I was on hrt around 13 years before srs, had to have scrotal graft.

As far as I can say there is also another group of surgical techniques.  Suporn, Schaff and some others may have an advanced technique than pi or sc.  I choose one from these newer techniques because of the look and feel, depth without skin or colon graft, becoming wet when aroused....

Quote from: MasterSifuVictoria on June 05, 2016, 05:47:08 AM

I'll add only this ... having consulted with Dr Suporn directly, I didn't select Suporn due to his GRS techniques of choice, differing beauty aesthetic, and the recovery experience of friends.

Differing beauty aesthetic? Differing from what? What is it exactly that you didnt like about his results aesthetically?

Quote from: Lara1969 on June 06, 2016, 04:40:37 AM
As far as I can say there is also another group of surgical techniques.  Suporn, Schaff and some others may have an advanced technique than pi or sc.  I choose one from these newer techniques because of the look and feel, depth without skin or colon graft, becoming wet when aroused....

Suporn is scrotal graft and cowpers gland for self lube, not sure any surgeons don't do that.

Practically all Thai surgeons are starting to follow Dr. Suporns technique, Dr. Thiti, Dr. Chettawut, Dr. Kamol, Dr. Sanguan, Dr. Saran, even Dr. Sutin and Dr. Burin who do Preecha's penile inversion at PAI, do non-penile inversion in their own practice. They obviously don't do the same technique into details, as they all have their own variations, but basic principle is taken after Dr. Suporns technique: non-penile inversion using scrotal graft for vaginal lining, and use of penile tissue flaps for vulva a.k.a Chonburi flap.   

Quote from: mmmmm on June 06, 2016, 07:54:03 AM
Differing beauty aesthetic? Differing from what? What is it exactly that y rou didnt like about his results aesthetically?

He's a good surgeon. I mean only beauty re FFS. My own face shape and background is more India/Spanish than Nordic or Oriental.

So what he suggested wouldn't have suited me aesthetically.

Hope that makes sense.

Kindnesses
Victoria xx

Well, I thought you were talking about GRS aesthetics, as this is thread about GRS.   

Quote from: mmmmm on June 06, 2016, 11:42:43 AM
Well, I thought you were talking about GRS aesthetics, as this is thread about GRS. 

In terms of GRS I rejected all Thai surgeons because 3 of my close friends have had horrific recoveries.

One is at Charing Cross with bleeding 3 months post op from Suporn.

Me, I'm fine 3 weeks later, & was up & out after 10,days with my surgeon.

However everyone has preferences and what's not right for me may suit someone else perfectly.

All I know is I had FFS, GRS and now VFS and I'm doing Tai Chi every day with little scarring visible & no pain.

Kindnesses
Victoria xx

Quote from: MasterSifuVictoria on June 05, 2016, 03:38:12 AM
Given how fast I recovered & I'm no Marvel comics super hero, I was up & fine in 1 week not bedridden for 4 - 12 weeks

I was up and fine in 2 days with Dr. Brassard. Bedridden for 4-12 weeks?! Never heard of such a thing post-surgery.

Quote from: AnonyMs on June 05, 2016, 06:51:00 AM
Briefly looking at that paper and some in the past doesn't inspire much confidence. I don't mean to be rude, but nothing I've read online, and its a fair bit, makes me feel good about the state of trans medicine anywhere in Europe.

I second this.

Quote from: Lara1969 on June 06, 2016, 04:40:37 AM
As far as I can say there is also another group of surgical techniques.  Suporn, Schaff and some others may have an advanced technique than pi or sc.  I choose one from these newer techniques because of the look and feel, depth without skin or colon graft, becoming wet when aroused....

I had PI and become wet when aroused, have decent depth and overall find the look to be fine. But, Suporn would have been my first choice if I had to redo things for even better results.

Quote from: MasterSifuVictoria on June 06, 2016, 12:10:44 PM
In terms of GRS I rejected all Thai surgeons because 3 of my close friends have had horrific recoveries.

One is at Charing Cross with bleeding 3 months post op from Suporn.

Me, I'm fine 3 weeks later, & was up & out after 10,days with my surgeon.

However everyone has preferences and what's not right for me may suit someone else perfectly.

All I know is I had FFS, GRS and now VFS and I'm doing Tai Chi every day with little scarring visible & no pain.

Kindnesses
Victoria xx

Did you go to Charing Cross itself?

Did you read the series by Juliette something or other in The Guardian? I thought it was great, and she really put people straight on Charing Cross and addressed the fear factor of the name.

It was a brilliant series of articles.

Quote from: alex82 on June 16, 2016, 03:06:13 PM
Did you go to Charing Cross itself?

