You have two choices; one surgery at a time or combining in some way. My choice was that it was too hard to recover from hysto and top but some surgeons see a benefit in doing all the surgeries possible in one or two operations, Daverio in Germany comes to mind. If you have top and bottom at once expect to be totally non-functional afterwards and need care for at least a month up to 3 months, worse case senerio longer.
You can also have parts of your GRS done with the hysto and then with top surgery if that is something you want. The hysto need be approached carefully and objectively, there are a lot of tissues that could be very valuable for your penis. For instance the round ligaments for anchoring after severing ligaments in the meta, vessels can be used for tunica grafting that can increase your erectile bodies erect size and nerves can be used for grafts. The uterus neck and cervix have also been forwarded as tissue to create a large sensate glans from. The vaginal mucus combined with tissue engineering offers the best hope of urethraplasty.
Because these surgeries are usually done separately, bridges are often burned. If you even consider the basic phallo nerve and vessel grafts are often needed from the leg but if the reproductive organs' nerves and vessels were at the least preserved during the hysto you wouldn't need to cut open the patients leg and take nerves and vessels from there. I had my hysto and my dysphoria pushed me to try and have everything removed. I got everything short of the vaginal vault removed which now means I have to use tissue from other parts of my body creating a (however minor) disability that didn't need to happen. If the doc had removed the vaginal vault like I wanted, I would have needed buccal mucus grafts for my urethra. If you think a penis is in or might be in your future really be careful where you cut and what you throw away. Also consider the incisions, a cut down is the worst, lap/ vaginal assist is better. You don't want to severe muscles whenever possible, I choose a lap/ vaginal assist and would have been back in the game in two weeks if I wasn't the king of complications.
If I was having my hysto today I would do things differently. I would ask the doctor to severe all connections as close to the organs as possible preserving the tissues, remove the ovaries, fallopian tubes and uterus leaving the neck and cervix. I would have them do a tunica graft along length and circumference of erectile bodies with the removed vessels.
Then a future surgery could turn the vagina into a flap for your urethra hook up and placing the cervix tissue near the glans for sculpting. Then you can extend the clitoris upwards using the preserved hysto nerves and vessels for any grafts needed and finish with PLGA tissue grafts for flaccid girth enlargement and scrotaplasty. Maybe you need a couple touch ups but it keeps the surgeries and damage minimal. You are in Australia, they pioneered the tunica grafting there. Lucky you. I have a much harder road because I was impatient.
Top surgery is pretty easy. I don't know your size but I had double incision and it was out patient. In fact I was up and outside smoking less then an hour after the surgery and that night I spent at the casino. I shouldn't have done that but I was feeling lucky.
The only problem I had really was the damn home care nurse pulled my drain early and I developed a seroma. You will be told that if there is less then "x" amount of fluid in the drain in a day you can pull the drains; before assuming that you have to milk the tubing in case it is blocked. The nurse didn't and paid the price. It looked like I regrew a breast by the time the ER drained about 1.5lt from my chest with me cursing the nurse. So milk your drains. Aside from that you want a surgeon who uses internal sutures and steri-strips externally, even when they fall off replace them with a strip of medipore tape to keep tension off the wound. Compression is needed post op but you can take 2 ABD bandages, place them over the chest and cover that with 6"-8" Medipore Surgical Tape which if placed right acts like the best binder you could imagine.
There are two products that you need post op if you want to avoid infections. One option though expensive is primary silver dressings. There are 4-5 brands and some work better then others. I use silvercell but there are others. These provide an area where most infectives can't survive. The other option which I recommend to everyone for surgical wound cleansing and is by far the best product on the market, Techni-care made by Care-tech. It kills most everything in 30 seconds, 2 minutes for established infections, can be used in the wound bed, does damage tissue, helps healing, gram positive, negative, yeast, fungi, viruses etc. The only thing it can't take out is spores. It is much better the CHG or iodine. Check your good local piercers out especially in the US. Almost all the body mod community uses it. I bought a gallon for about 80 dollar CAN and a small glue bottle to administer it. It last forever and has kept a necrotic tissue on my penis from getting infected since I can't take antibiotics. Shameless plug for the only product I have ever found capable of that.
You always tell your medical professionals any medications you are on; in emergencies where I am not comfortable disclosing I tell them I was born with hypogonadism and take HRT. It give me a way to disclose my drugs without outing myself in a dangerous situation but always find a way to tell and get a medical alert bracelet. All my regular care including hormone refills are done through my GP, if it is something new he doesn't know then he send me to a specialist of my choosing. Congrates on the T buddy.
->-bleeped-<-boy
