thing...

Yes!  Who is that masked man?

The Daily Bugle has a reward out for anyone who can reveal the secret identity of ->-bleeped-<-boy!

-Sandy(Oooohhhh! He looks hot in his red spandex tights!!!!)

[trannyboy]

Now, now red is already taken by superman. I wear them orange... *mutters* damn shedding dog everything I own is orange. In terms of my identity you will never know who that masked devil is unless I get to know you offline. I was titled ->-bleeped-<-boy because I began my transition young enough to be versed in computers and want that kind of title. I managed to snag it as my email address with a major email service and everyone just started calling me that in emails and posts. It has just become my nickname online. Though it does add credit to when I tie my towel around my neck and pretend to fly through the apartment. Anyone can shorten it to whatever they want just be clear you are talking to me.

What I am doing is risky and not going to be an option for anyone else right now. I am a medically minded medic and I like puzzles. I didn't really do the work though, other people created different techniques in isolation and I made it my mission to use available information to come up with an adequate surgical solution until the tissue can be grown. I am simply tired of waiting and willing to try something totally different. This gentlemen, is the completion of a what if moment many years ago and years of careful study waiting for the right time.

Dr Sava Perovic has pioneered many of the methods in use today and is the only surgeon willing to take on patient who require a custom surgery. I am leveraging his skills and my moto "he who dares, wins." Other doctors including Dr Rapheal in Texas and multiple specialist from different branches of medicine contributed to my work. You may use google scholar search to look for the article involved.

First Dr Helen E. O'Connell and John DeLancey's CLITORAL ANATOMY IN NULLIPAROUS, HEALTHY, PREMENOPAUSAL VOLUNTEERS USING UNENHANCED MAGNETIC RESONANCE IMAGING can teach about clitoral anatomy if you aren't sure. Testosterone does some fun things to the clitoris and there are no studies on FTMs so use basic rules that it will be twice as big and you can go from there.

Next would be the work in the field of "sural nerve grafting in radical prostatectomy". If they only damage one nerve at a time then function should return. It would result in temporary loss of function but I wouldn't be using it any time soon anyways. There is always a risk of loss of function permanently but it is unlikely and a risk I will take.

Once properly placed Dr Raphael's centurion technique of round ligaments to assist in anchoring the new penis while the tips of the cura will be anchored with the former suspension ligaments. This will decrease issues with slippage during penetrative sex. This will be done under IV sedation and epidural to decrease the dangers of multiple anesthetics.

By using something called Saline SubQ Infusion in my genitals to stretch the skin I am eliminating the need for superficial skin grafts. This is a well known technique in the body modification community. However it is very painful I am debate irrigating the area with a local for my next big stretch. I am also using cock and ball rings to assist the process. If you want more info check BME on google

At this point we are left with a long and thin cock which isn't that great. Now if we look to Dr Sava we have a great phalloplasty and tissue engineering doctor.
In "Enlargement and Sculpturing of a Small and Deformed Glans" he resolves the issues of a small and deformed glans using hydrogel.
In "New Perspectives of Penile Enhancement Surgery: Tissue Engineering with Biodegradable Scaffolds" he also resolves the girth issues.
In this way we become just like biomales who have thin penises.

Well of course there is one other thing most guys I know want their penis to do and that is pee standing up. This is a poorly dealt with area, first of all the male urethra is rifled like a barrel but we use catheter that is round to form the urethra around and we wonder why the urine spray isn't alway good? We also need to design a urethra that isn't the same diameter everywhere. A major technology change will be using specialized catheters that are designed to form a normal male urethra. If we use the vaginal tissue as the base and seed the catheter with cultured urethral cell we can have a normal multilayer urethra that won't be prone to damage from urine.

The catheter also acts as internal traction to prevent retraction. There will be a need for additional traction during initial healing to prevent retractions and damage to the new urethra.

In addition to everything above there will also be mons reduction/ liposuction, vaginectomy and scrotalplasty with implants. With the prior stretching I will be able to have adult sized implants right away with little risk of extrusion or complications. I will also be using fibrin glue, special compression garments, DHT and massage.

That is basically it. It is intense but carefully within my abilities. I expect full recovery including sensation in 1- 2 years and majority recovery 6-9 months.

->-bleeped-<-boy

P.S. If I create a viable surgery for FTMs, don't you think I have earned at least the title of sidekick or will I have to solve the hormonal issue as well?