Did you read the series by Juliette something or other in The Guardian? I thought it was great, and she really put people straight on Charing Cross and addressed the fear factor of the name.

It was a brilliant series of articles.

Please allow me to clarify:

1. "Charing Cross"My friend is (or was, she's discharged now) "at" Charing Cross to receive treatment because of Dr Suporn's work which has caused 3 month's of bleeding. I have 2 other friends who have gone to Thailand and both had similar issues, mainly with pain levels, long recovery times, and frequent dilation. There were also multiple surgeries required to revise the dead skin! Additional General Anesthetic is a serious risk and if this is typical of Thailand surgeons then it represents dubious work frankly.

PS By "bedridden" I mean Recovery. 2 hours of daily dilating does put one out of commission. And in the UK you are signed off from work for 3 months. This is how long recovery is expected to take.

So when I say mine took 10 days max. I meant it. I could bend, squat, move, dilate, and even light jog after 10 days. Why? I had ONLY penile skin used ... not one skin graft. This is the key to low dilation requirements, low pain, and fast recovery - no non penile skin grafts.

2. "Suporn Technique" Suporn's work is in substance modified penile inversion. He may be swapping penile skin for scrotal but the end result is the same. Plus he uses skin grafts, the same as standard inversion with the same results of long recovery and frequent dilation of length durations. As such one of the major drawbacks is the long (and forever) diliation requirements which are the same as standard penile inversion when skin grafts are added.

To restate, the major flaw with most methods of penile inversion as well as Suporn's revised version is the use of non-genital skin grafts. These skin grafts are what causes all the extra pain and needless hours of life spent on dilating or even years later the wound WILL close and no vagina! An avoidable nightmare.

3. "So-called Internet authorities." I appreciate that many believe that Sigmoid vaginoplasty is inferior and rely on surfing the internet blogosphere but the peer reviewed science absolutely favours the sigmoid solution.

Why because if you forget to dilate for weeks even years, your neovagina will NOT seal shut.

I encourage all to make use of Google Scholar. There are MANY science journal articles to support this conclusion. The belief that penile inversion or even the modified is superior in long term results is an absolute myth and needs to be dispelled with people relying only on hard data not the misinformation resulting from loyalty generated by "Buyer's bias" or pseudo-scientific "hearsay."

Here's a link to get everyone started.
http://scholar.google.co.uk/scholar?hl=en&q=sigmoid+vaginoplasty&btnG=&as_sdt=1%2C5&as_sdtp=

Kindnesses
Victoria xx

I've a few questions...

Quote from: MasterSifuVictoria on June 17, 2016, 03:50:42 AM
1. "Charing Cross"My friend is (or was, she's discharged now) "at" Charing Cross to receive treatment because of Dr Suporn's work which has caused 3 month's of bleeding.

PS By "bedridden" I mean Recovery. 2 hours of daily dilating does put one out of commission. And in the UK you are signed off from work for 3 months. This is how long recovery is expected to take.

Is this treatment at Charing Cross for granulation or something else? I've not heard many problems with Dr Suporn that are not directly related to the longer/difficult recovery process - I'm ok with that, not so much other things.

There's one women last year who had a really hard time of it; perhaps its similar.

https://www.youtube.com/user/NatalieLBG/videos

Quote from: MasterSifuVictoria on June 17, 2016, 03:50:42 AM
I have 2 other friends who have gone to Thailand and both had similar issues, mainly with pain levels, long recovery times, and frequent dilation. There were also multiple surgeries required to revise the dead skin! Additional General Anesthetic is a serious risk and if this is typical of Thailand surgeons then it represents dubious work frankly.

There's a very large difference between some Thai surgeons, and some are really cheap/bad. Who were these other two? Do you mean there was additional surgery under general anesthetic for these revisions?

Quote from: MasterSifuVictoria on June 17, 2016, 03:50:42 AM
PS By "bedridden" I mean Recovery. 2 hours of daily dilating does put one out of commission. And in the UK you are signed off from work for 3 months. This is how long recovery is expected to take.

So when I say mine took 10 days max. I meant it. I could bend, squat, move, dilate, and even light jog after 10 days. Why? I had ONLY penile skin used ... not one skin graft. This is the key to low dilation requirements, low pain, and fast recovery - no non penile skin grafts.

I could also bend, squat, move, dilate and even exert more effort if I wanted to, 10 days post-op. Low pain and fast recovery too but dilation and maintenance was time consuming the first couple of months.

Quote"Suporn Technique" Suporn's work is in substance modified penile inversion. He may be swapping penile skin for scrotal but the end result is the same.

