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Hi all, I had my srs on May 31st, today I decided my swelling had gone down enough that I would compare it to internet pics (ie labialibrary). While doing so, I've found something wrong with the anatomy - my vaginal opening is outside my labia. Without a pic, the best way I can explain is:

(o) - 'normal' vulva

( )
o - my vulva

I'm feeling heartbroken rn, that all this time and effort has been for this. Is this something revision surgery/labiaplasty can fix? Im only 22 but now I'm considering never letting anyone see it of I can't be made right

May we ask who you went to ?


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Phil Thomas, in the UK

This, like you explained it with () and o under, is the usual result of penile-inversion based techniques. If you look at SRS results online, this is the common shape, as penile flap is inverted, it means that labia minora starts above vaginal entrance, instead of being all around vaginal entrance. I dont want to ask any inappropriate question, but how come you were not aware of this before surgery? I mean, you were shown photos of your surgeons previous results?

How much can be this improved with revision depends on your anatomy. Experienced SRS surgeons have experience with this, as many patients come back dissatisfied with exactly the same thing as you are. But there simply arent many post-revision photos out there, even less before-after results. Maybe the best chance to see what can be done, is consult with surgeons, and ask to see pictures.
One way this can be improved, is to use some of labia majora skin, and make it into a fold, starting from lower end of vaginal entrance up until above vaginal entrance, where they can join it with labia minora. I cant promise you anything. Best that you can do now is wait until you are healed enough, that your surgeon can give a fair evaluation on what can be done and corrected. Until you are fully healed he can only speculate on what he will and will not be able to do.

Best wishes

The OEM vaginas I've had the pleasure of knowing all had the "o" in the lower half of the "( )". The upper third or so was the clitoral area.

Does the L majora just need lengthened?

Quote from: mmmmm on June 27, 2016, 02:15:24 PM
This, like you explained it with () and o under, is the usual result of penile-inversion based techniques. If you look at SRS results online, this is the common shape, as penile flap is inverted, it means that labia minora starts above vaginal entrance, instead of being all around vaginal entrance. I dont want to ask any inappropriate question, but how come you were not aware of this before surgery? I mean, you were shown photos of your surgeons previous results?

How much can be this improved with revision depends on your anatomy. Experienced SRS surgeons have experience with this, as many patients come back dissatisfied with exactly the same thing as you are. But there simply arent many post-revision photos out there, even less before-after results. Maybe the best chance to see what can be done, is consult with surgeons, and ask to see pictures.
One way this can be improved, is to use some of labia majora skin, and make it into a fold, starting from lower end of vaginal entrance up until above vaginal entrance, where they can join it with labia minora. I cant promise you anything. Best that you can do now is wait until you are healed enough, that your surgeon can give a fair evaluation on what can be done and corrected. Until you are fully healed he can only speculate on what he will and will not be able to do.

Best wishes

I wasn't aware that this was "the usual result" of penile inversion. Before this thread, most cosmetic issues I'd read about was the vaginal opening being slightly ajar when legs are spread a bit. Just curious if you have a source? (I'm scheduled for PI in a year).

If you look at SRS results photos online, this will likely be the best source. 

As for labia majora lenghtening.. Its not labia majora that is the problem (except if I misunderstood Kyla), its labia minora. You cant simply lenghten and stretch it further down (at least not by much), as lower part of skin flap is inverted for vaginal wall, and upper parts are labia minora and hooding. From what I understand (and I could be wrong), the only real option that surgeons can do is to take some of the labia majora skin, and basically fold it into labia minora. This is what one surgeon told me. Maybe other surgeons know a way how to do it differently, at least he wasnt aware of any.


Beth, I believe you should discuss such aspect of your surgery during pre-op consultation(s). Some surgeons like Bowers, Satterwhite, Schaff and some other european surgeons, are already advancing their PI technique for  improving this issue. The main idea is simply to use more penile skin on the outside for longer labia minora, and less penile skin for vaginal wall, and compensate for consequent lack of depth with larger scrotal graft. There just arent many latest photos available from these surgeons, so we can only speculate how this more recent results look like, while we can look at the older photos (unless those who have a chance to see recent results at consultations).

@mmmmm you're the first person to understand it, yeah the inner labia stops right above my vaginal opening. Is this really that common? From all sources (accounts on internet, surgeon reviews, my own consultation) most neovaginas are indistinguishable from natal ones, how can that be so if the vagina is in the wrong place? I've looked up post-op photos and the few I can find have the vagina within the inner labia :/

i was shown pics at my consultation, but 1) the labia were kinda closed up, so I presumed everything inside was normal and 2) they were really really hairy so details were hard to notice.

