Meta by itself is a 1-2 stage process, possibly 3 if there are revisions needed. In the UK I want to say all of them are 3 stages by default.

Phallo is another 1-5 stages depending on surgeon, donor site, individual procedures, etc. Hysterectomies are always done separately from phallos unless you're having it done in Europe.

I didn't use anyone for follow up here yet. Anything that I've needed to have looked at, I've sent pictures and a description of the issue to Dr. Miro and his assistant Dr. Marta. They get back to me in less than a day usually. The only issue I've had that needed solving was a UTI that I thought was a stricture. They told me to go get a urinalysis done and get on antibiotics, so I just went to CVS for all that. Since any surgical revisions are free with Dr. Miro (aside from the cost of travel), it is less expensive for me to return to him for anything beyond a simple healing issue (like a UTI or other infection).

I did meet Dr. Zhao and Dr. Weinberg from NYU while I was in Serbia, and have met Dr. Bluebond-Langner (also from NYU). If I were having significant issues and didn't feel confident that I could travel to Europe and make it through the trip, I would've called to see how soon they could get me in. Dr. Zhao told me he'd be happy to follow up with me if I was having issues, and he also had a colleague in my city that he said he would recommend for routine urology care if needed, though I don't think that doctor had trans experience.

That clarifies quite a bit, thank you.  So to be totally clear, meta is generally 1-potentially 3 stages, while phallo is 1 to 5 ADDITIONAL stages, for potentially a total of 8?  I know that revisions etc can be numerous, but hopefully, the major surgeries can be held to 2-3, I would surely hope.  Again, just to clarify.

I saw quite a bit about the NYU program and Dr Bluebond-Langner, and likely would go the similar route if she or other qualified physician at NYU could be there for me if any major issues arose.  We're about the same distance from NYC (we're just up in the Finger Lakes Region, NY), and that would surely bring comfort knowing there are experienced people in this regard within a day's drive. 

Is there anyway that we could take this conversation off the forum, or would you prefer it here for educational purposes?  ; )

Most people do not get both done. For most people it is either phallo or meta, but generally not both. Some guys who get meta go back for phallo, but I would say that is not the norm currently (it was in the past due to changes in insurance coverage - it was easier for people to pay out of pocket for meta in the past before the ACA made coverage more common for more expensive procedures like phallo, so they went back for what they really wanted after getting insurance coverage).

Staging is going to vary by surgeon. Some like to do things in very particular ways. If you're specifically looking at Dr. Miro, his metas are all a single stage unless you need a revision. And his phallos are 3 stages assuming you are interested in urethral lengthening and an erectile implant. If not, you may be able to knock it down to 2. Having had the majority of the "extra" work (scrotoplasty, vaginectomy, primary UL, testicular implants) done during meta, if I were going to go back for phallo I'd want to talk to him about doing it all in a single stage or staying in country longer and having it done in 2 back to back stages. So in total, I would be looking at 1-3 stages if I were to get both primary procedures done.

You can PM me on here or on Facebook if you want (FB link is the F icon under my avatar).

Well that fully clears it up!  Insurance.  Isn't that always what enters in to medical care and drives direction and decision making in course of treatments? 

Thanks so much for the full background.  I've put in a request for consult with Dr Miro, and will also do the same with Dr Crane (TX) and perhaps even Dr Bluebond-Langner.  Am still leaning heavily in the direction of Miro, so we'll see where it goes. 

Thanks again for your help.  It means the world.  I may reach out to you on FB Messenger as this Tapatalk thing is kind of crazy and works on my iPad but not so good on my phone just yet.  Hard to know when I have messages!  (Just an old guy with his electronics ; )

Again, many thanks.


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I decided to go for phallo, after all. Some of the reactions helped a lot (specifically the remark that a transwoman who got a phallo said it felt natural), and also I want to live my life NOW, like CMD042414 said.

I am worried about scarring as well and don´t want forearm flap surgery, as my wrists are already very slim and it would leave me with pretty much no forearms, plus there is the recognition issue (it´s mostly transmen who have those scars, as far as I know).

There was a topic talking about abdominal with a nerve hookup from the forearm which seems like a great option. I guess I´ll have to discuss it with different surgeons when the time´s right.

Also if you are still wondering or debating this in your head, feel free to post your thought process

Quote from: randomdude5 on August 01, 2017, 01:09:02 AM
I had thought about both phallo and meta. For me the main concern with phallo was the huge scarring on either the arm or thigh. I felt like people are becoming more aware of trans surgeries and feared someone might see that scar and automatically think oh that guy is trans. I knew I would never want to go out in a t shirt again if I had forearm phallo, but with meta I just felt like I'd still feel incomplete in a way.

For me it was a matter of priorities. I looked into MLD phallo and the main negative I read was that the sensation wasn't as good as other phallo types. For me, I know I wouldn't be satisfied with meta and could not deal with RFF or ALT scarring, and that was more important than having 100% sensation to me. Ended up opting for the MLD, had first stage up to now and do not regret it in the slightest. Even after only 1 stage my family doctor back home was impressed with the result. Totally feels like my own too and not just a tube of skin. It really is just comparing the pros and cons of each and getting the one that you feel will give you what you want out of surgery. For me anyways, anything was better than what I had before so even if the phallo doesn't come out perfect, it is still an improvement.