I disagree. For instance, scrotal skin absorbs better so that post-op girls with Suporn can actually take hormones vaginally, if they wanted to and have good bio-availability. I also think the feel of it, inside, would be different, perhaps easier + more pleasurable during intercourse (?). You also state that using skin other than penile skin involves longer recovery.

QuotePlus he uses skin grafts, the same as standard inversion with the same results of long recovery and frequent dilation of length durations. As such one of the major drawbacks is the long (and forever) diliation requirements which are the same as standard penile inversion when skin grafts are added.

If scrotal skin were used, why would this lead to increased dilation requirements? Scrotal skin shrinks (closes) more easily?

QuoteTo restate, the major flaw with most methods of penile inversion as well as Suporn's revised version is the use of non-genital skin grafts. These skin grafts are what causes all the extra pain and needless hours of life spent on dilating or even years later the wound WILL close and no vagina! An avoidable nightmare.

My surgeon used scrotal skin graft (in addition to penile skin) and I did not experience much pain. Years later, after not dilating for YEARS, my vagina is still relatively deep (close to 4 inches and probably more, if I started dilating again) and has not closed. Scrotum is genital skin.

Quote"So-called Internet authorities." I appreciate that many believe that Sigmoid vaginoplasty is inferior and rely on surfing the internet blogosphere but the peer reviewed science absolutely favours the sigmoid solution.

If this is indeed the case, why do the vast majority of doctors not use this method?

QuoteWhy because if you forget to dilate for weeks even years, your neovagina will NOT seal shut.

I repeat. I've had penile inversion, as you have (you state penile skin was used) and years of no dilation have not resulted in much depth loss and closure

I'm going with Dr Bowers.  She is the only ob/gyn that does this work that I am aware of.  Unlike many surgeons she is also covered by insurance, for me at least.  In terms of procedure, she is always refining it but uses single stage penile inversion with scrotal skin used too. 
Personally I would avoid anything with colon but as with all this stuff, we each have to make up our own minds. 

Quote from: KayXo on June 17, 2016, 09:42:11 AM
I could also bend, squat, move, dilate and even exert more effort if I wanted to, 10 days post-op. Low pain and fast recovery too but dilation and maintenance was time consuming the first couple of months.

I disagree. For instance, scrotal skin absorbs better so that post-op girls with Suporn can actually take hormones vaginally, if they wanted to and have good bio-availability. I also think the feel of it, inside, would be different, perhaps easier + more pleasurable during intercourse (?). You also state that using skin other than penile skin involves longer recovery.

If scrotal skin were used, why would this lead to increased dilation requirements? Scrotal skin shrinks (closes) more easily?

My surgeon used scrotal skin graft (in addition to penile skin) and I did not experience much pain. Years later, after not dilating for YEARS, my vagina is still relatively deep (close to 4 inches and probably more, if I started dilating again) and has not closed. Scrotum is genital skin.

If this is indeed the case, why do the vast majority of doctors not use this method?

I repeat. I've had penile inversion, as you have (you state penile skin was used) and years of no dilation have not resulted in much depth loss and closure

1. The "other skin" I refer to is not scrotal. I very much agree that using scrotal scrotal skin doesn't necessarily increase dilation - non genital skin does eg from abdomen. However, compared to sigmoid vaginoplasty however, overall there is significantly increased requirement for dilation yes.

2. 4 Inches is insufficient. Sounds like it closed. If it hasn't closed, why is the depth so shallow? If so why did the surgeon not provide adequate starting depth of 6 - 8 inches?

3. I disagree. whether scrotal skin is used for the cosmetic element - labia, minor etc or the penile, this is not innovative per se. Looks the same, feels the same, just as involving of a regimen to dilate as any other penile inversion, where's the unique benefit?

And yes according to his website "Vaginal Wall - From scrotal skin (and groin skin if necessary)" Suporn IS using extra non genital skin just like everybody else.

4. Years of dilation. Yes you had ONLY penile and scrotal skin. This is good! Like I did, though used for somewhat different cosmetic parts but fairly much the same. However, many many more people have added skin grafts, not just penile and scrotal, and this is where the short and long term problems start.

If we stick to "penile + scrotal = no problems" "penile+scrotal+graft = long recovery, long dilation, pain"

5. Why do surgeons choose penile inversion? It isn't safer as the multiple scientific journal papers show. I can only guess it has to do with Operating Theatre time and cost.

A penile inversion can be done in a few hours sometimes 2, but a sigmoid is typically an all day affair.

Money is the likely culprit. 2 surgeries per day versus one. 2 House in Malibu vs 1. 250K per year or half a million? I can think of no morally benevolent excuse.

Hope that all helps clarify my position further.