Sadly we cant post pics or link to the pics... But make sure you look at photos from surgeons who do penile-inversion based technique, not Chettawut or Suporn or some other Thai surgeons, thats a different technique (all penile skin is used for labias, hooding and vaginal entrance). If you look only at penile inversion technique, you will see that this is the usual result (surely there are many variations between results, and you actually need a photo with legs spread to see the labia minora definition)...

Its not that vagina is in the wrong place. Vagina is in the right place. Its just that labia minora are not anatomically correct (anatomically correct in comparison to cis female vaginas). 

...about that "indistinguishable from natal ones"... Yes, people like to say that. But people also often arent concerned with details, and anatomically correct aspects. When you stand, legs close, labia majora will be closed together, and everything will look indistinguishable from cis female vagina. Many people arent concerned with anything other than that. But with legs wide spread and someone who understands the anatomy and knows what to look for, not so manyy will look indistinguishable anymore. The closest thing (meaning practically almost all anatomical aspects are correct) are Suporn vaginas and Chettawut vaginas AFTER secondary revision for anterior and posterior commissure (hooding and fourchette).

I knew the vaginal openibg would be further down cos of pelvis stuff, but I thought that meant they mived the whole vulva down too... Not just the vagina itself. Since this realisation, Ive been lookibg at other pics. Even with the labia closed, none have the hole below them like I do. Tbh I am on 3*day dilating so its mega obvious, but on them its non-existant.

When I heard 'indistinguishable' I took it to mean the average guy wouldnt notice. I'm pretty sure anyone who knows whats up would clue on when the anatomy is this mixed up. Or do stealth women not actually have sex?

I wish I had been told this beforehand...

Quote from: mmmmm on June 27, 2016, 03:23:55 PM
If you look at SRS results photos online, this will likely be the best source. 

...

I have looked at many "before and after", and saw one example of this. The others were all pretty close to standard.

Quote from: mmmmm on June 27, 2016, 02:15:24 PM
This, like you explained it with () and o under, is the usual result of penile-inversion based techniques. If you look at SRS results online, this is the common shape, as penile flap is inverted, it means that labia minora starts above vaginal entrance, instead of being all around vaginal entrance. I dont want to ask any inappropriate question, but how come you were not aware of this before surgery? I mean, you were shown photos of your surgeons previous results?

This is just incorrect. Aesthetics vary from surgeon to surgeon as well as from person to person.

Of course aesthetics vary from person to person and surgeon to surgeon (Im not saying anything about that). But that doesnt change the fact where labia minora begins with penile inversion and how it goes all around vaginal introitus in cis-female, and closes together at the bottom as fourchette, which could probably be taken as anatomically correct. Or am I wrong?

I dont know which photos you were looking .. I went and rechecked, and at dr. Bowers gallery and dr. Mcginns gallery, there wasnt one example out of all fully healed results, that would have (o) labia minora. Most of them had labia minora either starting at the top of "o" or literally coming out of the top of "o". In some results was labia minora practically separarated from vaginal entrance. Maybe we are not looking at the same photos. If you go to PAI penile-inversion section, you have a very good looking penile-inversion result published there, despite the fact that it has typical penile-inversion appearance. 

mmmmm a lot of surgeons discard excess skin regardless of technique, what they make the vaginal canal out of does not dictate what the rest looks like.

there's no way you can tell the difference between a 70/30 60/40 90/10 scrotal + penile combo or a 20/70/10 groin + scrotal + penile canal or even 100 penile. Meshing vs non meshing has more relevance, was the patient circumcised, how much skin did they have to work with. How long were they on hrt.

To the op wait and see how it settles 3 months is a good idea. revisions are common, I recently was talking about width with my surgeon and he said the positioning of the vagina canal is a compromise between aesthetics and function, his preference was aesthetics and making it so most penis sizes would fit. Maybe your bone structure required it to be lower, maybe the surgeon just prefers to do that way. That's something only they can answer. I'm sure they will do a revision if you want it.

@mmmmm I'd never looked at any us surgeon bc I read that since every surgeon used different techniques it wouldn't accurately reflect what I would get. The pics I looked at were generic, with no surgeon's name attached. I've just been and looked, and you're right, they do have a similar structure (my vagina is still outside the outer labia but theyre still healing). They still dont look like natal vaginas tho. I dont get why people say they do.