Hi Randomdude5-- 


Who did your surgery?  I'm sorry if I've missed the information in the string.  So much helpful info in this string and --- I just yesterday landed my first consult appt with Doc BL @ NYU, Dec 4.  Excited to say the least!

My feeling is similar to yours regarding MLD; My forearms are too small to deal with ALT, and RFF would be a secondary consideration but I don't like the idea of the hair thing.  From some reading on several sites, I also understand that MLD has a slightly lower risk of morbidity and complications as the skin in that location on the body is just a bit different (Miro's site).  We concur in the discovery that MLD is a bit less sensate, but like you--I don't see that as a problem.  Healthy is key for me.  Honestly, I'm also not dead set that urethral lengthening as a requirement in this regard (healthy).  I understand that many of the complications related to the surgery requiring more revisions are urethral issues (fistulas).  Goals: 1. An end to adhesive prosthesis/packing and 2.  sexual function and decent aesthetics--are my two priorities.  (After 3 yrs using US men's rooms, it's always the stalls that fill first anyway, and locker rooms are fairly behind me as a former jock--now 54).

Does anyone on the string know more about alternate donor sites, like stomach, "pedicle flap," etc??  I'd be interested to hear more on that from experienced guys.

So I'm excited guys--to be moving forward on this.  I am also waiting for a follow up response for consult from Dr Miroslav Djordjevic (Doc Miro) in Belgrade.  He emailed me while on vacation a couple weeks ago, and I'm sure he's back and swamped and ---hopefully I'll be in their pipeline soon.  Like FTMax, who went to Doc Miro, the key analysis is 1. Surgical skill (how many steps, also) 2. Cost.  Truth is, insurance in US can be tricky and let's face it, when the mother hospital accepts it, the surgeons wind up trapped in their billing/coding systems and it gets more costly, so if your deductibles are high--travel can be an option I will be investigating.

I'm heartened in reading a couple of these posts, and I promise--I'm doing my best to figure out this Tapatalk thing and the browser based forum functions. 

Onward--gentlemen!!




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Quote from: SaerJoe on September 09, 2017, 07:43:13 AM
Onward--gentlemen!!

There is a site I have been getting most of my information from, it´s http://www.phallo.net/procedures/. If anybody knows any other site with great info, it´d be good to include in this thread I think. You basically have a choice between the operations named on the site.


- Pedicled groin flap (KIM). You would still have erotic sensation provided by your junk, buried at the bottom.

- Abdominal. Same as above, you´d have erotic sensation provided by your current junk. Urethroplasty is not usually done with this type of surgery. With bird wing abdominal surgery, urethroplasty is an option.

- Thigh (ALT). Depends on the patient. The site says that patients with more subcutaneous fat in that area might have a more difficult time due to excess tissue. The site does not mention sensation in this article. There are various variations possible within this type of surgery.

- Forearm (RFF). As I understand this is the surgery most FTM go for, since it provides better erotic sensation through the nerves from the forearm skin. I´ve also seen a post around here where they said that they can take a nerve from your forearm (instead of a flap) and then combine that with an abdominal flap, but I´m not 100% sure on that (maybe someone can give more info?).

- Dorsal (MLD). Uses part of a back muscle, including nerves. As I understand it´s possible to achieve a bit of a natural erection because the muscle still has the ability to contract. According to the site, sensation is lesser than RFF but better than abdominal and groin flap surgery. It also mentions low donor site morbidity.

- Lower leg. Harvests a part of the fibula. The skin flap can be re-innervated. However the site says that erotic sensation is not the expected result, meaning that sensation would still come from your natal junk. The actual bone in your penis can make it look like you have a semi-erection.

I took the liberty of summing that up. I don´t think the information on that website is complete, for each surgery there are probably many more things involved. Perhaps some of you can provide additional information 

I took the liberty of summing that up. I don´t think the information on that website is complete, for each surgery there are probably many more things involved. Perhaps some of you can provide additional information 
[/quote]


Great info.  Another general site I've referred to for years that seems to get updated  w relative frequency is https://www.susans.org/links/link/Help_&_How-to//For_Trans_Men//hudsons-ftm-guide-200   Thanks again for the info!


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I had my top surgery this june and now on T from 2 mnth.Looking forward to finally have phallo.so i can be called a male in all way.

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Quote from: SaerJoe on September 10, 2017, 07:53:49 PM

I took the liberty of summing that up. I don´t think the information on that website is complete, for each surgery there are probably many more things involved. Perhaps some of you can provide additional information 



Great info.  Another general site I've referred to for years that seems to get updated  w relative frequency is https://www.susans.org/links/link/Help_&_How-to//For_Trans_Men//hudsons-ftm-guide-200  Thanks again for the info!


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Gone through the link provided thanku..[emoji4]


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