Kindnesses
Victoria xx

Quote from: MasterSifuVictoria on June 17, 2016, 10:24:49 AM4 Inches is insufficient. Sounds like it closed.

Closed is 0 inches. I'm far from closed and can have sexual intercourse, finger myself, clean the inside of my vagina, etc.

Quotewhy is the depth so shallow?

Because I stopped dilating years ago.

QuoteIf so why did the surgeon not provide adequate starting depth of 6 - 8 inches?

With his technique, starting depth was around 5 inches. It's fine with me (it appears average depth in ciswomen is 4.5 inches) but I admit more would have been even better.

QuoteI disagree. whether scrotal skin is used for the cosmetic element - labia, minor etc or the penile, this is not innovative per se. Looks the same, feels the same, just as involving of a regimen to dilate as any other penile inversion, where's the unique benefit?

Scrotal absorbs medications better and is not the same type of skin as penile.

Quotea sigmoid is typically an all day affair.

Being under general anesthesia for such a long time isn't safe at all and significantly increases risks.

Quote from: KayXo on June 17, 2016, 10:33:30 AM
Closed is 0 inches. I'm far from closed and can have sexual intercourse, finger myself, clean the inside of my vagina, etc.

Because I stopped dilating years ago.

With his technique, starting depth was around 5 inches. It's fine with me but I admit more would have been even better.

Scrotal absorbs medications better and is not the same type of skin as penile.

Being under general anesthesia for such a long time isn't safe at all and significantly increases risks.

GA isn't dangerous if you are healthy. Any GA for smokers certainly is. Besides a heart bypass takes 6 hours & these guys ain't in great shape & survive just fine. The length of time argument falls a bit flat sorry.

Why would you need to have a vagina that absorbs medicine? I've not seen Estradiol tabs for vaginas before? Is this a common way to consume HRT in Thailand?

Semantics. Closed is losing depth with a rate that risks losing all depth. Since you lost 1 or 2 inches by not dilating, when you're a senior in an old folks home, how much dilating will you do? Over a few years it would be 0 zero inches.

Quote from: MasterSifuVictoria on June 17, 2016, 10:46:37 AM
Besides a heart bypass takes 6 hours & these guys ain't in great shape & survive just fine. The length of time argument falls a bit flat sorry.

Between 3-6 hours, based on several sources.

QuoteWhy would you need to have a vagina that absorbs medicine? I've not seen Estradiol tabs for vaginas before? Is this a common way to consume HRT in Thailand?

I live in Canada. Progesterone and estradiol tablets/capsules can be absorbed through vagina as well as suppositories and creams. Bio-availability is increased and first pass (liver) effect is avoided

QuoteSemantics. Closed is losing depth with a rate that risks losing all depth.

Closed is closed. 4 inches is far from closed. I've not dilated for 6-7 years and only lost 0.5-1 inches. Risk of closure appears to be quite low.

QuoteSince you lost 1 or 2 inches by not dilating, when you're a senior in an old folks home, how much dilating will you do? Over a few years it would be 0 zero inches.

0.5-1 inches over 6-7 years. One cannot assume that another 0.5-1 inches will be lost during the next 6-7 years. Besides, depth can often be recovered if dilation is restarted as some transsexual women can testify, even after 10-15 yrs of no dilation.

Quote from: KayXo on June 17, 2016, 11:06:31 AM
Between 3-6 hours, based on several sources.

I live in Canada. Progesterone and estradiol tablets/capsules can be absorbed through vagina as well as suppositories and creams. Bio-availability is increased and first pass (liver) effect is avoided

Closed is closed. 4 inches is far from closed. I've not dilated for 6-7 years and only lost 0.5-1 inches. Risk of closure appears to be quite low.

0.5-1 inches over 6-7 years. One cannot assume that another 0.5-1 inches will be lost during the next 6-7 years. Besides, depth can often be recovered if dilation is restarted as some transsexual women can testify, even after 10-15 yrs of no dilation.

Lol

I truly wish that were the case. The number of trans women who lose it due to lack of dilation is substantial.

You only need to read through the following thread:

https://www.susans.org/forums/index.php?topic=97349.0

OK I guess I could use the tabs as suppositories but .... Uhm I'm OK with injections and sublingual under the tongue really xx

PS Again, it's non genital skin that's the culprit & why you didn't lose inches at a fast rate over that period of time.

Quote from: KayXo on June 17, 2016, 11:06:31 AM
I've not dilated for 6-7 years and only lost 0.5-1 inches. Risk of closure appears to be quite low.

Just curious, but how long did you dilate for before you stopped? My understanding is that its really critical early on, and not so much later. I'm unclear on where that boundary lies.