@serenation I hope I can get one, I've heard Thomas can be stingy with revisions cos of the NHS thing

OP--

May 31st is less than a month post-op. Give it some more time to heal.

People say they look OEM because that's often the feedback they get from others, even when they don't know a person's Trans status.

Keep in mind that vulvas, like penis, come in all sorts if shapes and sizes, some visually appealing and some less so. But, they're all good if they are otherwise healthy and functional (and even that has some variability).

Be sure to love your body and all of its parts... :)

Quote from: mmmmm on June 27, 2016, 04:02:06 PM
Sadly we cant post pics or link to the pics... But make sure you look at photos from surgeons who do penile-inversion based technique, not Chettawut or Suporn or some other Thai surgeons, thats a different technique (all penile skin is used for labias, hooding and vaginal entrance).

For people coming new to this thread it's important to note that lots of us do not agree with mmmm's assessment of so-called penile inversion. Most surgeons, esp in Thailand, now perform a combination of techniques which are constantly refined. Mmmm is rather behind the times in this regard. PAI (Preecha) institute for instance do either a colon graft or a peno-scrotal inversion which incorporates some of the techniques pushed by Dr Suporn. An abstract (without 'nudity') of the Preecha institute can be found here: http://www.ncbi.nlm.nih.gov/pubmed/25356769
If you want to see the full article which has graphic pictures of their surgical SRS technique there is a link on the abstract.
It's a myth to push the idea that such-and-such a surgeon has a dramatically new or different technique. They don't. Differences nowadays are very minor.

Back to Kyla's agony. The first thing to say is that there is massive variety in cis-female vaginas. I've seen so many different types that there really isn't a standard natal vagina.

That having been said, I would have thought some revision in a little while should be more than possible, perhaps by extending the labia as has been suggested above?

Take care hon and push for some revision x

(I disagree with that opinion of penile inversion as well, but as the only way to disprove it would be to post pics of my genitalia to the internet, I've accepted that I won't be able to convince some people. :) )

There are cis women who lack the fourchette as well. (The fourchette is, as has been explained, the part where the inner and outer lips come together under the vaginal opening.) Heck, there are cis women who don't have labia minora to speak of. I think there was even a woman on this board whose cis female partner had a vulva that was "less natural" than her own post-op results... which  makes it clear that it's sometimes not worth fretting about what is and is not natural, when the variation in people born with vaginas encompasses such outcomes.

The fourchette is a difficult bit of anatomy to construct in the initial operation because so much stress is placed on it by dilating; I can attest to this personally, as I do have a rudimentary fourchette and dilation actually caused a fairly painful and seriously annoying tear there where the stitches pulled loose from the tension of dilation.

In other words, the results you have gotten *are* within the range of vaginas and vulvas handed out by nature at birth. But if you're still unhappy with it when you're fully healed, you also have the option that cis women do of seeking minor plastic surgery/revision to perfect the aesthetics. However, a month post-op is VERY early, and I also wouldn't leap to any conclusions about what the final results actually will look like. Oftentimes swelling reduces and healing finishes and then the labia settle and drape much more naturally.

I feel like I'm not explaining the problem very well. I have a fourchette, its still healing but I do have one, the problem is that my vaginal opening is below it. Where both labia minora and major meet at the bottom of my vulva, my vaginal opening is below that, theb its straight onto my perianum.

I believe I've seen photo's of the kind of result your describing. I used to do a lot of research on SRS surgeons and I think I found some like that among the Thai results (actually Thai porn). I don't know who the surgeons were. It was long ago and I don't have links. I never found many photo's for the British surgeons.

I've seen photo's of post revision Suporn results (including fourchette), and I while they are very good I can still tell they are a result of SRS.

I'll pm you something.

Kyla : Well, it's not really a "fourchette" unless it *does* meet below the vaginal opening, so that's probably the source of the confusion. I understand now, though - you're saying that the labia do come together, but above the opening.

No, that's not normal or typical (and it's not a usual result of penile inversion, either, where the expected "flaw" would be a lack of fourchette/the labia don't meet at all). However, it should be easy enough to fix simply by undoing the point where the labia connect. As I understand it, revisions that don't require extra material or additional fine detail work are usually much easier than the rest; you may even be able to find a non-GRS plastic surgeon who can open that back up. (If you want the true fourchette constructed below the vagina, that would be more complicated but probably still doable by a GRS surgeon who handles revisions.)

