Susan's Place Transgender Resources

Community Conversation => Transsexual talk => Female to male transsexual talk (FTM) => Topic started by: spacerace on August 11, 2013, 02:20:42 PM

Title: combined bottom surgery procedures/hysto questions
Post by: spacerace on August 11, 2013, 02:20:42 PM
The simple meta Bowers does seems really appealing to me as it seems the meta complications revolve around the urethral lengthening part of the procedure. I could also always get it done later.

One thing though - the hole has to go. What happens after the simple meta, it is just there hanging out under the testicle implants? That seems even worse in some ways. Anyone know if Bowers ever does a vaginectomy with the simple meta, or if it is possible to have another surgeon do the vaginectomy at some point afterwards? Just the vaginectomy, not anything else.

Also - one hysto question. There seems to be mixed opinions about leaving the ovaries in. I understand it is good because if there is no T access, you will still have hormones circulating. But what about cancer risk? Aren't the ovaries prone to this? What reasons are there for taking them out too?

I didn't post this in the bottom surgery forum because not many people seem to visit it.

EDIT: Apparently the vaginectomy has its own set of serious complications. :(  No way to avoid risk I guess. Still curious what it is like down there with it after the simple meta without the vaginectomy.

Title: Re: combined bottom surgery procedures/hysto questions
Post by: Jack_M on August 11, 2013, 05:59:02 PM
There's actually no studies on risk of cancer. It's more just a maybe. They suggest you get them out, and in some places that's what gets you the right gender marker and also it means you can avoid the dreaded pap smear (if they actually take out the cervix too, if you get a hysto you should make sure because it's not always the case!) As for risk, it's really only proposed as a maybe. There's no real evidence to show cancer risk, so it's more up to the individual.

Rest: I dunno! Sorry!
Title: Re: combined bottom surgery procedures/hysto questions
Post by: Soren on August 11, 2013, 06:50:20 PM
If you get testicles, I believe they close it up first as part of the procedure.

The thing with the ovaries is that ovarian cancer is pretty much impossible to find until it's lethal, moreso if the doctors have no access to the area. However, your body needs a certain amount of sex hormones to stay healthy- whether it's estrogens or androgens, your body will convert them as needed.
Title: Re: combined bottom surgery procedures/hysto questions
Post by: Simon on August 11, 2013, 07:11:38 PM
I've been looking into the cheap simple meta with Dr. Bowers for a little while now myself. It doesn't include the testicle implants, scrotoplasty, or vaginectomy. The simple meta with her is just a clitoral release. No thrills, no frills. I'm thinking about going that route first because I don't want to pay for a meta with everything (urethral lengthening etc) and then be unsatisfied with the results. At least doing the simple first there is a way to see what you've got and either stop or go from there.

As far as the hysto, I went ahead and have had everything removed. Technically you could live without hormones after you had your ovaries removed if you had to (think about cats & dogs that are neutered). Our adrenal glands emit enough hormones to keep us alive BUT without synthetic hormones afterwards you would be very sluggish, bone health could suffer, and there could be weight gain. Basically afterwards you're going to want to take hormones so you don't feel like crud all the time.

Title: Re: combined bottom surgery procedures/hysto questions
Post by: spacerace on August 11, 2013, 08:56:26 PM
Quote from: Soren on August 11, 2013, 06:50:20 PM
If you get testicles, I believe they close it up first as part of the procedure.

Getting rid of it without the additional surgery would be fantastic - I'm surprised it doesn't need to be open when it is still there to let it 'breathe', for lack of a better way to put it. (what terrible imagery - sorry)

Quote from: Soren on August 11, 2013, 06:50:20 PM
The thing with the ovaries is that ovarian cancer is pretty much impossible to find until it's lethal, moreso if the doctors have no access to the area. However, your body needs a certain amount of sex hormones to stay healthy- whether it's estrogens or androgens, your body will convert them as needed.

Not a great choice to have to make.

Quote from: Si on August 11, 2013, 07:11:38 PM
I've been looking into the cheap simple meta with Dr. Bowers for a little while now myself. It doesn't include the testicle implants, scrotoplasty, or vaginectomy. The simple meta with her is just a clitoral release. No thrills, no frills. I'm thinking about going that route first because I don't want to pay for a meta with everything (urethral lengthening etc) and then be unsatisfied with the results. At least doing the simple first there is a way to see what you've got and either stop or go from there.

Yeah I think you were the one that posted something about it that even made me aware of it in the first place. I would add-on the implants with the release. I saw the surgery quote on her website, but I wonder how much the implants add to that cost.

Probably really too soon for me to worrying about this, but so far this is the only bottom surgery procedure I've had any interest in. Also, Bowers seems like someone I could really trust to be my surgeon, and I like that the surgery would be done in the U.S. The price is nice as well.  Here's hoping she still does the surgery in two years when I could be ready for it after enough time for downstairs changes.
Title: Re: combined bottom surgery procedures/hysto questions
Post by: Simon on August 11, 2013, 09:19:40 PM
Quote from: spacerace on August 11, 2013, 08:56:26 PM
I would add-on the implants with the release. I saw the surgery quote on her website, but I wonder how much the implants add to that cost.

