any tips on GRS via Dr Bowers?

[veritatemfurto]

So it looks like I'll finally be able to get my GRS sometime around September 2014 🙂 the insurance I now have through Disney/Cigna is going to cover it, but as far as I know, Bowers is the only choice I have that will take it, which isn't an issue for me after waiting for so long and I'm pleased with the photos I've seen of her work.

So with that said, what should I expect on making my trip to San Mateo, CA?

I'm also wondering which method of GRS Bowers is using now- the old simple inversion using the scrotal skin for an extension to the vaginal canal, or the newer method that actually saves and recycles most of the scrotal tissue by bisecting it along the scrotal seam to form the labia. I didn't see any info like that on the website.

And what about labial functionality when everything's all better? Should I expect things to be able to perk up when I'm aroused or shrink down when cold?

[Vicky]

Marci had her turn to work on me last January.  I am very happy with my results.  I actually did not know what had fully been done to me until last September when I went to one of Marci's presentations at a national TG convention mostly just to say Hi and Thanks to her.  At the convention, she showed a video that compressed a 3 hour surgery into 10 minutes, so I know that my scrotal tissue is now a major source of lining for my vagina, the penis shaft is a goodly part of my labial structure, and the urethral mucosa is my labia minora and part of the clitoral hood structure.  I do have a great deal of feeling all through the area, but some of it is a little confused right now and I am still mapping the sources of stimulation which is right on time to finish itself up in a year to 18 months. 

After surgery, you end up with a private room that has a place they will let someone else with you stay over night if they want to. The food is good there, but the San Mateo area is food heaven for gourmet eaters.  Also, there is a staff of RNs and LVN's that Marci has trained, and they are really just super.

You will be out of bed and moving 36 hours after surgery, at least in the hallways, and able to go to the recovery home or a hotel if you have people to help you at about 60 hours.  You are encouraged to become active as soon as you can.  It is a bit discomforting to be lugging your pee bag around for the three full days between hospital dischare and when Marci's office takes out your packing and the catheter and teaches you the life long art of dilation. 

Thats a good start for you to think about for now.  PM me if you would like. 

[veritatemfurto]

hmmm really? its going to take me a bit to have my mind grasp that reconfiguration... if only there was a full length video or diagram of it... and i think i would be ok with her using footage of my op for the benefit of others, as long as i could have a copy. oh how masochistic of me lol

[mrs izzy]

hmmm really? its going to take me a bit to have my mind grasp that reconfiguration... if only there was a full length video or diagram of it... and i think i would be ok with her using footage of my op for the benefit of others, as long as i could have a copy. oh how masochistic of me lol

There used to be that clip on youtube but it has been removed? It is a shame being it was a good showing of the surgery.
Just looked there are a few with Marci on youtube if you wish to look.
Izzy

[veritatemfurto]

I've been trying to, but everything I've seen so far is of clients vlogging about going there rather than seeing the cutting and suturing.

[Vicky]

Mel -- Call Robin or Janet at Marci's Trinidad office, the number is on the website there and ask if they know where the video Dr. Bowers shows at conferences is on the web, if it is, or could you get a DVD from them.  They are easy to talk to and super helpful, tell them you have cross posted with a Jan 2013 patient and both of you are confused.  (They may know which one I am by that description. )

[Jennygirl]

I am very interested in this too, I am looking at insurance options and California covers SRS if it is in-state. Initially I was thinking Brassard, but Bowers seems worth checking out as well because then I could do this for 1/4 the cost.

[Catherine Sarah]

Hi Mel,
Follow this link and scroll to the bottom of the page to " External Links" and select the Marci Bowers video.

https://www.susans.org/wiki/Penile_inversion

It would be very helpful to you to have another women with you during this time of recovery who can help in the "surgery" between the ears. I had my sister-in-law and the information and understanding about being a woman in a feminine world was priceless.

Wishing you every success, you certainly deserve it. You are in great hands. Just keep doing the work until you know and are totally happy with what's going to happen. Even to the point of arranging an inspection of the hospital so you'll know exactly what is required of you on the day.

Love
Catherine

[veritatemfurto]

hey Catherine! 🙂

I watched the video, had to slow it to half or .25 speed for me to see everything. I'm the kind of person that likes to visually study stuff *heh* but i did notice that it looks like the old Biber inversion method rather than the newer method Vicky was describing that she had done. 😕 I'm glad a lot has changed since that video from 2007.
What confuses me the most is her observation that the urethral mucosa is now used as the labia minora and part of the clitoral hood structure... I assume that it is the part of the tract that went from the glans to mid shaft- which is bisected to run up and down from around the base of the neo glans to the vaginal opening? does it help minimize hygiene issues along that area? it doesn't seem to me like that would be much material to work with- like half the size of a drinking straw... Or is it to provide some more material to work with to minimize the need for a follow up labiaplasty?

[Flan]

What confuses me the most is her observation that the urethral mucosa is now used as the labia minora and part of the clitoral hood structure... I assume that it is the part of the tract that went from the glans to mid shaft- which is bisected to run up and down from around the base of the neo glans to the vaginal opening? does it help minimize hygiene issues along that area? it doesn't seem to me like that would be much material to work with- like half the size of a drinking straw... Or is it to provide some more material to work with to minimize the need for a follow up labiaplasty?

It's for as much aesthetics (color of the vulva and vestibule) as function (sexual arousal). There is a small amount of increased risk using it but granulation tissue is a risk with any inversion based surgery. The amount of urethral tissue used depends on surgeon tech but generally don't expect it to go down to the vaginal opening because of the amount of stress there during initial recovery with dilation.