I don't blame you for being unhappy, and this means the comments saying that you should have known it was possible are irrelevant; this is a case of the surgeon *adding* a detail that isn't anatomically correct, which is not something most surgeons will advertise beforehand and not a known issue with penile inversion. (The only other time I've seen what you describe was on a patient of Dr. Rumer's, who very clearly did have the labia meeting and closing up well above the vaginal opening.)

Hi Serenation, what do mean by meshing? Thanks :) Allie

QuoteMeshing vs non meshing has more relevance

As I understand it some surgeons aren't able to create a full labia minora that surrounds the vagina canal in the inital surgery. From everything I've read a labiaplasty aka revision can fix this aesthetic issue.

No matter if things are not anatomically correct. it's best to wait until you are fully healed before considering a revision as with my post operative experience things looked different from hours after surgery to one month then to two months. Even if there is not significant changes you may very well find that the final outcome is acceptable.

Quote from: allie0365 on June 30, 2016, 10:11:49 PM
Hi Serenation, what do mean by meshing? Thanks :) Allie

I'm to queesy to look at mid surgery pics, but suporn basically punches lots of holes in the skin so it can stretch much further, I'm told he does this for the inner labia not just the vagina canal, that's why his the only one that doesn't require grafts from other sources if there's not enough materiel to work with.

Quote from: Serenation on July 01, 2016, 04:26:15 AM
I'm to queesy to look at mid surgery pics, but suporn basically punches lots of holes in the skin so it can stretch much further, I'm told he does this for the inner labia not just the vagina canal, that's why his the only one that doesn't require grafts from other sources if there's not enough materiel to work with.

Surgeons form labias with skin flaps. And this is what average meshing machine looks like:

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fwww.molnlycke.com%2FPageFiles%2F8514%2Fbrennen-skin-graft-mesher.gif&hash=a89e6a024c15e74813114963fa993fd9631b0ed0)

Now, important question! Would you bring a patient to the machine, or would you bring a machine to the patient, to mesh her skin flaps?

Quote from: allie0365 on June 30, 2016, 10:11:49 PM
... what do mean by meshing?

If you go to Dr. Chettawut (who uses normal scrotal graft) you get 6 inch depth. If you go to Dr. Suporn (who uses meshed scrotal graft) you get 7.5 inch from the same scrotum.

"The depth of the neovagina is usually limited by the length of the rectovesicle septum, typically 10 to 12 cm, or about 4 to 5 inches"

"The depth of the typical neovagina created by male-to-female sex reassignment surgery is generally limited by the length of Denonvilliers' fascia,[citation needed] and is reported to be between 11 and 12 cm (4.3-4.7 in), within the range of the natural female vagina."

https://en.wikipedia.org/wiki/Human_vaginal_size

Hint: Your vagina isn't supposed to come out of your back.

Quote from: Devlyn Marie on July 01, 2016, 11:11:40 AM
"The depth of the neovagina is usually limited by the length of the rectovesicle septum, typically 10 to 12 cm, or about 4 to 5 inches"

"Maximum vaginal depth attained with the scrotal skin graft beyond the original position of the peritoneal reflection (Douglas Pouch). A minimum of 6.0" (15.25 cm) vaginal depth is guaranteed immediately after surgery in all cases of SRS. The modal average is 7.0" (17.8 cm) depth."

http://www.supornclinic.com/restricted/SRS/srstechnique.aspx (http://www.supornclinic.com/restricted/SRS/srstechnique.aspx)

"2016 Cadillac Escalade/MPG

Up to 15 city / 22 highway."

It doesn't actually get anywhere near that. It's called advertising for a reason.
Doesn't mean we have to fall for it.  :laugh:

Quote from: Devlyn Marie on July 01, 2016, 11:52:14 AM
Doesn't mean we have to fall for it.  :laugh:

Im happy to show you photos privately :) ... They made photos before surgery (where you can see lack of donor material), during surgery photos, immediately post surgery photos, 1 week after... and I can make a recent one.

 

No thanks. It's just my opinion, but I'd rather have a tight vagina the same size as a  healthy woman than some Wiley Coyote tunnel painted between my legs. To each their own, I guess.

Quote from: Devlyn Marie on July 01, 2016, 12:08:56 PM
I'd rather have a tight vagina the same size as a  healthy woman than some Wiley Coyote tunnel painted between my legs. To each their own, I guess.

