I'm a 42 year old transgender woman that has recently started HRT. Can anybody recommend good U.S. bottom surgeons? My biggest fear is scarring as I've read various horror stories about them so anybody that can tell me doctors to avoid in that regard will be greatly appreciated.

Quote from: TiffanyShanahan on June 21, 2018, 09:21:18 AM
I'm a 42 year old transgender woman that has recently started HRT. Can anybody recommend good U.S. bottom surgeons? My biggest fear is scarring as I've read various horror stories about them so anybody that can tell me doctors to avoid in that regard will be greatly appreciated.

@TiffanyShanahan
  Hello TiffanyShanahan,  PLEASE KNOW that I am not trying to hijack your thread and evade your question but I see that you had just become a member of Susan's Place and this is your very first posting... so please allow me to give you my Official Welcome.

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@TiffanyShanahan
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If you would, please go to the Introductions Forum to tell the members about yourself!

Again, Welcome to Susan's Place,
Danielle

Hi Tiffany,

When I was choosing a surgeon I spent many hours browsing through previous posts in the GCS forum here - reading others' decisions, experiences and followup.  I was also concerned about ending up with a scar but having had GCS I can now say there are many factors in addition to scars.  (And I don't have a scar). 

After spending more time reading posts I realized the importance of each surgeon's requirements for:
- Working with your insurance company if insurance will be involved.
- GCS approval letters from other professionals.  Two are often required, and one may need to be a PhD level therapist or psychologist.
- Dilation schedule.
- Genital hair removal prior to surgery.
- Travel requirements/timing if you're flying home.  Cannot lift heavy luggage right after GCS.
- Surgery aftercare.  After hospital discharge are you sent to a recovery center with 24-hour nurses, or to a hotel?
- Followup if there are complications.

For some of us GCS is absolutely a great thing - but there is a lot to consider.  I found previous posts were super helpful in my decisions.

All the best,

Kendra

I haven't met with too many GRS surgeons. I met Dr. Stiller and looked through his portfolio during my consultation. I was quite impressed with him and his work. If you go to their websites, some surgeons have their result photos posted. Dugi in Portland is under OHSU and they don't post theirs, but Bowers does in California. I liked Dr. Stiller in Idaho, so I didn't look much further.  There aren't too many GRS surgeons, so you'll hear the same names come up. Spiegel is another that I hear a lot about. I would go to their sites and see who has photos posted. I am a firm believer in meeting a surgeon face to face and see what kind of feeling I get from them.

Do a search for "A collection of links to photos of srs results".

Hi Tiffany,

I second to start the research on this forum, but also checking out websites from doctors. Preferable those with an online picture portfolio.

If you are in a local support group ask questions and try to visit seminars from doctors if possible.

For myself I narrowed my search down to Dr. Rumer, Dr Mcginn and Dr. MacPhee.

I did spoke with Dr. Rumer at a seminar she did and talked to Dr. MacPhee in her office.

The decision maker as to which doctor to choose finally came by talking and asking many questions among my local friends who had their surgeries done. Five of them went to my doctor, Keelee MacPhee in Raleigh NC., and where all happy with the results. So am I. I am almost 9 months post op, limited depth. Incisions (scars) are strategically located out of sight. Dr. Keelee  MacPhee is trained by Dr. Marci Bowers.

Hope this helps getting you started in the right direction. BTW, of course everyone recommends her own Dr. so eventually it does come back to your own feelings as in which one to choose.

Dr. Keelee Macphee: https://keeleemacpheemd.com/

Dr. Rumer: http://www.rumercosmetics.com/

Dr. McGinn: http://www.drchristinemcginn.com/drmcginn/

There's a fair lot of complaints about Dr Rumer, including photos. Worth researching carefully.

Quote from: AnonyMs on June 23, 2018, 01:56:08 AM
There's a fair lot of complaints about Dr Rumer, including photos. Worth researching carefully.

In a dedicated (to me) support group meeting about GRS there where probably about 12-15 ladies who had GRS performed, including 3 with Dr. Rumer. Indeed 1 person wasn't happy about the aftercare she received from her doctor. The other 2 where happy. But those 2 ladies had their GRS done years before the unhappy one.

Which is why I want to add to the OP to also do research on aftercare, which is pretty important to have in place.

Thank you ladies for your advice
It's greatly appreciated

Recommending a doctor is a very responsible thing to do, so I will not recommend anybody, but I will just say that there are several good doctors performing SRS in the USA. They all seem to achieve constantly good results with very few minor complications. Choosing your doctor really depends on your personal preference and the feeling you get from a certain doctor. The cosmetic results are different for different doctors so carefully comparing the photos available online will get you to the doctor who is the right one for you.

