Best SRS/ GRS (M2F) ???

[2124abc]

Hi, So I wanted to ask in this section because I want to really hear from post-op trans, M2F, those who are happy with the results - Can you recommend a surgeon to me?
I'm in Australia so there's next to no SRS surgeons, the common thing to do here is to travel to Thailand and get SRS there. But this is very important. I don't want to do some cheap surgery. I don't want to have the hole closing for no reason even when dilating per instructions, I don't want a bladder or blood infection. I will be willing to travel ANYWHERE in the world for good M2F SRS.

I care very much that I want to get a vagina that is pleasurable, but aesthetically realistic - as similar as possible to a woman-born vagina, the features need to be there, it can't just be a hole on its own. In fact maybe that's what I find most important - I want a CONVINCING vagina. I can't stress that enough.

I've heard Canada has some amazing surgeons. Also the UK. Let me list the two surgeons I've heard good of (if you've had SRS with them pls detail your opinions here):
Mr James Bellringer (UK)
Dr Brassard (Canada)

PLEASE PLEASE If you know anything about surgeons who can give me a realistic female vagina, PLEASE tell me. I want the best SRS surgeon in the world for me. It has to look real.
Thank you

[Mirian]

May I express my (perhaps unpopular, polemic) opinion ?
Surely others will answer you differently, based on personal experiences (mostly).
And my personal case also doesn't count (I came out from an Italian surgeon, I'm functional but
horrible to see, my vulva looks pretty everything else than a normal vulva and my V is maybe 10 cm
when fully stretched).
In the past months I did make some search on the Internet for SRS results (read: actual photos) but
I can confess that, even if some results are surely better than others, in NO CASE I could say "Wow !
That really looks good, like a natural vulva!". That said honestly: NO.
Just search for "SRS results neovagina" or such with Google images if you want to make a journay and
understand what I mean. Be aware that most results are not from SRS, but rather from females born
with vulva but without vagina (that's why some of them look so natural
Now the general opinion is that most surgeons excluding those from the Thai school or some from the USA (like Bowers) are butchers to keep off from.
But please keep in mind that most girls will never admit their vagina is not fine, at least not to admit that their efforts and pain was worth to nothing (is a psychological fact), and so most of them will claim that their
surgeon actually did a masterpiece.

Here're some links:
http://www.annelawrence.com/vaginoplasties.html
http://thesexchange.com/ (the Thai school, very huge gallery, the link is not always working)
http://marcibowers.com/mtf/mtf-services/grs/outcomes/

Then you can tell what you want, but I'm not seeing any natural looking vulva.
So the matter is chosing the best the "market" offers us in terms of look and functionality.

[Jenna Marie]

(one issue with photos that I had is that most are immediately post-op, and it can take a year - or in my case, more like 2 years! - to settle into its final appearance. It also helps to have seen a gallery of cis vulvas; there are some sites and books out there that do that. I felt a lot better once I could find a dozen pictures of cis vulvas that looked just like mine.)

I went to Brassard. I have since been sent to a gynecologist to obtain a letter for my insurance company that I am a woman in surgical menopause and *need* to be on menopausal levels of HRT despite my age; I assumed the gyn knew what's up, but I got a letter stating she'd found evidence of a hysterectomy! So I'm taking that as proof that even an expert couldn't tell the difference. (I had to call back and ask her to fix the letter. At first she didn't believe me about why. It was funny, if annoying.) I was also in an ER for an unrelated condition with my pants off and everybody again assumed hysterectomy explained the HRT, although there wasn't an internal exam that time.


I'm going to just infodump b/c I'm too lazy to retype all of this.   This is more or less the most comprehensive post I put together for someone with questions about Brassard. (As for who's "best," it depends on your priorities! I thought Brassard was b/c I prioritized sensation and looks over depth; for someone who cares more about depth, he's NOT an ideal choice.) If you have any questions I didn't cover, please feel free to ask.



reposting more or less the gist of my PM, with some edits to make it comprehensible with the OP's text removed :

In fact, I had essentially full sensation - clitoral, labial, and internal vaginal - from the moment I woke up from surgery. This was a downside during the initial days, as you can imagine, although the pain wasn't all that bad.

Yes, I am easily orgasmic. It took a bit of effort to relearn my body, but my first orgasm was 3 weeks post-op in a dream, so clearly the nerves all worked fine and it was my brain getting in the way!

Not sure about prostate sensation. I didn't ever experiment with prostate stimulation pre-op, so I wouldn't necessarily recognize it post-op. I do have an area of highly erogenous sensation in roughly the equivalent spot to the "G-spot," which I have been told is likely the prostate.