Cis female vaginas are able to stretch, especially during arousal. 4" can become 7-8". SRS techniques are not there yet.

Quote from: mmmmm on July 01, 2016, 12:13:17 PM
Cis female vaginas are able to stretch, especially during arousal. 4" can become 7-8". SRS techniques are not there yet.

You think it will ever get to that point ? And if so would the already post ops be able to get it considering they already been snipped ?


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Quote from: TinaVane on July 01, 2016, 12:22:13 PM
You think it will ever get to that point ? And if so would the already post ops be able to get it considering they already been snipped ?

In a way its already possible. Colovaginoplasty with sigmoid colon or jejunal colon segment, makes a lot more cis-female like vaginal wall. Its just a lot riskier surgery, with quite higher rate of complications than more common skin inversion techniques. Partial vaginal prolapse is one of most concerning of those complications. Others are related to simply having more invasive surgery on intestinal area. Large percentage of patients report too excessive discharge, which can require use of panty liners. With sigmoid colon vaginoplasty you get quite visable scar in abdominal area, which can supposedly be avoided with jejunal segment vaginoplasty... In short: it sadly just isnt the ideal option. And for most people, the risks outweights the benefits. It is however commonly used as a revision vaginoplasty for cis and trans women.

Other option is vaginoplasty with mucos membrane as well... mucosa from cultured autologous oral epithelial cells. But its still in very early stages.. There has been various studies done on use for vaginoplasty on cis women, and one study with 6 patients which was done in Italy (2013-2014).. http://www.ncbi.nlm.nih.gov/pubmed/24374675
It showed promising results short term... which sadly turned out for worse later, after papers were released. Study was planned to be repeated, but after all patients had severe complications, it was dropped.   
Still, its probably the best and most promising solution for MTF vaginoplasty in the future... but current science just isnt there yet.


... When it will become common practice, yes, you could have a revision vaginoplasty, if thats what you wish and more importantly need. I just dont see that many, who have otherwise a normal functional vagina, opting for mucosal revision without a very good reason behind it. 

Quote from: mmmmm on July 01, 2016, 12:13:17 PM
Cis female vaginas are able to stretch, especially during arousal. 4" can become 7-8". SRS techniques are not there yet.

Yeah I think this is what makes the sizes misleading. Stretch-ability makes the difference between cis and post op vaginas. That being said, the average cis, even when stretched is probably around 5 to 6 inches (my lady for example, 5 1/2 stretched).  Getting 7-9 stretched for a cis female is probably on the much deeper end, and most likely unnecessary for most guys, even with bigger penises. With big ones, most of the sensation doesn't come from the base of the shaft anyways but from the first 4-5 inches from the glans. Don't ask me how I know  ;D

I get not wanting a deeper vagina. I'm only a little over 5 inches and I'm happy. But generally I find mmmmm to be very reliable, insightful, and smart, not one to give into false advertising. I trust what she says :)

- Ruby

QuoteIf you go to Dr. Chettawut (who uses normal scrotal graft) you get 6 inch depth. If you go to Dr. Suporn (who uses meshed scrotal graft) you get 7.5 inch from the same scrotum.

ah, thanks for the explanation!! What happens as the meshed tissue heals, does it form scar tissue? Could that possibly cause a tightness or constriction?

I'm curious because I'm having consults this fall and hopefully surgery next yea   :P

Quote from: Devlyn Marie on July 01, 2016, 12:08:56 PM
No thanks. It's just my opinion, but I'd rather have a tight vagina the same size as   a  healthy woman than some Wiley Coyote tunnel painted between my legs. To each their own, I guess.

                         X Beep, beep 

Quote from: allie0365 on July 01, 2016, 03:26:31 PM
ah, thanks for the explanation!! What happens as the meshed tissue heals, does it form scar tissue? Could that possibly cause a tightness or constriction?

There is a lot of tissue contraction even with techniques where normal skin grafts are used (flaps make easier recovery in that regard). Use of meshed grafts makes scar tissue contractions even that much stronger. To oppose these contractions, so called dynamic dilation was introduced, which helps to break down scar tissue a lot more efficiently. Regular "static" dilation, simply wouldnt be enough.

