I had SRS 4 months ago as of posting this. I originally wrote this information to be put with the information package you get from Andrew in the months before surgery but I will post it here.

First off though, Here are some interviews with Andrew were you can get to know him, his technique, what he does and where he trained. Be sure to watch all three if you have an interest in seeing Andrew.

Background


Technique


Types of surgery and dilation etc


I had a 6 month wait after I booked in and he does about 3 or 4 srs operations a month as far as I know. So you get quite a bit of time with him, and his been happy to answer any questions via the phone or have me come in for check up whenever I was unsure about something. For me it was a great peace of mind having that level of follow up care.

About Andrew Ives

He is very focused in that he only keeps information relevant to his surgery in his mind, any question about hormones or finances etc he has some one else to take care of that. The after surgery care has been great, I've seen him around 5 times since SRS initially to have silver nitrate done and some stitches trimmed and a general clean up. He is very kind and understanding and visits you every day in hospital to check up on you and answer any questions you have directly.



I wished I had more information about the whole process of the surgery before going in, and while the experience is different for everyone a lot of it will be the same. So this is one patients experience and advice.

Day 0

The day before going to Masada private hospital you will have to drink two bottles of fleet and a lot of water. You also need to have a shower. I had to start drinking at fleet at 6pm, I figured I would have a shower after the fleet had cleaned out my bowels and catch a a couple hours sleep before heading to the hospital for my 6 am admission. 1 am I was still running to the toilet. Make sure you have some moist wipes. You will still be sore but they will help.

This is a good time to talk about what to bring with you, you will have underwear supplied as well as salt, mirror, lube, condoms and foam. So I was only able to wear my own clothes on the eighth and ninth day so I advise not worrying about bringing much in the way of clothing, you will mostly be in a hospital gown. I also brought ugg boots instead of slippers. Bad idea in hindsight.

Day 1

So off we went to the Hospital, it's actually locked at 6am so you have to press the buzzer and speak in the intercom to get in. It's the first time without make up in a long time but in a few days you will wish you looked as good as you do right now, so don't worry about not being able to wear make up. At this point I met some of nurses and was asked to shave myself. I hoped I'd done it well enough and had, I also had some blood tests and spoke with Andy and Marianne, The rooms are nice with your own shower and toilet, basin and mirror. (you also have a TV with Foxtel and there is WiFi available though it requires a password which they gave me on a card, I'm not sure if it's free as I just used the data on my phone)

I fell asleep in my clothes and woke to a knock at the door saying it's time to go. (you maybe be offered calming medication and more time to get into the gown but they let me sleep because I looked relaxed). They wheel you down a corridor and into a little room, this is wear you get the stimulator's put on your legs, these are your friends and will keep you company for the days and nights to come. They massage your lower legs to keep the blood flowing. You will also have a very warm and blanket put on you. I got out of bed and walked into the theatre wearing my warm blanket like a cape, it was time. It is very cold in here. I got onto the table and they strap your arms and legs down. Marianne said I would feel warm and fuzzy soon and then I have some vague memories of being in the ICU someone saying I can't understand you and cover her eyes. That is all I remember from the ICU, most people will remember waking up in ICU and Andy will tell you how it went.

Day 2

I woke up to a breakfast being served, at least I think that was day one, I was confused if I was allowed to eat or if I even felt like eating (yes you can eat but make sure to ask if everything's low residue diet, just in case) did the operation go well?, I felt ok, sore but ok. Later that afternoon I was able to talk to my mother and she told me the everything had gone well ( I probably should have asked a nurse). The nurses will be constantly checking on you and giving you medication. Day two goes pretty fast, mostly spent sleeping, I was told I would feel like I'd been impaled by a tree and that seemed a pretty fitting description. Personally the pain was at about a 7 out of 10 for me. It's not intense pain but it's consistency and relentlessness can get to you. If you can wiggle your toes, paddle your feet and move your hands you should. The more you do the easier things will be over the next few days. Worth noting at day two I realised both my hands where numb which made, texting, eating even pressing the nurses buzzer very difficult. A side affect of being under it probably won't happen to you but it might. Everyone always said the surgery doesn't make make you feel any different and they were right aside from never feeling movement down there I felt exactly the same as I did pre-op and I was so well bandaged it may well have been there still.