I am fully sensate inside my vagina. Again, not orgasmic from vaginal stimulation alone, but it's NICE.

Never any numbness, either.

In fact, the pain was less and ended faster than I'd expected. It was still probably 3-4 months before I wasn't a *little* sore after a long day, but less than a month before I was almost 100% pain-free.

Yes, I have labia majora which are aesthetically correct and properly located. Mine are pretty puffy, but I also had tremendous, ridiculous swelling right after (even the nurses were shocked), so I'm not convinced it's all gone away YET.

Ditto the labia minora. They're fairly small, but that's not atypical.

Yes, I have both a fully (extremely!) sensitive clitoris and hood. Incidentally, both the clitoral hood and labia minora have the inner portion lined with leftover urethra, which is mucosal tissue that is light pink and moist just as in cis women, a detail I appreciate.

Yes, my urethra is correctly positioned and functional. It's just barely distinguishable from the vaginal opening (ie, directly above), which matches what I see in my wife and on anatomical diagrams. There were some issues with spraying early on because of the severe swelling, but everything works fine now.

My vaginal opening is also correctly placed and looks normal.


I did not do hair removal, and have had no hair regrowth except in areas where I would expect it (pubis, outside of the labia majora).


5" of depth as far as I can determine. I'm content with that. I started with 5.5" but that half inch may have been swelling for all I know.

No serious complications aside from one stitch that pulled out early but healed cleanly. I did have a reccurring soreness and a need to massage/stretch the scar tissue around 3 months post-op, which I've been told is normal for any surgery (not just GRS).

I did have a devil of a time with the catheter, though. Again, bladder spasms are harmless and common, but that was AWFUL. I was so glad to see that go.
   

He offers free revisions for the first year but I was happy. It's quirky/not identical to other vulva I've seen, but hey, that's normal!

As a final note, I also do self-lubricate somewhat, and can "squirt" at orgasm on occasion. (But I have a female partner; my experience with penetrative sex does not involve men, if that matters.) All in all, I'm very satisfied.

[Veronica M]

I find this information extremely useful. Even though I am at least 3 to 4 years out at best from SRS if not longer it is nice to be informed. I do have a question as in relation to penetrative sex as sexually I am into men. That is the depth issue. Mind you, I am very new to this and do not have a lot of knowledge on the subject. Let's just say that if ones partner is quite large or long, is there risk of doing damage? Any information here would be very helpful..

Thanks,
Veronica

[Jenna Marie]

I don't do men, but my understanding is that once you're fully healed there's no real risk of damage, or at least not more than is likely with a cis woman - it *is* possible to have some minor tearing or chafing, for example, but nothing that would require surgical correction etc. - the main downside is that he'll "bottom out" (reach the back of the vagina).

With that said, lots of cis women have vaginas too shallow to accommodate Long Dong Silver, and there's also the fact that not all of the penis goes inside b/c of things like bones and tummies in the way, so a 6" penis will NOT penetrate to a depth of 6". My personal experiments, using a strap-on so that it's probably *more* likely my wife could get extra length inside than the reverse, is that a 7" "penis" had no problem whatsoever penetrating to maximum depth in what I know from my dilators is a 5.5" vagina.

And speaking of dilators, the largest we use is 1.5" diameter, or nearly 5" circumference. If I ever met a man that big, I'd congratulate him while backing slowly away.

[Veronica M]

And speaking of dilators, the largest we use is 1.5" diameter, or nearly 5" circumference. If I ever met a man that big, I'd congratulate him while backing slowly away.

LOL... Yes I think I would do the same... I prefer regular sized men, 6" or so perhaps a little larger, but in the future if I happen to run into as you put it, "Long Dong Silver" I just wanted to know if it could cause harm. Thank you very much.

[2124abc]

Thank you Mirian & Jenna Marie for your excellent answers. Mirian - I will look at those websites you've suggested and try to learn more about it all...

[2124abc]

Jenna Marie - Thank you so much for the info on Brassard's SRS and your results. To answer your query on what I find to be the best - I care more for looks over depth, as long as the depth is about 5 inches I'm happy, but i really care that it looks real with all the structures present. I'm into both men and women but I don't think this depth will be a problem unless it closes to 4, 3, 2 inches, which worries me.

From what you describe, the pleasure factor sounds excellent for Brassard's SRS.

Personal question: do you need to be uncircumcised for Brassard's SRS? I'm circumcised

Are there various types of SRS that Brassard performs and how do I make sure he gives me the SRS that you got? - that includes an aesthetically realistic look with all necessary structures present??? That lubricates a bit too?