Quote from: mmmmm on July 01, 2016, 11:47:11 AM
"Maximum vaginal depth attained with the scrotal skin graft beyond the original position of the peritoneal reflection (Douglas Pouch). A minimum of 6.0" (15.25 cm) vaginal depth is guaranteed immediately after surgery in all cases of SRS. The modal average is 7.0" (17.8 cm) depth."

http://www.supornclinic.com/restricted/SRS/srstechnique.aspx (http://www.supornclinic.com/restricted/SRS/srstechnique.aspx)

Don't believe everything you read from Suporn. His a brilliant salesman. As far depth goes you get what you get. Suporn just has to discard skin if he can't make the cavity as deep as his meshed grafts allows. People go to Suporn and get less than 6 inches, there is no actual guarantee, maybe it's lost in translation but you just go home with less than 6 inches.

If you have any proof of anyone actually getting their srs refunded because of this I'd like to hear it.

Quote from: mmmmm on July 01, 2016, 11:05:53 AM
If you go to Dr. Chettawut (who uses normal scrotal graft) you get 6 inch depth. If you go to Dr. Suporn (who uses meshed scrotal graft) you get 7.5 inch from the same scrotum.

That's probably misleading, the amount of skin available, with or without meshing does not equate to depth.It  It just removes one potential limitation.

This thread has totally derailed into a suporn fest.

Quote from: Serenation on July 01, 2016, 08:29:11 PM
That's probably misleading, the amount of skin available, with or without meshing does not equate to depth.It  It just removes one potential limitation.

This thread has totally derailed into a suporn fest.

Hehe and you just went in for the REAL ...


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 :police:
Lets please be respectful of each other and of surgeons. Bashing and attacking others is against TOS 10 and 15. Lets please keep that in mind. Thanks
Mariah

Quote from: KylaStorms on June 27, 2016, 07:50:33 AM
Hi all, I had my srs on May 31st, today I decided my swelling had gone down enough that I would compare it to internet pics (ie labialibrary). While doing so, I've found something wrong with the anatomy - my vaginal opening is outside my labia. Without a pic, the best way I can explain is:

(o) - 'normal' vulva

( )
o - my vulva

I am having the same stress! I was shown what it would look like and it doesn't!! I am sick over this! I was told I needed a skin graft for depth only. I believe the skin graft would of been used for the labia. I never had it since he said it wasn't needed. Sure I have 6 inches, but I have a constant hole. I am so stressed and depressed over this. It has been only 20 days since surgery, but I don't see it getting better. I had Dr. Burin at the PAI clinic.
I'm also feeling heartbroken!!

Quote from: shellsters on September 20, 2016, 03:18:54 PM
I am having the same stress! I was shown what it would look like and it doesn't!! I am sick over this! I was told I needed a skin graft for depth only. I believe the skin graft would of been used for the labia. I never had it since he said it wasn't needed. Sure I have 6 inches, but I have a constant hole. I am so stressed and depressed over this. It has been only 20 days since surgery, but I don't see it getting better. I had Dr. Burin at the PAI clinic.
I'm also feeling heartbroken!!

A constant hole as in say if you were to douche something up in ur vagina you could not hold the liquid up in there ? But it is still kinda new but I wonder are most of these neovaginas like just a hole where u can't grip it closed


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Shellsters, I would definitely give it time. Brassard says four months *minimum* before there's even a chance of getting an idea of what the final result will look like, and even then it'll be a year or more before the result IS final. Seriously, what it looks like now will probably change almost daily. Swelling in particular can make the labia stick out rather than draping properly, which leaves the vaginal introitus more exposed than is desirable. Please try not to worry too much so soon.

Tina, I think you might want to research the surgery more... but for the record, the vagina is formed by making a space through the muscles in the area, and these are the same muscles that cis women use to squeeze something in or push something out, so trans women by definition have those muscles surrounding the vagina. (I can eject a dilator with some force, or squeeze my wife's fingers until she starts to lose circulation.) That's true of any surgical method, too - the vaginal canal pretty much has to be in that location, regardless of the other details.

Ive had exactly the same thing happen although I had my surgery a few months before you.

It doesn't look too bad now when my legs aren't spread but when I do spread my legs it looks really quite bad.

Also got a problem that i think too much erectile tissue has been left and if i get aroused it causes a lot of discomfort and it swells so much the clitoral area and below extends very far out.

Im going to talk to the surgeon about it as I think this may become a major psychological issue for the remainder of my life.

I dont regret the surgery and am still hopeful I can be fixed though.

If anyone wants more info or anything id be happy to talk.