Here's hoping she still does the surgery in two years when I could be ready for it after enough time for downstairs changes.

The thing I see that most guys don't understand is this isn't a one time thing. It is multiple procedures depending on what exactly you want. I'm going to add a link to Dr. Meltzer's page where he explains scrotoplasty. It is a multiple time procedure before you can get the testicular implants. That's why I'm going for just the release at first and then go from there. My thinking is after a release I can pump for a couple years while saving up for something else down the line...or maybe, just maybe be happy with what I have after that with nothing else required (fingers crossed).

It's just soooo much money to get bottom surgery. I was watching a YT video the other day and someone asked a guy how much his meta (he had a hysto and meta with urethral lengthening. Nothing else.) and it was around 40G he said. He went to Dr. Bowers. There is always overseas which is cheaper but I dunno. I had a short flight home once after a surgery and it was hell. I can't imagine having a 16 hour flight after one. Then what if you get half way around the world and there is a complication? It's all a lot to decide.

The link I mentioned:

http://www.tmeltzer.com/Surgeries_Procedures/ftm_surgeries/lower/scroto_ftm.html
Title: Re: combined bottom surgery procedures/hysto questions
Post by: spacerace on August 11, 2013, 11:25:51 PM
Several doctors do the testicle implants in one stage surgery at the same time as the simple meta - including Bowers as far as I know. Djordjevic in Serbia for sure does it at the same time as a full meta. Bowers wants you to come back for the implants if you do the ring instead of the simple.

Bowers does hysto, simple meta and testicle implants all in one go. All of it together could add up for sure. She also does a ring meta.

I think out of the three of them price wise Serbia guy is cheapest, then Bowers, then Meltzer. Meltzer is $40k++ I believe.

I would not want to deal with being overseas for a surgery of this level.


Title: Re: combined bottom surgery procedures/hysto questions
Post by: Simon on August 11, 2013, 11:44:35 PM
Quote from: spacerace on August 11, 2013, 11:25:51 PM
Several doctors do the testicle implants in one stage surgery at the same time as the simple meta - including Bowers as far as I know. Djordjevic in Serbia for sure does it at the same time as a full meta. Bowers wants you to come back for the implants if you do the ring instead of the simple.

They all need to get together and decide on one way to simplify all of this for us, lol. I know I've mentioned Bowers but I'm also considering McGinn. She has good results as well. Serbia is out of the question for me too.
Title: Re: combined bottom surgery procedures/hysto questions
Post by: aleon515 on August 12, 2013, 09:46:43 AM
Dr Crane is another one who does this (CA). I had a friend that got a (more complex) meta from him and is pretty happy with it. I believe he said he doesn't have an opening there. I do believe there is no proof that T causes this stuff. I think there is a self-care issue with guys not wanting to go to the gyno. If someone can do a complex meta they can do the simple one. My understanding is the simple does not involve the urethra. There are a lot of possible parts to leave out or add.


You might search for "Hung Jury" about bottom surgery. There is more stuff on phallo but they do talk about meta. There's also a book and movie (ok not the movie, just movie) :)

--Jay
Title: Re: combined bottom surgery procedures/hysto questions
Post by: spacerace on August 12, 2013, 11:26:17 AM
I am going to have put into effort to get that area right above really really lean. Apparently it significantly helps your results look better - makes sense. It is really hard to lose weight in that area so far for me though - I am hoping it is part of the fat that redistributes along the way.
Title: Re: combined bottom surgery procedures/hysto questions
Post by: Arch on August 12, 2013, 12:32:09 PM
Quote from: aleon515 on August 12, 2013, 09:46:43 AM
I do believe there is no proof that T causes this stuff. I think there is a self-care issue with guys not wanting to go to the gyno.

I've run into a lot of guys who just don't go. Even if they have exactly the same risk factor as a cis woman (and no higher), that's an unnecessary risk, as far as I'm concerned. But it's their choice.
Title: Re: combined bottom surgery procedures/hysto questions
Post by: spacerace on August 12, 2013, 12:34:57 PM
Quote from: Arch on August 12, 2013, 12:32:09 PM
I've run into a lot of guys who just don't go. Even if they have exactly the same risk factor as a cis woman (and no higher), that's an unnecessary risk, as far as I'm concerned. But it's their choice.

I have never had a pap smear or pelvic exam... I was surprised they didn't ask me about it at the T appointment. Probably time for one, ugh.
Title: Re: combined bottom surgery procedures/hysto questions
Post by: aleon515 on August 12, 2013, 01:22:35 PM
I was DEFINITELY asked in my T appt also given a script for mammogram.

--Jay
Title: Re: combined bottom surgery procedures/hysto questions
Post by: Arch on August 12, 2013, 06:23:34 PM
When I had my top surgery consult, I switched off something in my brain and just let the surgeon poke around my chest and mark it up. I let it all hang out and was able to be very matter of fact about my chest. Maybe knowing that the consult was an absolutely essential step toward getting the things removed made that possible.