[Elwood]

Okay... tissues grown... is this implying a partial or full transplant?

Unfortunately, your description here isn't making much sense to me. It implies that it is easy as 1-2-3 to connect nerves and build an organ with over 100 parts from scratch. It's kind of unrealistic.

If your surgery works, I really won't care how you make it work. I'll just be happy that it works.

My only question is; how is it going to look? Is it patch work? Stretch marks? Does it act normal? Does it even act at all? Typical phalloplasties just sort of hang there and must be persuaded by a penis pump. Medioplasty is often a bit too small for some of our needs (I'd imagine penetrating a man would be a problem with a small dick). Finally, I've heard that even in full transplants (which there have only been a couple, those on cisgendered, naturally born sexed males) the patient is unable to penetrate, or rather, it's recommended that they don't. For either a very long time or for the rest of their lives. The reasons vary, from possible rejection/infection to perhaps the structural risk (as a transplant is never as good or stable as the real thing).

My concerns vary because I want the most convenient/natural solution. Being a little small isn't a major problem for me, but I'd like to be a size that is reasonable at least sexually. I don't mind sitting to pee, but it will be weird peeing behind it (assuming the urethra wasn't moved).

[Christo]

Whoo hoo dude cograts

[trannyboy]

I believe the future of FTM surgery is growing penis in the lab using advance technology similar to an ink jet printer but that is at least 5 and more like 10 year away. We do have the ability to grow limited non-dense tissues though and that is what I mean by tissue engineering in this surgery.

My description here is not intended for doctors and people with a medical background, however I can explain at that level. I choose not to because most here wouldn't understand and would be turned off the discussion. It is not as easy as 1-2-3 but it is by no means impossible. With the proper experts it is possible and safe as any surgery.

Please remember that this surgery is not meant to build an organ from scratch as I have already said we can't do that yet. This is taking the tissue that is there and modifying it more extensively then we are currently doing. The nerves being connected are quite large (2mm) and have already been grafted in people with bladder and prostate cancer.

It will have normal genital skin, physical appearance and function if all goes well. No on stretch marks or patch work. There will be a circular degloving scar around the base that should fade and be covered by hair but that doesn't worry me. That and a horizontal scar at the top of the pubic mound that is concealed by hair is really the extent of scarring. The flap will be taken through the mastectomy scar and the rest of the work will be through my lap scars and vaginally.

If the nerves heal I should have full erectile function and sensation though it will take time for the nerves to heal. The rule of thumb is 1 inch for every month, so if we extend the tissue 12" from the initial graft point it will take 12 months to heal nerve functions. If erectile function doesn't return I can use a vacuum pump and cock ring to have normal erections. I do believe that it is a good idea to vacuum pump during later healing to prevent retraction but I don't believe it will be needed for erections in the end.

Please read the info in the first article I posted about clitoral size. Yes the met is short but that is because they aren't pulling the whole thing out because up until a few years ago we didn't have a way to do this safely. Now we do and that is what I am demanding. Let me explain that I am going to have about a 6" dick. That allows for 1.5 inches to reattach the suspension ligaments. Once we have a long enough dick it is time to make it thick enough that I don't get laughed out of bed.

Ok, I know you have to take it easy on transplants but lets be realistic here. The phalloplasty is a form of transplant and has the same issues as this surgery in terms of connections. However I am sure the vast majority of transguys would be very pissed if after all of the surgeries and healing that they couldn't have sex. I think they would be very surprised seeing as many are using their dicks to have sex right now. The real issues are during healing, don't screw around literally or figuratively post op until the doctor clears you. Also because the suspension ligaments are reattached and the round ligaments provide 2 additional points of stability, I doubt stability will be the issue here.

I in no way promote transplants from other donors because of the anti-rejection medications. I can't speak to what limitation that would have besides possibly killing you and certainly making you very ill for the rest of your limited life.

I want a penis that works normally, is sensate, proper sized and I can piss through. I, however will not accept anyone else's tissues and cells but mine. Nor does the idea of our current options appeal in the least. However I ask you what is more natural then the penis you have right now?

->-bleeped-<-boy

P.S. I tried to respond earlier but the board ate the first 2 replies. sorry

[Jamie-o]

I in no way promote transplants from other donors because of the anti-rejection medications. I can't speak to what limitation that would have besides possibly killing you and certainly making you very ill for the rest of your limited life.