I have this same result. Vagina below labia minora instead of within. I hesitate to ask my surgeon about this because of two reasons: 1 -  don't want to insult his work. 2 - I was given my SRS through Medicare and the remaining costs were picked up by Financial Assistance.  I feel that for these reasons I should just be happy and not complain. Well, I am happy, but I do wish a revision could be performed. I have pictures on my website showing my surgery result.

Quote from: Violet on April 30, 2019, 02:40:44 AM
I have this same result. Vagina below labia minora instead of within. I hesitate to ask my surgeon about this because of two reasons: 1 -  don't want to insult his work. 2 - I was given my SRS through Medicare and the remaining costs were picked up by Financial Assistance.  I feel that for these reasons I should just be happy and not complain. Well, I am happy, but I do wish a revision could be performed. I have pictures on my website showing my surgery result.

You should complain.  Your surgeon agreed to do the surgery for the price he insurance wanted to pay for it.  This has nothing do with the outcome!  The surgeon seemed to have made a mistake, and it needs to be corrected.  Periode!

If you buy a low cost car, you would not be OK with it missing a wheel, why should you accept that from surgery?

Quote from: Violet on April 30, 2019, 02:40:44 AM
I have this same result. Vagina below labia minora instead of within. I hesitate to ask my surgeon about this because of two reasons: 1 -  don't want to insult his work. 2 - I was given my SRS through Medicare and the remaining costs were picked up by Financial Assistance.  I feel that for these reasons I should just be happy and not complain. Well, I am happy, but I do wish a revision could be performed. I have pictures on my website showing my surgery result.

I noticed this, too, with mine from the same doctor. However, when I had my office revision he kind of "cut" the inner labia along the bottom seam and restitched it, and after that things look MUCH more "normal" anatomically. Before the office labiaplasty my vaginal opening looked like a separate "hole" beneath everything the inner labia, but now it is framed almost completely and (I am told by the various men in my life) looks pretty much like anybody else. While I am sure that there will always be anatomical differences, I am far happier with my cosmetic result at this point. I am also VERY orgasmic, which to me was the big thing. I am still having minor urinary issues that I think may need to be addressed later however.

Quote from: Violet on April 30, 2019, 02:40:44 AM
I have this same result. Vagina below labia minora instead of within. I hesitate to ask my surgeon about this because of two reasons: 1 -  don't want to insult his work. 2 - I was given my SRS through Medicare and the remaining costs were picked up by Financial Assistance.  I feel that for these reasons I should just be happy and not complain. Well, I am happy, but I do wish a revision could be performed. I have pictures on my website showing my surgery result.

It is not an unusual result from penile inversion technique. In fact I would say it is pretty typical.  Non-inversion technique results in a much more natural looking vagina with the labia coming further down. You will notice this with Thai surgeons who do non-inversion technique.

But like the previous poster AutumnLeaves wrote, a revision surgery can likely improve the aesthetic result for you. IMO penile inversion really is a 2 stage technique that always requires an aesthetic revision. That's how it used to be too, many years ago.  But for some reason most surgeons who do it these days just do it in one stage and say "good enough".  My guess is because a 2 stage procedure or a revision surgery costs more money. So if you can afford it, get the revision.

I sent my Doctor a second message to inquire about a revision. While I am very grateful for the surgery I am not happy with with the results. My vagina just doesn't look normal. I am extremely depressed after all I went through to get the surgery and now this.  :embarrassed:

Quote from: Dietlind on April 30, 2019, 08:42:00 AM
You should complain.  Your surgeon agreed to do the surgery for the price he insurance wanted to pay for it.  This has nothing do with the outcome!  The surgeon seemed to have made a mistake, and it needs to be corrected.  Periode!

If you buy a low cost car, you would not be OK with it missing a wheel, why should you accept that from surgery?

I was hoping I wouldn't need another surgery, but if this can be fixed then I am so ready. After transitioning for nearly 5 years now I am ready for the medical part of it to be done. My vagina just doesn't look right. I am happy with it though, but I just wish it could be made more realistic like Autumn Leaves mentioned.

Quote from: echo7 on April 30, 2019, 11:38:11 AM
It is not an unusual result from penile inversion technique. In fact I would say it is pretty typical.  Non-inversion technique results in a much more natural looking vagina with the labia coming further down. You will notice this with Thai surgeons who do non-inversion technique.