Day 3

I started to look around a bit today and recognising nurses, the pain had gone down to a 6 out of 10 and my stimulator's had been buzzing all night and day. I ended up calling them my magic legs as I found them quite comforting.My hands had finally lost the numbness.  At this point you will have tried to move your legs and rolled over for inspection and found it very difficult, not because of pain but I swore the machines on my legs were made of lead. They actually are light and made of cloth. Exercises as much as you can even though it's very hard it helps you in the long run. This is a good time to talk about the dressings and bandages, I had an IV tap in my left hand and two tubes coming out of the bandages, one on the left was the catheter and the one on the right drains blood. If you ever feel like you bladders full ask a nurse to check if the catheter is flowing as sometimes they can stop. By the time I left the hospital I was very good at getting it working again by myself, just watch how the nurses do it.

The next few days are just watching TV moving your arms and legs as much as you can you will be standing, which is very difficult. I was afraid I would hurt myself were the tubes go in if I sat, but in hindsight I believe there is some sort of protective cover over the vagina and the blood tube goes in your pubic area not down below. I felt like I weighed eight times more than I did, I got exhausted very quick from standing, it's interesting how difficult this gets after just a few days of bed, maybe you will do better than me because you have been doing all those exercises. Next time you take a few steps, you improve quite a bit each time you try. Soon you'll actually be able to walk into your bathroom and brush your teeth and hair etc Each day the pain gets less but also more isolated.

The nurses are very caring, some of they have been helping people recover from this operation for nearly two decades. They are often from interesting places with interesting accents. Being a country girl I really enjoyed this. Often each nurse does things a little differently and some times your request from an icy pole might get lost between shift changes but just remind the next one. I had lots of nausea I think from the antibiotics in the IV , but they helped me through it. Also there probably will be some student nurses assisting sometimes they were fantastic and brightened my day. I grew kind fond of all the regulars. From here until about day 5 you will be just doing the same things with exception of walking a little further each day.

I think day 4 I started feeling new sensations down there, pulses and contractions. You occasionally feel nerves firing and phantom itches.

Day 5

This is when I had the bandages removes, honestly I just laid back and closed my eyes, they brought in giant spotlight and attached it to the bed, when the packing comes out it feels like it's unravelling, like pulling a giant thread out of you. I don't recall much else about this day other than being a little disappointed I still had the IV and catheter in. I think you get the foam *mould in also. I had my eyes closed.

Day 6

Just when I was getting into the rhythm of things, today the IV was removed and the catheter. It was all painless, felt a bit weird when Andy squirts water into your bladder then pulls the catheter out. By this stage you should have been able to walk to the bathroom and you get to pee for the first time on you own. This was something I thought would be difficult to wrap my head around but I just sat on the toilet and it happened, had my first shower and salt bath (it's not actually a bath but a bowl you sit in) today was very hard for me, I had to start learning to do the moulds (see end of post for info on moulds). I'm a pretty sensitive person, I found looking at the new genitals quite confronting, between the swelling and the stitches. I don't know any advice for this other than you just have to get through it. On the bright side the thing you hated is gone, life only gets better from here.

Day 7

Ideally you have independence today and can go home today, I had some issues with the mould and got set back a day (I or a nurse got blood on the foam and the replacement foam was not the correct size which caused me quite a bit of pain, discomfort and it took a toll on my confidence, one of the more experienced nurses did sort it our for me when she clocked on and I doubt this issue would ever happen again) so I stayed till the 9th day every ones different remember that. I sat in the back seat of the car and was fairly comfy for 45 minute trip home, having a salt both in a real bath is wonderful.

Things get much better at home, worth noting there is still some packing near where the catheter was, and I freaked out when it came out days later after being home and wasn't expecting it and it looked flesh like and even had a stitch in it. So now you know not to freak out.

I'm finishing writing this on around day 16 the mould finally went in a bit easier today. The swelling has gone down a bit but still a ways to go, lots of stitches still but I'm finally feeling a bit more comfortable. Tomorrow I go see Andy and learn about the dilaters.

I wish you the best with your surgery and recovery.

*The moulds are a rectangle piece of foam, he cuts them to a specific size for each person. You roll the foam as tight as you can and put a condom over it. Then twist the end of the condom, so it's air tight. put some lube on and put it in. It's about the size of a finger or something at this point, once it's in you let the condom untwist and the foam expands to and inch or inch and a half. You leave that in 24/7 and change the condom and reinsert after a bowel movements.

I think he started me on dilater's earlier than normal, because the foam mould just didn't want to stay in. I'm not sure what's with the foam to be honest. Not heard of anyone else use it. 


I am not an expert on surgeries or techniques but I'm happy to try an answer any questions.