I was reading in the paper recently about some researchers who gave a group of kidney transplant recipients a bone marrow transplant from the donor before doing the kidney transplant.  So far, the patients have had no rejection problems, and have not had to take any anti-rejection medication.  (As I recall, this was a couple years after the surgery.)

Of course, in that situation we're talking life-or-death.  I doubt many doctors would be willing to wipe out your immune system for something as "trivial" as a penis transplant.  Plus, in the experiment they were dealing with live donors, so I don't know if it is feasible for transplants in which the donor doesn't have an extra to spare.

Still, it goes to show that new breakthroughs are being made every day.  The possibility still lingers in the future.

[trannyboy]

An interesting idea but still not a risk for me. I am not sure if you have known anybody who had their immune system fried but that procedure alone has serious after effects.There is no promise that your immune system would reboot after the graft. If it fails or at anytime in the following weeks you get an infection it is highly  likely to end in death that is why you have to be in isolation from the point you system is killed until the marrow graft takes and you have a healthy immune system. This not even begin to include how crappy you feel. If it worked I still would want my own penis not someone else's.

On the other hand if we assume that the penis came from an MTF live donor they might be willing to make marrow donation as well. I would still need to read the article could you send it along. However that is amazing news for my friend who is in her 13 year of her last kidney transplant (she has has 2 already) and struggles greatly on the anti-rejection meds.

->-bleeped-<-boy

[Elwood]

->-bleeped-<-, you got my hopes up but I've realized this is kind of full of crap. At least in terms that it won't be available to the public.

They can't grow tissue with a printer, let alone an organ. The penis is more complicated than the human heart, and they're having difficulty growing a heart in a pig (which, I must say, has a VERY similar heart to the human heart anatomically).

You've been watching a bit too much discovery channel... what they talk about on TV isn't necessarily really being practiced. The ink jet printing idea is not very well developed, and a person has much better chances grown an organ on a host (my example was the pig).

One thing is, rather, that I've been looking at male and female anatomy extensively over the past few months. I've found that the female bladder and the male bladder and positioned differently. The male bladder is quite higher, leaving room for what my dad calls the "root" of the penis. The erectile tissue extends internally into the body, unlike the clitoris which is almost completely external. To alter the clitoris this extensively would require mostly removing it.

The difference between a phalloplasty and grown tissue is that the tissue from the phallo is coming from MY body. Additional erectile tissue would have to come from a different source, and the body has chances of rejecting it. And I never said phallo could not have sex; they most certainly can, which is why so many people get them. But they don't erect on their own and in my view I believe they tend to look grotesque.

I think everyone wants a normal penis. But it's not like it's so easy that just any schmuck can design their own surgical plan. The anatomy tells me different; that a lot more stuff internally would have to be changed. Also, how can the penis function without other key component parts to it? A penis isn't just a urethra and erectile tissue. There's at least 50 different parts that sustain it.

[trannyboy]

I am just keeping the community up to date on my process. If I fail it is my body and my risk. This won't be available in experimental protocol until next year at the earliest and general public usually see new surgeries becoming prominent in the five years after. However as always a surgeon has to choose to do something new and anyone can present a case to a surgeon.

In terms of organ growth it is far off, we only recently grew a bladder. I don't really care how they do it because it isn't the option I am investigating. From what I have been told by the experts in tissue engineering at the University of Montreal is that the printer approach holds the best hope for building complex organ that include nerves, vessels and other tissue. Organs right now are generally outside of our ability to grow and in no way relates to the surgery I am talking about. I don't know why you are focusing on growing organs when I have stated that is not what I am doing here.

I am glad you have been studying anatomy. You are however incorrect in your statement the clitoris is a mostly external structure. In reality about two thirds to three quarters are inside the body. While only a third of the penis in internal. If the doctors removed any part of my clitoris there would be hell to pay. I request that you read the study that I indicated in my first post as prior anatomy information of the clitoris is greatly lacking.

They are severing connections one leg at a time and relocating it outside of the body. In terms of supporting structures what ones are you concerned about? As you are right there a great deal of interconnection between the different tissues and some are critical to erection and other functions and some aren't. However since the amount of different parts as you stated is quite large and I am not inclined to list each one; could you please be clearer on what parts you feel would be damaged. I however assure you that the doctors would not be willing to preform this surgery if they thought it would fail.