But like the previous poster AutumnLeaves wrote, a revision surgery can likely improve the aesthetic result for you. IMO penile inversion really is a 2 stage technique that always requires an aesthetic revision. That's how it used to be too, many years ago.  But for some reason most surgeons who do it these days just do it in one stage and say "good enough".  My guess is because a 2 stage procedure or a revision surgery costs more money. So if you can afford it, get the revision.

Quote from: Violet on April 30, 2019, 11:12:14 PM
I was hoping I wouldn't need another surgery, but if this can be fixed then I am so ready. After transitioning for nearly 5 years now I am ready for the medical part of it to be done. My vagina just doesn't look right. I am happy with it though, but I just wish it could be made more realistic like Autumn Leaves mentioned.

Hi Violet

I understand how you feel as I have the same result and have to consider if I want a revision to "fix" this part however with my surgeon I am told 12 months minimum before revision would be considered. However other than the vagina not being within the labia minora I am very happy with the way things look and really am not sure if I want yet another surgery. I am really at the point where I am sick of it all and I have still have at least one more surgery coming up(not trans related) in the next month or so.  I think you are entitled to complain and make it known you are not happy with the result.

Liz

Thank you Liz. I don't want another surgery either, but if it will help the aesthetics then I will. Thought I was done though. I don't know yet if Medicare will cover a revision surgery. If they don't there is no way I can afford it. This "separate hole" is causing me much depression and stress. I try not to think about it, but I still do. What bothers me the most id that I know of two girls that were given revisions at 6 months post-op. They have the same Doctor as I. Why haven't I been offered a revision? Possibly because I am on Medicare?

Quote from: LizK on May 01, 2019, 03:39:05 AM
Hi Violet

I understand how you feel as I have the same result and have to consider if I want a revision to "fix" this part however with my surgeon I am told 12 months minimum before revision would be considered. However other than the vagina not being within the labia minora I am very happy with the way things look and really am not sure if I want yet another surgery. I am really at the point where I am sick of it all and I have still have at least one more surgery coming up(not trans related) in the next month or so.  I think you are entitled to complain and make it known you are not happy with the result.

Liz

Good question...why haven't you been offered one. These things can eat away at you and after everything you have to go through to get the surgery it can be very disappointing to find what seems like a mistake could easily be seen as a feature but getting the Fixed becomes an issue. From the outside looking in it can be very frustrating. I hope you get revision

Take care

Liz



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Thank You Liz. One way or another I must get it fixed because this situation is really starting to screw with my head. Like you said, this is eating away at me.

Quote from: LizK on May 01, 2019, 11:15:54 AM
Good question...why haven't you been offered one. These things can eat away at you and after everything you have to go through to get the surgery it can be very disappointing to find what seems like a mistake could easily be seen as a feature but getting the Fixed becomes an issue. From the outside looking in it can be very frustrating. I hope you get revision

Take care

Liz



Sent from my iPhone using Tapatalk

Quote from: Violet on May 01, 2019, 10:32:38 AM
Thank you Liz. I don't want another surgery either, but if it will help the aesthetics then I will. Thought I was done though. I don't know yet if Medicare will cover a revision surgery. If they don't there is no way I can afford it. This "separate hole" is causing me much depression and stress. I try not to think about it, but I still do. What bothers me the most id that I know of two girls that were given revisions at 6 months post-op. They have the same Doctor as I. Why haven't I been offered a revision? Possibly because I am on Medicare?

I have Medicare, too, so it should be covered. I had to ask Dr. Dugi about the revision and explain what was bothering me. I think my case had been especially extreme since my labia minora seemed like they "fused" a bit when I was healing. Fortunately the revision surgery was done in-office under local anesthetic, so it was in-and-out and had none of the healing and pain like in the original procedure. However, he told me for anything more major I would have needed general anesthetic.

Hope this helps!

That helps a lot! Thank you Autumn. Unfortunately they are making me wait until August before my revisions can be discussed. That's too long for me, but I have no choice. How did you get yours fixed so fast?

Quote from: AutumnLeaves on May 02, 2019, 03:23:01 PM
I have Medicare, too, so it should be covered. I had to ask Dr. Dugi about the revision and explain what was bothering me. I think my case had been especially extreme since my labia minora seemed like they "fused" a bit when I was healing. Fortunately the revision surgery was done in-office under local anesthetic, so it was in-and-out and had none of the healing and pain like in the original procedure. However, he told me for anything more major I would have needed general anesthetic.

Hope this helps!