What's dilation like for you, does Brassard offer the typical instructions? - x number of times a day dilation for the first year then once a week? How long before you progressed to different sized dilators?

Thank you so much for helping, Brassard is sounding excellent.

Also since I'm way overseas, not anywhere in the Americas, how long will I have to stay in Canada before flying back home? And will I have to dilate on the plane? (o god! what about Scanners & Customs - they'll think dilators are pleasure toys and confiscate them, o no!?)

[Vicky]

(o god! what about Scanners & Customs - they'll think dilators are pleasure toys and confiscate them, o no!?)

I am not one of Brassard's patients, but I have flown with my dilators in my carry-on luggage with nary a problem.  You will have documents from the doctor that will qualify your dilators as necessary medical appliances, and the fact that here in California (where Brassards dilators are made and sold) they are only about $40US which means if you have to pay customs duties at home, which I doubt with the medical documents, it will not be a whole heckuva lot.  An airport scanner did pick up my dilators, I was asked to open my bag, I showed them to the agent who was quickly more embarrassed than I was when I told him they were medical stents because I had had vaginal surgery!!  All with a straight face.  I giggled like hell when I got out of the screening area.  As I said no problem for me.

[Jenna Marie]

2124abc : As far as I know, he only does one version (unless you specifically request that there be *no* vagina created), so you should be OK there. And I was circumcised; if someone is exceptionally small, he will do skin grafts from the thigh, but he does warn you beforehand if that might be necessary. Some of what we get is the luck of the healing or possibly nature's gifts, of course; for example, I know someone who got 6.5" from Brassard, and someone else who had nerve damage with him (which is a risk with any surgery, not just GRS).

Brassard does provide a letter saying the dilators are medically necessary, and they generally recommend around 11-12 days in Canada. That's 2 days in the hospital, and the rest in the recovery residence.

Mirian : I admit, now that I took a peek, the sexchange web site photos do *not* look natural or normal. I wonder which surgeons those were? I have not seen very many results that look so anatomically unnatural that I can't figure out which structures I'm looking at, but some of those... I see your point!


I'm going to repost Brassard's schedule from the informational packet he sends patients. Right now, I'm doing twice weekly for 15-minute sessions with the largest dilator, tapering down slowly to once a week. He leaves the "tapering" period up to the patient, and I'm going more slowly than many.

BRASSARD'S OWN INFO  FOLLOWS :
Post operative dilation and douching instructions

Dilations

Healing after a vaginoplasty lasts one year.  Keep in mind that the
success of this surgery depends on maintaining the length, girth and
depth of your new vagina.  To achieve this, you need a set of 4
dilators and respect the instructions below. Do not stop dilations
without advising your surgeon.  Stopping dilations will cause the loss
of the vaginal canal and is irreversible without further surgery (skin
grafts or bowel transposition).

Relaxing

Relaxing is the key step.  It will make dilations much easier.  Taking
ten slow deep breaths before beginning is one good way to get rid of
tension.

Angle

After you have localized the vaginal opening with a mirror, insertion
should be made for the 2 first inches with a slightly downwards 15°
angle.  Do not go directly towards the rectum.  After that the angle
should be corrected so that the dilator becomes almost parallel to the
bed while trying to aim at the navel.

Pressure

Insertion should always be gentle and slow.  When the dilator is
inside the vagina for the entire length, apply constant not forceful
pressure.  Gaining depth by applying more pressure is not advised.

Dilation instructions

Wash your hands

The first day of your dilations, the attending nurse will show you
every step of the process.

-       Hold dilator #1 like a pen

-       Apply about one teaspoon of lubricant gel on the tip of the dilator

-       Insert at a slight downward angle for the 2 first inches

-       Leave dilator inside 5 minutes; remove slowly

-       Repeat with dilator #2 for 15 minutes

The second day of dilation can be more difficult because of swelling
that sets inside the vagina during the night. It is perfectly normal.
Be patient.

You should gently and frequently wipe out the gel that is coming out
at the bottom of the vagina.

Wait 3 months before having intercourse.



DILATION SCHEDULE

At the residence

You should dilate 4 times per day.

Day of traveling

You should at least dilate once before leaving the residence.  If you
have time, dilate more that once before your departure.  Even if you
have a long day of traveling and you cannot dilate for hours, you
should plan on doing at least one dilation when you arrive at home.
Please be active on the plane.  Walk as much as you can.

Home

Resume your schedule as soon as possible.

At home, you should dilate 4 times per day with, #1, #2 for 5, 15
minutes for one month.

Dilate 3 times per day with #1, #2, #3 for 5, 10, 15 minutes for two months.