The bladder is certainly resting high enough to place crura under without causing any compression of the tissue. I know this because I can read an MRI and mine was quite clear what I have and what placement it is currently in. The male and female pelvis well being different don't prevent anything I have described. As it the root of the penis/ clitoris is the crura which both run in the same tissue but the clitoris continues further.

Again, you have nearly the same amount erectile tissue (in terms of length) after T as a bioman, the one thing lacking is girth. My clitoris will be the erectile tissue in my penis. The only way this surgery relates to a phalloplasty is that they will wrap the girth of my clitoris in the LD flap. All tissues in this surgery will come from my body only. I agree the phallo doesn't get erect on it's own and that is one of the major difference between this surgery and the phallo. My surgery provide natural erections and normal length and girth.

You can believe whatever you want but in less 3 months I will either be dead, have a proper penis or have failed. Either way I will keep the community up to date. If I fail nobody but me loses; if I win maybe we all win. In terms of your statement of any schmuck designing a surgical plan; I am not any schmuck and it is up to the surgeon preforming the surgery to decide if it is viable. The doctors at the hospital in Montreal are prepared to do the major relocation of my clitoris and have successfully done similar things for other patients. I trust my surgeon would not do something they thought was impossible.

I can assure you that I have been evaluated by multiple psychiatrist who know of my intention and have been cleared as being stable, sane and competent. The surgeons have tested my health and knowledge and believe I am capable of following through with this surgery. The MRI confirmed that I have sufficient erectile tissue and proper nerve placement for this procedure. The robotic techniques allow for more precise cutting and grafting of the nerves in this case. The procedure in people with cancer has been tested and proven. If you doubt me check out "sural nerve graft in radical prostectomy".

Again all the tissue that sustain function in the penis exist in the clitoris. The penis isn't all that different then a clitoris. You don't have to believe anything however until you see the results for yourself nor do I expect people to. Any one can say anything what matters are the results. Those will be available as the surgeries progress. Photos and documentation will be released as each surgical stage is completed. First stage is scheduled in 17 days and it will probably take a week for me to recover enough to care about posting photos. So in 24 days you will see I am not lying. Otherwise feel free to dance around the fl->-bleeped-<-ole shouting ->-bleeped-<-boy is liar until then you will have to wait and see.

->-bleeped-<-boy

[Elwood]

Well, I really shouldn't argue. Again, I don't care if it makes medical sense... if you find a way to do it, I'll be very satisfied with the results.

As for growing organs, the penis is an organ, are are the testes and prostate. Anything that isn't just a cell, just tissue, or just a membrane is probably some sort of organ.

When speaking of the clitoris, that 2-3/4 of the clitoris is not very much; certainly not enough to anchor a penis. Now, when I was talking about it being mostly external, I was thinking along the lines of after HRT, where it externally extends outward.

In regards to damage, that isn't the issue, I'm concerned about there being enough ROOM for a structure that is about 12 times as big as the one you and I currently have. I suppose I can really only post an image to show what I am describing. Internally, the penis takes up a lot of room. This is a bit small, but it helps describe my point.



On the male, that pinkish thing on the top is the bladder. On the female, it's the same color, partially under the uterus. That bladder in the female body would have to be pushed up some distance to make way for erectile tissue and support for the penis. The urethra would have to be extended a substantial amount. And no one is explaining how the organ is to sustain itself without other key components. The penis isn't just a thing you stick in people. It's a complex reproductive organ. I assume these surgeries would leave the person fertile, but still, just how much of the penis would a person have? If it is "hand made" from many parts rather than grown, it's not going to be a standard part. And very likely, it's going to be odd looking. That's why I ask.

If the doctors and you agree that the bladder is high enough, that solves the biggest issue in my mind.

The female pelvis is more broad, so if anything, it provides more working space and shouldn't be a problem.

If T provides 10-12 times more erectile tissue that I currently have, I will be a very happy man.

I hope you live, regardless of whether or not you make the right penis. Because if you are as smart as you think you are, your research could help so many people.

I realize the penis isn't very different than the clitoris, but the size difference seems quite obvious in my opinion, even after T.