Thank you for writing this, you have taken nearly all the mystery out of the SRS process and nearly all the fear.
It's great the almost everything went well, I'm so happy for you and want to ask you so many questions... If you are OK with that?

Quote from: Sarah82 on September 17, 2015, 05:37:12 AM
Thank you for writing this, you have taken nearly all the mystery out of the SRS process and nearly all the fear.
It's great the almost everything went well, I'm so happy for you and want to ask you so many questions... If you are OK with that?

sure, I'm often in the chat also if you want to chat, either is fine

Did you see any other SRS patients there? I've often wondered how many he does each year.

Quote from: AnonyMs on September 17, 2015, 07:02:39 AM
Did you see any other SRS patients there? I've often wondered how many he does each year.

I think he says in one of those videos 3 or 4 a month, so 40-48 a year. There were 2 other girls when I was there. One was the same day as me, other one must have been the next day.

Ok so the questions came a bit sooner than I thought! Did Andrew require hair removal before the operation, electrolysis etc? I saw in another thread that you had a skin graft - is that typical of his surgery? where did the graft come from? I know aesthetics are highly subjective but without seeing example photos like you get on many of the international surgeons websites, firstly are you happy with the results? and secondly, would you describe the aesthetics of his work to be more in line with the north american surgeons e.g. bowers rather than Thai surgeons, e.g suporn?  You also mentioned you were able to orgasm at two months, what information does Andrew give in that regard? is your experience typical? In the video, Andrew said he tends to go conservative on depth due to the risks of hitting the colon, that seems to make sense to me - does he give any estimate of depth or is it very dependant on the patient?

Sorry if any of those q's are too personal -  please ignore if you are not comfortable discussing - I am very interested in going with Andrew after reading this thread and the thought that I could have the surgery only an hours flight from my home in a city where I have family and friends certainly appeals to me! Have you considered writing an extension of this piece describing the longer term healing process? I must admit that a similar write up by a patient on the healing process of my hair operation was very useful in allaying my concerns as i progressed through the healing stages.

Thanks again,
Grace x

Quote from: Grace_uz on October 07, 2015, 07:26:08 AM
Ok so the questions came a bit sooner than I thought! Did Andrew require hair removal before the operation, electrolysis etc? I saw in another thread that you had a skin graft - is that typical of his surgery? where did the graft come from? I know aesthetics are highly subjective but without seeing example photos like you get on many of the international surgeons websites, firstly are you happy with the results? and secondly, would you describe the aesthetics of his work to be more in line with the north american surgeons e.g. bowers rather than Thai surgeons, e.g suporn?  You also mentioned you were able to orgasm at two months, what information does Andrew give in that regard? is your experience typical? In the video, Andrew said he tends to go conservative on depth due to the risks of hitting the colon, that seems to make sense to me - does he give any estimate of depth or is it very dependant on the patient?

Sorry if any of those q's are too personal -  please ignore if you are not comfortable discussing - I am very interested in going with Andrew after reading this thread and the thought that I could have the surgery only an hours flight from my home in a city where I have family and friends certainly appeals to me! Have you considered writing an extension of this piece describing the longer term healing process? I must admit that a similar write up by a patient on the healing process of my hair operation was very useful in allaying my concerns as i progressed through the healing stages.

Thanks again,
Grace x

Hi Grace, he does not require electrolysis, I had a scrotal graft because I was on hrt for 13 years beforehand, didn't have much to work with. He will tell you up front whether he thinks a graft will be used. I don't have a lot of experience in what neo-vaginas look like from each surgeon, but if you wanted prominent labia minora you would have to talk that over with him but I think thailand is best for that aesthetic, I do recall asking him about it after I had srs and he said he could increase the size of minora if I wanted, but I'm happy with having an 'innie'

He did spend time with Marci Bowers and the surgeons in UK so I would expect that more than the thai aesthetic. He was happy I could  orgasm at 2 months, so maybe I was ahead of the curve in that respect.

As far as depth goes like everyone you can ask what you want and it ultimately depends on not only your skin but your insides as to what can happen. He really won't know till your on the table. I'm happy with the depth I got. After 13 years on hrt I'm not sure I would have got any better in Thailand.

theres some after care information for you

So I have gotten past the dreaded foam mould stage about five days ago. I went and seen my surgeon Andrew Ives and he showed me how to to use the dilators. The set comes with 5 sizes, starting at size 0 and ending at 4. We tried starting with number 2 but that wasn't being agreeable so went with a successful number 1. These particular dilators have a detachable handle and you hold them in up to the hilt, I'll provide a link to see them at the end of this post.