I like to think that if I were preparing for bottom surgery/hysto, I would be able to be examined down there without getting all freaked. I imagine that the surgeon will have to look down there over and over because of the multiple stages of surgery. But I don't know. The way I get when I have a Pap and an exam is not a very hopeful indicator.

Spacerace, if you are very young, if you are not sexually active, and/or if you have tested negative for HPV, you might escape the Pap test, but be prepared for someone to ask you to be looked at down there at some point. My own clinic tends to make hormones conditional: if you want hormones, you will schedule the exam. But it doesn't seem to be a hard and fast rule. I know a trans guy who says that he told them he absolutely will not go--and he claims that they just keep giving him hormones. Yet I was pressured to get an exam even before my regular doc thought I needed one, and one of my friends was told that he needed to be seen. He was questioned about it repeatedly, and he has PTSD about it because of a rape a few years ago. But still they made him go.

Sorry to derail...
Title: Re: combined bottom surgery procedures/hysto questions
Post by: Chaos on August 12, 2013, 06:42:56 PM
I plan to go release first anyway and give some time for growth then proceed.On a personal note,unless i can find someone to do a hysto before then-ill be having to pay extra in order to have it removed when GRS time comes.I figured i would have to *jump around* in order to get all methods done that im seeking *lengthening ect* i wouldnt personally,feel comfortable with any left inside *female organs* no matter if its ovaries,cervix or anything else.It would allow me to sololy focus on complete change over,minus the fact that i have sever PCOS and my body feels like its trying to reject the whole thing anyway.I plan to go step by step as i move up that ladder,starting with release then complete hysto then so on and so forth.if that means jumping from one surgeon to the next,oh well lol
Title: Re: combined bottom surgery procedures/hysto questions
Post by: Simon on August 12, 2013, 06:45:06 PM
Quote from: Arch on August 12, 2013, 06:23:34 PM
When I had my top surgery consult, I switched off something in my brain and just let the surgeon poke around my chest and mark it up. I let it all hang out and was able to be very matter of fact about my chest. Maybe knowing that the consult was an absolutely essential step toward getting the things removed made that possible.

I like to think that if I were preparing for bottom surgery/hysto, I would be able to be examined down there without getting all freaked. I imagine that the surgeon will have to look down there over and over because of the multiple stages of surgery. But I don't know. The way I get when I have a Pap and an exam is not a very hopeful indicator.

I really didn't flip out about being examined down there before my hysto until I had a trans-vaginal ultrasound. They wanted to do a third the day before my hysto and I flat out refused and wanted to know why. After a pap smear, cervical punch, and two ultrasounds I really felt that they knew everything there was to know about my junk. The only thing positive I can say about exams down there is they're generally very brief.

I'm really nervous about being examined for top surgery. Even more so then having a doc look down below. Why? I think it is because I spend so much time making sure my chest is hidden from the world. My gf rarely sees me without a shirt on (she does see me without a binder because I refuse to be uncomfortable in my own home). Add to that the fact that my chest is getting really hairy and I can't shave it because it breaks me out and I just feel really dysphoric and nervous about having them examined...and touched (gag) by the surgeon.
Title: Re: combined bottom surgery procedures/hysto questions
Post by: Arch on August 12, 2013, 07:36:39 PM
Funny how different guys have different reactions. A part of me says that *of course* the bottom half is more dysphoria-inducing than the top half, but I know it ain't so for everyone. I have friends who never intend to have any kind of bottom surgery, and I can't imagine feeling that way because I feel so strongly the opposite.

I hate that I want/need phalloplasty. Why can't I be happier with meta or even nothing at all? Why go this route?

It's just what I must do.
Title: Re: combined bottom surgery procedures/hysto questions
Post by: Jack_M on August 12, 2013, 09:18:50 PM
For me I want a phalloplasty so bad, but I know the forearm is the best site to use and I personally hate how it leaves you with a huge, noticeable scar.  Every time I feel like, "Yeah, definitely want it!" I usually go back to thinking about how much I don't want the scar! :-/

Also, with regards to pap smears: if you are a 'true virgin', as in you've done NOTHING with someone else down there (petting, oral, skin-to-skin genital contact, or anal), you've never smoked, and don't have a family history of it, then you don't actually need a pap smear.  It's only said that after 21 you should get one because, well, people aren't honest!  Lol.

I've never had one because I was asked was when I was 18 and I told them I was a true virgin.  Since then, I just continued saying that and they never pushed it.  It's not that I fear it in a way that I MUST avoid it, if I needed it, I'd man up, it's just a completely unnecessary procedure for me.  ~99% of cervical cancer is spread via HPV and the other tiny percentage is from mother to baby, but in most cases that clears up on its own which is why it's so rare.

So if you're what they refer to as, 'true virgin', have never smoked, and don't have a family history, then don't worry.  You may get asked for one in the future, in fact I bet it comes up for me at some point, but it's nothing to worry about if you've not had one.