Dilate twice a day with #2, #3, #4, for 5, 10, 15 minutes for 3 months

Dilate once a day with #3, #4, for 5, 15 minutes for 6 months.

Slowly increase the interval of time between each dilation until you
reach one dilation per week with #4, for 15 minutes for the rest of
your life.

If you have difficulties with a bigger size dilator, wait before you
are comfortable with this one before using a bigger size.  You can go
back to a smaller size and increase the frequency for a few days.


CARE FOR DILATORS

Wash the dilators after each use with non-abrasive antibacterial soap
in warm water and dry thoroughly.  Do not wash them in the dishwasher
or clean with alcohol.  This could damage them.

While at the convalescence home, the dilators are kept in Hibitane,
Dexidin 4 or  Hiciclens 4  to find in pharmacy.  25ml of solution in
one gallon of demineralised water) Use one or the other solution.
After 2 months, store them in a clean and dry place between dilations.

In two months, stop: vaginal douche, soaking your dilators and sitz bath.

The Polysporin cream is for 10 days.

Maintain at least 2 hours intervals between dilations (from the time
you finish one and the time you do another one, 2 hours minimum.

[End of surgeons' own info]

[2124abc]

I showed them to the agent who was quickly more embarrassed than I was when I told him they were medical stents because I had had vaginal surgery!!  All with a straight face.  I giggled like hell when I got out of the screening area.  As I said no problem for me.

Lol  thanks Vicky, that makes me feel much better 

[Jenna Marie]

Oh, right, and what's dilation like for me - boring, mostly! It feels a bit weird and stretchy, and there were some stinging pains early on, but it was never particularly painful and within about 3-4 months settled down into a routine of watching TV or reading a book while stuffing that thing into me. It's time-consuming early on, and annoying and boring forever, but 15 minutes per week shouldn't be bad (even the current 2x weekly is fine).

[2124abc]

Thank you so much Jenna Marie, that's so much helpful info.

I get a little bit confused after reading all the instructions, especially the parts about dilating before I get on the plane home but after leaving the place of residence- like does that mean I have to dilate at the airport? Won't i get kicked out of the lounge for doing that? And I have to stay active on the plane? That's interesting, I don't know how often I'll need to be moving about while trying not to tear anything.

I assume I need to order the last two dilators? That means I need to order them from California and have them shipped to my home country?

Also the dilation times confused me a bit, at the end he says leave minimum two hours between dilations, is that between the sessions of using each dilator one after the other or actually two hours between dilator #1 and dilator #2 etc? (sorry im so stupid)

The angle of the dilator going into the vagina confuses me too, like does it go in parallel to the ground? If so, why doesn't it go upwards (sorry if I've had no experience with actual vaginas before, but I thought the hole goes at an upwards angle?)

[2124abc]

Oh, right, and what's dilation like for me - boring, mostly! It feels a bit weird and stretchy, and there were some stinging pains early on, but it was never particularly painful and within about 3-4 months settled down into a routine of watching TV or reading a book while stuffing that thing into me. It's time-consuming early on, and annoying and boring forever, but 15 minutes per week shouldn't be bad (even the current 2x weekly is fine).

And like does it matter what time you do it, does it have to be the same time every day you dilate like always on the morning or midday, like wondering if sleep affects it?

Can you do exercise without risk of damaging the vagina? Will there be some exercises or stretches (yoga etc or intense swimming, or squats, 4e.g.) that might damage the vagina, later on?

[Jenna Marie]

Brassard will supply all four dilators, although you won't need to use the bigger two at first. And the nurses will explain the dilation and demonstrate it for you if you need it - you don't need to worry about the angle stuff yet. They'll walk you through it until you're sure. Same thing for all the dilation, really. You'll have it explained until you understand it.

His instructions say to dilate once before leaving the residence, twice if you can manage it. You should not have to dilate while traveling. As for walking, they had us up and walking around 18 hours after surgery, and encourage getting as much gentle exercise as possible. I (slowly, carefully) walked about half a mile the day before I left for home.  As for exercise, he says no lifting more than 10 lbs or exercising too vigorously for the first two months, and after that go by how you feel. Some women are back to their usual routines shortly after; some take months to feel up to it. That's going to be up to you. Once you're fully healed, your vagina will be as sturdy as a cis woman's; you will be able to do any exercise you want. It took me a year to get back to riding long distances on my bicycle, admittedly, but I did get there.