I was happy on the car ride home, Through all of this the foam is what I had the most trouble with and I had thrown it ceremoniously into Andy's bin. Walking and sitting was already easy and I had an extra gulp of my drink knowing pee'ing would be a lot easier now. Stopped at the supermarket on the way home and made a last minute choice to take the dilator kit out of my handbag and leave it in my car. Which was a great relief as I watched Aldi search the woman's handbag in front of me.

I felt a little intimidated at home as it's like having to use the foam for the first time yourself, but ultimately dilating is less of a process than the foams. So the instructions were to go for 30 mins twice a day for a few days with no 1. It's a bit difficult at first and it stings and there is resistance, once it's in though it's not to bad and I just watched netflix, takes some light pulling to get it back out and then you go wash them in warm soapy water.

So after a few days I had to do 25 mins of no 1 and then 5 mins of no 2. Once again I was intimidated by the size and length difference of number 2 it really did not want to go in and stung. I managed to get it ¼ the way in for 5-10 mins. I felt defeated.

Next try I did 25 min again with no 1. Number 1 and I were friends at this point. We had an understanding, but number 2 and I did not get along. I was pretty happy to get ½ way this time, and the fact I was progressing made me feel a little better. Third try was ¾. 4th try sadly was not all the way but almost. I rang Andrew today and he said that's ok just keep progressing, but try using no1 for 10 mins and no2 as best I can for 20 mins. So that is what I will do tonight.

Almost 3 months after srs

A quick update, I eventually felt well enough to leave Melbourne on week 5, the drive home wasn't so bad though I did take an Endone half way. I did also beat dilater no2, I havn't seen that thing for awhile now. I just use no3. I can't quite get no3 all the way in, so close though and if this is the depth that I end up with then I am ok with that. I do think the staggered length dilaters are not the best idea as in my case where no3 was just not happening to start on. You end up a few weeks of not going to full depth.

I rang Andy and asked about it and the message I received via his wonderful secretary Ashlee was that I would gain more depth but it would take some time. I'll be sure to ask about this much more in depth at my 3 month check up.

The swelling has gone down a bit but I still think it has a way to go, again this is something I'm unsure about and will ask Andy. The scars are still pretty intimidating but everything has improved.

Finally this week I've been able to get off the paracetamol, things are still a little uncomfortable etc but I can sleep and drive and do the things I need to do without pain killers.

I also had my first orgasm a few days ago, I think that deserves an entire blog entry of it's so I will do that.

My 3 month appointment went well, he said I'd healed amazingly fast though I still felt a long way to go. He said I can go and do whatever I want now!

Orgasm
Ok so it's been a month since I said I would talk about this. Have had 3 so far while awake and 2 in dreams. It is very surprising how different this feels with a neo-vagina. There is satisfaction even when you don't reach orgasm which is handy since orgasm is a lot harder to achieve, so no matter if you orgasm or not after having some sexual experience you feel better afterwards, were as a male might feel frustrated and discomfort if they don't achieve orgasm.

The sensations themselves are much higher than male orgasm and I think that helps. So you can feel much stronger feelings constantly spiking over and over without orgasm. The orgasm itself is very demanding, the first time I almost did I was shaking and just unable to control my body enough to finish. So I figured I needed some outside help for this and ordered some vibrators.

So after getting back to the point were things were feeling good and switching on my new friends I was able to just let go and have an orgasm so strong that it's not really perceivable by imagination. So strong and just unable to be audibly quiet and the shaking and overwhelming feeling in whole body. Very very very happy with that.

The ones in dreams seem far less strong and seem more in line with male orgasm.


I'm at almost 5 months now, the scars are blending pretty good already. On the largest dilator (1.5 inch wide), The graft at the end has been noticeable this last month or two. It will soften up in time Andy said as I continue to dilate. I'm at a point were I'm pretty good but still not perfect and I have a friend that had srs on same day and I'm not going to talk about her out of respect other than she has bounced back a lot faster than me.

I still feel fairly uncomfortable on a bike seat and just certain feelings still remind me that I had srs. Though all of these things are less uncomfortable than they used to be, so I'm confident I'll eventually feel 'normal' again.

I'm going for another check up in December.

