Susan's Place Transgender Resources

It's been 7 months since my GRS with Dr. Chet and I'm doing fine.  I do two dilations each day (his instructions say 3 should be done) one in the morning when I wake and another in the evening.  It seems to be working out fine.   I know that I'm supposed to keep going for a year (or more, I forget), but I'm wondering if that's going to be necessary.  Everyone's body is different, so I'm not convinced that the guidelines need to be followed to the letter in every case.  Even after just 7 months, dilations are pretty easy for me.  I've not lost any depth and the shrinkage of the scar encircling the entrance to my vagina is getting easier and easier to stretch open.

My question is:  How does one know when daily dilations are no longer needed?  Is it a matter of skipping a day to see how my vagina feels when I resume the next day?  Is it when I no longer need to work up to the #4 stent with smaller ones when dilating?  After 7 months, is there still the risk of losing depth if I dilate less frequently? 

Thanks for any advice/experience you can share.

I would follow your doctors orders, there's a reason they give them. Missing one once in a while isn't a big deal tho.

I always understood that your body would tell you how often you need to do it? If its starts getting difficult do it more, otherwise try less.

Many of my gf had it done at Chett and yes I'm aware that he wants it 3x a day. My gf....and you know who you are,are very independent and they have already switched to 2x a day.

I has my srs done by PAI , Dr Sutin and I only do it 2x a day, as instructed .. its worked well for me and after 4 months I have had sex without problems. I do feel that you need to keep this up for a year. Living in Bangkok I have a second post op examination at 6 months and will await further instructions.

I agree that people are different, some may need three times a day after the first year while there are some out there that dilate once per week.

For the first year I performed dilation three times a day. The following  six months twice a day then now at once per-day and have skipped days.

I am about 5 months post op with Chett.  I started back at work at 2 months and was only dilating twice a day for 4 days and did 3 times a day on Wednesdays and weekends for the next 4 weeks.  Since mid-March (3 months) I have only been twice a day as I can't work and dilate and to be honest, I can't be bothered doing the 3rd dilation on weekends!  It has gone OK.  My progress increasing dilator size was very slow because I was very tight right from the start.  That said, I have been using the No: 4 dilator for a month or so (moved to this way later than Chett's schedule) and everything is fine.  Depth has not changed.

I plan to continue at twice a day for a few more months (maybe at 9 months?) and then see how things are going.  I am so looking forward to once a day.
 

It does seem that each person has their own way of doing dilations.  I think Chet's guidelines are there to cover just about everyone safely.  In my situation, twice a day seems to work fine. 

Recently, I've noticed that I have no trouble at all inserting #3 at the start, so this morning I tried starting off with #4 after a minute of gentle stretching of the entrance scar tissue with two fingers.  It slipped in with no discomfort.  I'm going to continue doing it this way for a few days to see if all feels right. 

The way I see it, there's no reason to make dilation more onerous than it has to be.

Dr. Suporn's GRS post-op instructions (which specifies 'dynamic dilation') includes this:

After 6 months, all patients may reduce their dilation regimen to one Quality Session per day.  Some may choose to reduce this a little, but they should be sure to check the depth at each session and if necessary return to higher frequency if they feel that depth is not being maintained.

I have been using his dynamic dilation technique twice a day for months and find it very effective. It has helped to keep the scar tissue that encircles the opening to my vagina pliable enough to where I only need to use the largest (1-1/4" O.D.) stent.  I can't imagine these scars ever becoming unnoticeable to the touch though. 

Well with me I pretty much did it as a trial and error. At 3 months I started 2x and got used to it pretty quickly, 6 months 1x then every couple months I expanded to every 2 days, then 3 until today I'm once every 3-4 weeks. If you feel the gap is too large try doing it abit more frequently until you get back to a comfortable rhythm.

The more you do in the beginning, the less you'll have to do later on. But your surgeon should know.

Currently I only do it once a month, sometimes even less. And I'm 2 years post-op.

I've reduced my dilations to once a day at bedtime after 7 months since surgery.  So far, so good. 

I dilated 3X a day for two months, then 2X a day until recently.  I've been using the dynamic dilation technique recommended by Dr. Suporn despite having my surgery done by Dr. Chettawut.  I've been using Walmart Equate brand lubrication gel which costs me $1.98 for a 5 oz tube.  For the past 2 months, I have not needed to douche to control odor from bacterial growth.  It seems that good bacteria has taken hold.  I no longer need to use panty shields either.

I switched to coconut oil, it's the best thing I've used. I bought some in bulk, very cheap, that lasts me a lifetime.  :)

I'm now almost 5 months post op. I have a private nurse and she also serves as my assistant in Bangkok. We have used KY jelly and I have 6 inches and use what can be referred to as a number 4 ( Chett standard). My surgery was done at PAI by Dr Sutin.

I'm really interested in using coconut oil and there is a wide variety here ...what type do you recommend. I'm going to talk with Dr Sutin on my 6 month checkup.