The two hours between is from the end of one dilation session (using all 2-3 dilators) to the beginning of the next. There's no real break between one dilator and the next in a session, except maybe a minute to lube up the next one. I think a lot of us tend to do it around the same times each day just because it's easier to set a schedule, but you don't HAVE to. If you wait too long between sessions, you'll know when you're a bit tight/sore the next time, that's all. I never had any trouble sleeping 8-10 hours, either. If you needed to sleep like 14 hours, you *might* have an issue, but honestly I was so exhausted that I was napping constantly all day plus the 8 hours at night, and never had a problem with oversleeping!


btw, as far as size goes, my wife can't even fit the biggest dilator!  She was sore for 3 days the time she tried, and I used to be pretty well endowed. So I figure we come out of it very well in terms of width - I can comfortably use that size dilator.

[2124abc]

O the width will be good, alright! - thank you so much. Hopefully I'm not annoying asking too many questions I just want to pick a good surgeon. Brassard sounds amazing. The nerve damage tho, sounds a bit worrying, I hope that hasn't ruined that girl's life somehow, like I thought nerve damage can paralyze you or something, IDK? I'm scared of something going wrong.

So most SRS surgeons require letters from psychs and also that the patient has to have been living full time as a girl for a year or so, just wondering when that year begins? Like how do they know I've been living full time as a girl (i haven't yet btw, I want to be full time girl in a month or so) so do I have to go and see the psychiatrists and say to them "Look, here I am! I'm full time as a girl. Start the yearly timer please, so I can get SRS next year."

Do I say that to them?

[Jenna Marie]

2124abc : I'm always glad to help! Oh, and no, the nerve damage is a tiny patch of numbness, nothing serious. It has happened with most surgeons who deal with nerves; even basic plastic surgery has that kind of warning. I think the paralysis kind is when the surgeons are working with the spine; for GRS the biggest risk to the nerves is just that some of them won't come back online in the genital area after being cut or rearranged. But it's good to read all the possible complications going in, just to be prepared.

I honestly don't know how that works in general. My therapist pretty much wrote whatever I wanted on my letter, although at that point she knew I'd legally changed my name about 2 years previously.

[Cindy]

O the width will be good, alright! - thank you so much. Hopefully I'm not annoying asking too many questions I just want to pick a good surgeon. Brassard sounds amazing. The nerve damage tho, sounds a bit worrying, I hope that hasn't ruined that girl's life somehow, like I thought nerve damage can paralyze you or something, IDK? I'm scared of something going wrong.

So most SRS surgeons require letters from psychs and also that the patient has to have been living full time as a girl for a year or so, just wondering when that year begins? Like how do they know I've been living full time as a girl (i haven't yet btw, I want to be full time girl in a month or so) so do I have to go and see the psychiatrists and say to them "Look, here I am! I'm full time as a girl. Start the yearly timer please, so I can get SRS next year."

Do I say that to them?

Hi,

I'm in Adelaide South Australia and there are lots of Aussie girls (and boys) on the site.

Generally to get treatment in Australia you need to see a therapist, most commonly a psychiatrist and they lead you through transition, get you referred for HRT etc and generally help you deal with all the issues that crop up. Most in Australia practice informed consent.
Generally after a year RLE they write the letter, and you need two for Brassard from memory.

To find practitioners in your area try www.anzpath.org there is a list of providers on there.

Otherwise let us now where you are and one of the girls can direct you to someone.

Cindy

[2124abc]

Thank you Cindy. I'm in NSW. I have a psychiatrist who was recommended to me by my endocrinologist. I'll ask the endo whether or not the second letter will need to be written by another psych or just the endo himself.

I think based on what people are saying I should see the psych again once I'm living full time, just so he gets an idea of when I have started full time so that way next year or year after he can help me. Since I see the endo more times, he'll know, too, that I will be full time by the next time I see him.

So I think 1 letter from psych and 1 letter from endo will do.

[2124abc]

Jenna Marie, the first link that Mirian provided I had actually seen before - that was where I first read of Dr Brassard. Looking at all the pictures for all surgeons, Brassard's results stood out IMMEDIATELY to me as more natural looking than all the others. That is probably why I thought he seemed the best for me.

I think I'm really sure about this doctor, and I read elsewhere that Brassard's practice used to have an incredible SRS doctor who's now retired, who would have taught Brassard the best.

I think when I'm ready I will be getting the SRS and breast implants with Brassard, like I really want the SRS ASAP (in 1 year), you know?, but the implants i read somewhere that I should wait for 3 or more years for the breasts to fully develop. IDK if I should get the implants at the same time as SRS or fly back a few years later for the implants because I don't want my breast growth to be hindered if they hadn't fully developed but I sooo badly want to get rid of this thing between my legs and replace it with a vagina like it should have always been.