Wow! Thank you so much for taking the time to put that together! I think I will make my initial contact with Andrew before the end of the year as I would like to plan for the op in about 12months depending on his availability. I also may need to change my private health as I'm with bupa at the moment  with only basic hospital coverage. Do you think he or his office could advise how get the most out of Medicare and which health funds/coverage is best? Happy To hear from you or others who might also know?

Grace x

Your welcome Grace,

The Medicare process is straight forward don't worry about that. You will be given item numbers at your first consult that you need to confirm with your private insurance to make sure they can cover each item, I was with Medibank with top hospital cover. Perhaps you can ring Andrews office and ask for those to be sent out since you will have to wait a year after changing. Andrews waiting list for the surgery itself was around 6 months for me.

I had referrals from the psychiatrists that work along side him in Melbourne, but you will need something like that also.

Great, thanks for that! I figured I would need to change my private health and wait 12months hence why I am getting organised now. I think I will make an initial consultation as soon as I can just so I can sort out the private health side of things and then wait out the waiting period. Thank you so much for your help!
Grace x

Grace,
Be aware that some of the Australian private health companies are listing gender surgery under 'psychiatric' conditions. Cover for psychiatric conditions is often an option you need to specify. They are just playing dirty as usual!

Quote from: Cindy on October 07, 2015, 09:00:51 PM
Grace,
Be aware that some of the Australian private health companies are listing gender surgery under 'psychiatric' conditions. Cover for psychiatric conditions is often an option you need to specify. They are just playing dirty as usual!

Thanks for the heads up Cindy - I hate dealing with my private health fund (Bupa) it seems like they are always raising the premiums while my coverage stays the same or gets worse! Once I get the info I need from Andrews office i will go in and see bupa to work out what I need to do - it may be just the case of increasing my hospital cover from basic to top and it might also be the case that I drop Bupa completely! I guess what I would really like to know is (particularly if i change companies) if there were any funds that were better suited to this situation given the procedures involved and the particular private hospital. 

I'm with HCF, top cover. No problems, except when I gave the item list to the woman to ensure I was covered and she looked them up, I thought she was going to faint!!

I think they recommend Medibank at the gender clinic, I remember Dr Harte photocopied my Medibank forms a few years ago to use for  guide for new patients, but you can ask yours if they work with Masada Private Hospital as thats where you would be staying.

I'm pretty sure one of them item numbers is "penile amputation" Cindy so I'm not surprised

Just found the list:

Medicare No followed by procedure.

Check if your health fund covers them and of course private accommodation at Masada. You also need to stay for about 2 weeks in accommodation out of Masada before travelling back to Tas. You have to pay for that plus airfares etc. You can claim them back through the PAT scheme. You need a companion as well. And a suitcase full of salt

45563- neurovascular island flap
37405- penile amputation
37342- urethroplasty
35565- vaginal reconstruction
30644 (x2) - exploration of spermatic cord
45206 (x2) single shape local flap

Not that I discuss to either having or not having GRS. I have decided my genitals are not open for discussion.

Thanks for that Cindy! I can see how they might make for an  interesting conversation! Fair enough regarding discussing surgery, I'm thankful for any advice I can get

I will check back in here when I get some things organised!

Grace x

Oh! A new option too look into. I was pretty sure I would go with Dr Brassard but since Andrew Ives is in Australia and has experience with GCS, it just seems so much more convenient. Just curious, how did you hear of Andrew?

I had heard about Andrew through word of mouth - both from people in my local support group and some others from interstate who came down to speak at said group. But that was only a mention, so when I started researching I came across him again and luckily found this awesome thread!
Grace xx

Quote from: Annabelle on October 08, 2015, 07:58:02 AM
Oh! A new option too look into. I was pretty sure I would go with Dr Brassard but since Andrew Ives is in Australia and has experience with GCS, it just seems so much more convenient. Just curious, how did you hear of Andrew?

In Victoria we used to have Simon Ceber, Andrew took over after Simon retired. Lot of trans sites still list Simon as the current srs surgeon though and not Andrew.

Ok, today has been very exciting! I got in touch with Andrew's office yesterday and today I made an initial appointment to see him next month! They also sent the item numbers, which I already had (thanks Cindy!) so I went to my health fund and it turns out my existing hospital cover already covered all the item numbers! I still upgraded to the top cover due to psychiatric services not being included but happily they only have a two month waiting period. So in the end I don't have wait 12 months!! It will probably be nearly that by the time I schedule the surgery but at least I have the option to go a bit earlier if he is available!

So excited!!!!!

Thanks everyone for your help!!

Grace xx