Plus my nurse/assistant still douches me after dilation. I've asked her but she said to wait until my 6 month check up.

I ask cos it's feels dry after about 5 inches ...the last inch is a bitch to get there ....feels so dry and it's hard to get lubricants up that far.

Quote from: warlockmaker on June 10, 2016, 11:01:25 PM
I'm now almost 5 months post op. I have a private nurse and she also serves as my assistant in Bangkok. We have used KY jelly and I have 6 inches and use what can be referred to as a number 4 ( Chett standard). My surgery was done at PAI by Dr Sutin.

I'm curious why you use QC?

I've seen a lot of people recommend QC over KY, but you can't buy QC very easily in many places, certainly not in Australia. QC is used by Suporn and I think Dr Chettawut.

Quote from: warlockmaker on June 10, 2016, 11:01:25 PM
I'm really interested in using coconut oil and there is a wide variety here ...what type do you recommend. I'm going to talk with Dr Sutin on my 6 month checkup.

I ask cos it's feels dry after about 5 inches ...the last inch is a bitch to get there ....feels so dry and it's hard to get lubricants up that far.

I've used KY, Almond but currently I only use coconut oil. Just any brand will do.

Pro's: It only melts at body temperatures, so it's easy to apply to the dilator which means less messy. When inserted, it instantly melts and lubricates. It doesn't hurt as much as almond or KY does. It keeps moist, KY seems to dry up quicker. I can do a complete session if I rub the dilator once with coconut oil. It lubricates excellent, better than any lube. When inserting and pushing deeper, it doesn't hurt as much. When intimate, I also use this on partners. The body does respond very well to coconut oil, gynecologists are starting to recommend it even to cis woman. It's cheap. A jar lasts years, long shelf life even when opened. Antibacterial. And: it doesn't smell, and isn't sticky.

Con's: None found so far (Besides that the oil might degrade latex and PU.)

To keep this comment balanced, there are reported downsides (although I don't experience them) see this page (http://goodcleanlove.com/4-reasons-not-use-coconut-oil-lube/).

Quote from: AnonyMs on June 11, 2016, 01:30:07 AM
I'm curious why you use QC?

I've seen a lot of people recommend QC over KY, but you can't buy QC very easily in many places, certainly not in Australia. QC is used by Suporn and I think Dr Chettawut.

I still have a couple of the tubes of QC from Chett.  Once back in Australia, I ordered lube called Optilube from Paralogic.  It is sterile and is sold to those who live with a catheter.  It is as close to QC as I can find and not as watery when warm as KY.  Cheaper than KY too. 

I am a Chett girl... Almost 5 months post op... honestly.. I am at twice a day and some days just once a day.  I am dating now so that does help a little...
I will try to stay twice a day for at least a year... then most likely go to once a day.

It does help to dilate before sex actually... easier to have fun and relax... because your not so tight
Keri

It is not advised to go on experimenting. I learned it the hard way... What I learned from experimenting is that it's a bad idea. At 6 months I started to spread it out over once a month to see what would happen, but it got narrower and it took me a few extra months get back where I was. Only after 1 year I was able to do it once a month. 12 months seems to be a certain moment where the body seems to "give up" in remodeling that area, and let's go of it. Which coincidentally is the same amount of time for a scar to be completely mature and remodeled. Dilation prevents the body from remodeling the area too tightly, it's like stretching a scar in some sense. After 12 months it's only maintenance: stretching the skin to keep it used to being stretched.

I would agree that it's not a good idea to make a big change in your dilation routine.  Gradual changes with careful monitoring should be okay, though.  I tried reducing my dilation from twice to once a day after 5 months and found out rather quickly that I wasn't ready.  So back to 2X a day.  Recently, at 7 months post-op, going to once a day is working out well.  I don't see the point of doing it more often than is necessary, and it sure is nice to free up the morning time slot to get on with my day.

I measure my depth by observing how far up the stent the lube is pushed at depth with my legs always in the same position during the dilation exercise.  I notice a routine variation of about 1/4 inch day-to-day.   Last night I could only manage a penetration depth of 5-1/2" (Chet's #4 stent), so I did another dilation this morning and was able to reach the normal 6" mark.  I have no idea why there would be 1/2" difference over barely 8 hours.  I pushed with equal force on both occasions. I decided that whenever I have a short penetration, I'll do an extra dilation that day until the depth returns to 6".  I'll be 8 month post-op next week.  The scarring around the vaginal opening is still quite apparent, but it is becoming easier to stretch open the opening to insert the stent.  If I don't rush the insertion, there's no pain involved.

15 years ago post op. I hadn't dilated for years, and was concerned about depth/width so I did it again the other day.  I was amazed I had apparently not lost any depth or width! Not something I recommend though.  Remember, skin can be made to stretch longer & deeper if you take it slowly, don't push or tear anything.   My partner on the other hand has nearly completely atrophied from never dilating, so I think its all personnel.  It was her choice not to.