Anyway, despite our sparring, I appreciate your work and I hope it goes well. God speed, Brother. I really hope it works out for you. I don't think you're a liar, I'm just questioning. I'm paranoid and I keep feeling like it's impossible. If you prove it's possible, I'll be so relieved. A lot of my stress is caused by saying "it's impossible."

[trannyboy]

Thank you for being clearer, I think I understand what you are trying to say. I am going to respond to your post out of order because some points are simple to address and other aren't. I hope this is alright.

You are welcome to argue with me, it through the fire of discourse that new ideas are born and old one die. If we ever stop debating we stop learning.

I am not arguing that a penis isn't an organ, hell the skin is an organ. I am not suggesting growing organs but culturing cells of an individual type. I would not consider this organ engineering because it is still only a piece of the whole.

The clitoris grows internally as well as externally. The growth seen is not just the result of being pushed out of the body. You still have the same ratio inside your body as out or at least according to my MRI I do. This is more then enough to anchor the penis and allow for a decent sized dick.

Room for penis

The bladder in both men and women is separated from the erectile tissue by pubis symphysis and other tissue and doesn't touch. I have been studying your pictures and well it doesn't even show the clitoris and the penis has little relation to bladder even in your photos. The closest part would be the bulb of the penis which even then is separated by way of the prostate. The bladder is in greater pelvis space well the penis/ clitoris in the Superficial Perineal Pouch. The penis is anchored in front of the pubis about 1- 1.5" anchored. The penis is not 12 times larger then the clitoris and if you multiplied your clit 10- 12 you would be a monster. You have a misunderstanding of the size of the clitoris. For reason little understood the clitoris grows in length and not much in girth in response to testosterone. This is why we have a long enough cock but not a thick enough one.

Um this surgery would require a vaginectomy and hysterectomy so no you would not be fertile. That is generally a requirement in bottom surgery. Yes the urethra would have to be extended greatly but that is the case in any surgery where you wish to urinate out of your penis. The key components are already there. I need you to be clear by key components are you meaning key to erection? I will explain that in my next post if that is what you mean. I didn't think my penis was something just for sticking in people, it is also to fill my pants, make me happy and feel good, peeing and reproducing (in biomen).

Like I said earlier, I may be able to make precum and ejaculate but that will not mean I can get someone pregnant. You will not produce sperm unless you have real testicles but to me that is a benefit. I definitely don't want my genetic material passed on. Each person end size is determined by their own personal growth and no one can really predict that for sure. It won't be the standard part but it will be closer then anything else available. The great part is even if nerve growth fails you can still have erection with the use of vacuum pumping and a cock ring. The only thing that would make this fail is total loss of graft but that is prevented by only removing one side at a time.

I can say that my doctors were concerned about many factors but I have had none suggest that there could be an issue with space. The most major concern was that in my anatomy the nerves to my anus and urethra not be cut. With the MRI we showed that the nerves could be safely cut without compromising other functions.

I definitely want to live but in taking part in an experimental procedure I am risking my life regardless of history of safety in other procedures. I don't think I am going to die but then most people don't think they will and some do. If I wasn't ready to accept that I shouldn't be doing this.

The reason the size disparity is so stark is mainly girth but you are right that it isn't fully the same length. I believe this is because we are missing a hormonal piece of the puzzle. However that is outside the scope of my investigations, if you are curious doctors have experimented with IGF2 and HGH and the results are interesting. Have a look at penile growth factors on google.

I hear what you are saying about the despair caused by not thinking it is possible. I guess the reason I am able to do what I do from inventing stoves, innovative electronic equipment to trying to find a new surgery is because I refuse to believe anything is impossible. I can understand not knowing how to do something but nothing is really impossible. I hope that some day you will learn that as well. Despair is an awful feeling and I hope this surgery works if only to alleviate some of yours and my suffering.

Spar away though, I am happy to temper my ideas by fire or friend.

[Elwood]

Well, then you've educated me on some levels. Some of the things you've told me I hadn't known before. I appreciate your input and patience.

The clitoris in most medical drawings is too small to see... I really don't know if the size is accurate.

Erection is just one of the key components. Organs have hormonal maintenance, and for the penis, a lot of this comes from the testes and prostate, I believe. I haven't read extensively about the organ.

Unfortunately for me, I really want to be a father, but it's never going to happen.

I used to think like you. That I could design the perfect surgery that would fix it all. But my medical knowledge is limited, and from what I know, it is very hard, impossible, or medically unethical...