Within the last few years, there has been a notable increase in GRS surgeons.  As you research here and other places on the web, you may want to pay attention to results (pics), depth predictions, reputation for bedside manner, education, who they were trained by, insurance acceptence, fees, and other factors.  It's a tough and critical decision for us as we only get one shot (well, there are revisions, but you know what I mean) at gaining a functional and aesthetically pleasing neovagina.   

I went to Dr. McGinn, today was the 17th time I was at Papillion with respect to my GCS. The 6 genital clearings is in addition as well as the BA visits pre and post.

I chose Dr. McGinn because she is close and a very good surgeon. I am intersexed and did not have much material. I had an operation at age 12 on my genitals and I had damage, self inflicted through the years. To boot I had very little vascular support for the scrotum and no shaft tissue. I had GCS and at 6 months had the clitoral hood made then at 1.5 years I had surgery with Dr. McGinn to complete the GCS.

Presently there is a 1 year wait to get an appointment to see her and 4 months scheduling for the GCS. If you go to her web site she has the letter requirements needed for her to accept you as a GCS patient. Start now if you decide you want her. Then in a year you can see her and (you need 1 year RLE any how) then 4 months later you have the GCS.

Summer GCS is very busy as many trans want the surgery in the summer. So avoid the summer if you can. Mondays are busy at Papillion in the summer. If you do the summer get the first appointment. This is super important for the visit after GCS when sitting is painful. Make sure you bring your cushion and use your meds.

Post op I had 3 weeks bed rest and each week a visit to Papillion. I started dilating at the 2nd week with a specific length with absolutely zero pressure.

My graft survived 75% and as a result there was a lot of scar tissue ( this is because my scrotal tissue had poor vascular support). I also had a ring where the scrotal tissue attached. When the scars shrank it became extremely painful to dilate with orange. After my revision work I am 100% pain free. I have a anterior scar that is flat and unfortunately I have hyperpigmentation (we do not know why) so it can be seen. It is 100% like skin around it and without the hyperpigmentation you would not be able to see it.

I have two 5 inch posterior scars from my revision. A lot of skin was removed ( Dr. McGinn gave me a free butt lift and it looks good) she removes a lot of skin and move some to complete the bottom of my vagina. The posterior scars are flush now and fading. My revision also deepened my vagina and repositioned my urethra. The skin in front of the vaginal canal was removed and the transition is perfect.

During todays exam the PAc said it looks beautiful. I am not an expert. Although I was married 23 years and we were intimate at times for 18 years I never saw her vagina. I never saw a vagina in person. So I am very inexperienced and had no comparison other than pictures. I have no labia minora due to no penile tissue. If I did it would look like the pictures I have seen. Some woman have little or no labia minora and I look like that. I have a lot of feeling and blood flow in my vagina and vaginal canal.

My entire glands penis was used and I have all the feeling there. I had a clitoral hood made for me at 6 months. During the revision it was redone but very extensively. The nerve from my clitoris and 4 inches above is very sensate now. I had a 4 inch incision at the revision and I wondered why. I was told it was redone. I love the feeling when it is rubbed. There is a minor amount of numbness on my left labia majora. I hope that improves in time. Since using the magic wand I think the stimulation has helped.

All things being equal. If I had the operation now I would have chose to have a peritoneal graft. I would not have known about the challenges I would have needed to tackle. I would have had to go to NYC many times plus 6 times for the clearings. I would have done this because of the thought of having a self lubricating vagina and reduced need to dilation. Perhaps I would have asked Dr. McGinn if she could have a gastro doc in the GCS and harvest some peritoneal. Perhaps that would have survived and my scrotum could have been used for labia minora.

I am happy with my choices and glad I went to Dr. McGinn. I do know she stood by me with all my complications. I never asked for a revision she just said I need to have it. She never charged for the revision. I asked Debbie why and she said she does not charge for revision work. The hospital and anesthesia were paid and Papillion placed the insurance request. The could have been paid but chose to not bill. All my revision codes were intersexed codes and through Aetna.

I need to write a letter expressing the gratitude I have for Dr. McGinns and all her team.

I though for a while that I would never heal properly. My skin is healed and scars fading (from recent operation the scars from the original GCS are gone with the exception of some of the hyperpigmentation).

My BA is awesome. My breasts looks very good and are absolutely done perfect.

I had genital hair clearing 6 clearings 5 to 6 weeks apart. You should start on that now. If you get the six now you can get one or two additional clearings and have plenty of time for your skin to heal for GCS. Papillion local clearing are booked 2 months in advance. So schedule somewhere soon and schedule 6. If you can schedule two additional clearings when you are half way through. Do not have GCS without hair clearing. You do not want hair in the vaginal canal. You will smell like fish down there, very strong and not good. You will need to clean inside and some how remove the hair which is not optimum. Yes, Dr. McGinn does remove hair follicles and she will do GCS without hair prior removed but all it takes is one hair to harbor bacteria and make a lot of smell and you will be very self conscious. A rug would be a disaster.

Anyhow, good luck with your GCS and congratulations.