[Vicky]

Thanks for finding that one Catherine.  There have been a couple of changes from this to what I had and this is a different clip than I saw in September, although this was a good view for most of the show.  When I had spoken to Marci in September 2012 at the conference I have gone to for the last 5 years (at that time 4 years) she had told us (me) of some changes she had made including the mucosa tissue thing.  I do self lubricate to a limited degree because of it being there, it is the inside lining of my labia minora which my gynecologist favorably remarked on even when I had to see her for a yeast issue.  The use of the urethral mucosa is all of what people have said above. 

I had no granulation problems, even though one was suspected at about 2 weeks, hence the gynecologist visit, and diagnosis of yeast and a quick clean up of that.  All the yeast did was to have me ordered off the remaining contents of a vaginal antibiotic by both my gyn and Marci's office.  The antibiotic gel is used for your first few weeks of dilation along with your other lubricant.  A glob of it goes on the tip of your appropriate "boyfriend" (dilator) and the rest of the lube goes up toward the handle end. It is messy for the first few weeks of post life.

[Jennygirl]

Would anyone know of any differences (if any) between Bowers and Brassard's current method?

[Jenna Marie]

I don't know Bowers' full method, but I do know Brassard's. (I actually read the full operation report for what he did to me! It was pretty cool.) He uses penile inversion with scrotal skin to augment the vaginal canal as needed, scrotal skin to create the labia majora, and scrotal skin on the "outside" of the labia minora plus urethral mucosa to line the inner side, with the mucosa wrapping up to create the inner portion of the clitoral hood. The effect of that is that the labia minora and clitoral hood are a) light pink and b) mucosal, exactly as in cis women; one pleasant side effect is some degree of self-lubrication, varying by patient (I get enough to be moist but not to need a pad or to be adequate for sex, but I also get some internal lubrication *somehow* [??] that is enough to get by). The only external scars are about 3" in the center of each of the labia majora, from which I infer that he must stitch them together at that point, and at the base of the vagina where everything is connected. I gather there are also internal scars where the scrotal skin grafts are joined. Lastly, he also removes a 1" square of the perineum where the vagina will be located, and preserves that skin to use for additional vaginal grafting.

The overall effect, to me, is *very* natural - he deliberately places the hair-bearing scrotal skin in places where a cis woman would have hair (outer side of the labia majora) and urethral lining in places where a cis woman has moist pink mucosal tissue. Personally, since I know the scrotum is made from the same structures that create labia in the fetus depending on hormone bath in utero, I'm pleased to have it rearranged to where it should have been. 😉

[Vicky]

Thanks Jenna Marie -- The two techniques are slightly different although they do use the same tissue in some places.  I have the mucosa tissue in roughly the same configuration you described, but I have more scrotal tissue inside than you do.  The scar pattern is probably very similar too, although I do not really look to find mine.  I was interested to know myself since both do a one step surgery and I had heard rumors about what you describe, but no "first vagina" experience on it.  (Bad Vicky!!)

[Jennygirl]

Wow that sheds a lot of light. Thank you both!

So one other difference I see is that with Bowers genital hair removal is a must.

This is going to be a really hard decision between these two.

[Catherine Sarah]

Hi Jennygirl,

Dr. McGinn's technique is essentially the same as Bassards. Scrotal electrolysis is largely dependent on how well endowed you are in that area. I don't know if Dr Bowers makes it mandatory or not, as I discussed this issue with her last February when I saw her for a consultation. I advised her I would not be having scrotal electrolysis and that hair removal would be up to her.

Dr. McGinn who I finally chose, only recommends it, she doesn't enforce it.

Although I'm not well endowed with pelvic hair, the final result is very pleasing with respects to hair issues. The hair in the upper portion of the mons pubis is still recovering, and I've had to lightly shave the lower portion only once, to keep it tidy and under control.

As I understand, scrotal electrolysis is very painful, requiring substantial administrations of local anaesthesia. From memory of reading about this procedure, I recall that it must be competed no later than 6 months from your surgery. I can understand why. The skin trauma from electrolysis plus the surgery trauma must place this material in a risky category for necrosis, or at best granulations.

I know I still bear damaged skin on my jaw line from an over zealous operator. I can imagine the same may or can occur in the pelvic region as well.

Ask lots of questions from many people before you indulge.

Huggs
Catherine

[Jenna Marie]

Vicky : Cool, and thanks for chiming in - I know you're an expert on Bowers. 🙂 Plus you made me giggle. And yes, I dunno what's up with the hair thing, but I was NOT complaining that Brassard didn't require it (and I have zero hair issues afterward). I suspect how much scrotal tissue is inside also varies based on things like how much the surgeon has to work with for a given patient; if it's being used as a supplemental skin graft, it would stand to reason that the more penile shaft skin there is, the less of the rest is needed? Brassard offers free revisions for the first year, but despite it being a one-step technique, I had no desire to take him up on it. I think these days the one-step surgeons really have it nailed.

Oh, and I realized I forgot one obvious thing, heh. Brassard also takes all the nerves that run to the glans and combines them in the small portion of the glans that he preserves as a clitoris! No complaints there either; I was fully sensate the minute I woke up and it's only gotten better since.

[veritatemfurto]

from what I heard from my friend that's now a couple months post, it is only recommended too, since they will try to extract the obvious follicles during reshaping into the final form regardless of having it zapped or not. she did fine without it, so far...

[AlexisB]

@Vicky: I'm just wondering did you need electrolysis down there before hand?

[Jennygirl]

Oh, and I realized I forgot one obvious thing, heh. Brassard also takes all the nerves that run to the glans and combines them in the small portion of the glans that he preserves as a clitoris! No complaints there either; I was fully sensate the minute I woke up and it's only gotten better since.

Hearing things like this is what keeps me coming back to Brassard. Anyone know if Bowers does this, too?

That sounds amazing