8 WEEKS POST-OP STAGE 2

Having had the surgery on the 10th of March 2014, I had to figure out for myself how long exactly before I could get back on track and here are time delays precisions -

For that second stage, which is far less heavy on the body than first stage, only 3 hours on the table was necessary (when it goes up to 8 hours for stage 1) and i'd only spent one night in the clinic before being driven back to a hotel room the day following surgery -
Sticked around in Belgrade for 10 more days and took a flight, wearing the supra-pubic catheter once again, but this time had a neat device not to get drips of piss soaking my jeans..whilst walking around loaded w/th luggage....which had been an issue in the past -

SAFE N SMOOTH                                              

                                                                                                         

Back in a small studio sublet for post-op care, a lot of stitches to strenghten buccal mucosa graft in place + around rectum area where some skin tissue had to be removed (to avoid unecessary swelling)
now was only a matter of time before they fall off -

It took precisely 45 days before I could confirm physical mobility without any suture getting in the way - Before that and from day one , I had been mobile, having to shop or travel or getting meds but the whole area was obviously sore and risk of inflammation always present.
Especially since i had decided to swap medium-size testicles to larger ones, that was an added bonus that did go along the graft but which required some more time before resuming daily activities or long walks.
Once the soreness had gone, the few leftover stitches were enough to be an issue when trying to get active, even putting jeans on was a pain in the butt.. That's when you're a happy lad just hanging around in a pair of shorts, genitals dropping, avoiding tight knickers or itching of any kind.


       POST-OP KIT

            









          

                                                          CATHETER... OUT

TYPE OF SURGERY - Description

MLD PHALLOPLASTY Stage 1

Including : vaginectomy, neophallic reconstruction - microvascular MLD free flap phallo, clitoral lenghtening and straightening with the fixation at the base of the neophallus, urethral reconstruction 1st stage and scrotal reconstruction with bilateral testicular prostheses.
Total cost was around 18 000 Euros + Stay (about 2000 E for 15 days , inc. food )
(To double-check depending on what your surgery includes)

OUTCOME RESULT - 5.5'- 2 months post op

 Vaginectomy includes total closure of the vagina and removal of internal tissues - "Mucosa and submucosal wall are removed and then a muscle is used to close the space and create perineum as in male." No complication whatsoever on that side, no inernal pain, skin has sealed around the testicles, scar is barely visible. Also one of Belgrade's team achievement, vaginectomy is a difficult  procedure but they somehow handle it in less than an hour without risk of extreme bleeding and possible blood transfusion.

Clitoral lenghtening and straightening  with fixation at the base of the neophallus;

as you can see on the photograph, the head of what's left of the previous clitoral glans is visible between the balls ; it feels like a small piece of skin, very sensitive at the touch and it will be covered by the phallus in stage 2 - As far a I am concerned this is the only small detail that I hadn't expected, I had asked Miro about it and he was honest on saying that it would be placed between the testicles but for some reason I had assumed that there would be no trace of it after the intervention - I did not actually specified for it to be buried at that stage and when i asked about it a few days after surgery , from the answer i got and from what i gathered , it is safer  to "leave it aside" and focus on the urethra first. It does seem sensible to give priority to internal functionning and intervention is huge enough not to take any risk regarding aesthetical results. Still I am looking forward to 2nd step so that the head can totally disappear.

Urethral reconstruction stage 1

Neo urethra - 7 weeks post op

 Miro definitely succeeded in extending the urethra up to  1/3rd of the phallus (as shown ) .

I could use it after 4 weeks and it is a nice feeling Not to have any tube or catheter inside to be able to urinate; No infection , hardly no pain when peeing

It does go a bit everywhere at first but then flow gets steady and I can pee standing up almost without having to put jeans down -

Scrotal reconstruction w/th bilateral prostheses (21ml)

Medium-size Eurosilicone gel-filled prostheses (will go for larger size on a next stage), still quite hard to the touch at that point but should get squeezier wth time - Very sore first 6 to 7 weeks, very tight too , getting better after 2 months, skin is loosening around, scar barely visible -

One is looking up, the other one is lower down , will take a few more months before they both settle down and feel 90% natural..

Add: They are Several ways of creating testicles area;

there is the possibility of gradually loosen the skin Prior to get placement of implants (Scrotoplasty),

place some tissue expanders and then place permanent testicles prostheses on a later stage - You will find good description of those procedures on Meltzer website, http://tmeltzer.com/Surgeries_Procedures/ftm_surgeries/lower/tissuex_ftm.html

 Expanding tissue and placing prostheses at once is possible but it is quite intense regarding post-op pain, and risks of complications or infections are to be considered too. Every body has its own immune defenses and reaction to medical intervention, healing process is essential..

SURGERY AND IMMEDIATE POST-OP - STAGE 1

Surgery being scheduled on the 15th of November, I stayed for 2 weeks around, leaving on the 1st of december -

Spent 6 nights in a small, private hospital, checking-in the night before the intervention, clean, quiet , the nurses had long shifts , with a touch of sense of humor and got to learn a few words in serbian -

                                  ST MEDICA CLINIC

 First night - got a visit from Miro checking out last details and ultimate questions + from the anesthesiologist who explained what to expect for the day after surgery.

Morning before the surgery - After a light breakfast, priority is given to emptying your digestive system, you're being given a suppository that makes you go to the toilet, not a very pleasant feeling but is necessary, do take it in and use it, that'll be something less to worry the day after surgery-

One detail that was much appreciated, I got a first numbing shot beFore being taken to the operative room, in my room, so actually saw and felt nothing of the journey through the corridors, excellent.

During the stay at the hospital, you're lying down and hardly moving for 5 to 7 days, genitals are lightly bandaged and checked everyday and you get liquid painkillers and antibiotics through a tube connected to your hand - Body liquids go into 2 bags on the side of the bed -

The week post-op at the flat is when you actually take the measure of what your body has gone through;

flat is for rental (60 + 14% tax per night), comfortable, with all the facilities and in a quiet area.

I did ask myself before going to Belgrade if I wanted to handle the whole stay by myself and eventually decided that it would be nicer to have someone around.

It is not too much having a close friend or your partner to be there to help for food shopping, cooking and daily tasks (like putting shoes on..). And for company also -

That first week after the intervention is quite heavy and your body does feel slightly out of control;

in my case but from what i can suspect to happen to guys after phallo you are not in total control of the way your body voids urine, I got wet several times, best is to organize your bed covers, (and spare pairs of shorts and leggings..) and accept the idea - it only lasts a while and that will go as soon as the phallus catheter is taken out.
You have 2 catheters coming out of your body after surgery

Once the phallus catheter ( "foley" catheter ) is out - 15 days post-surgery, you still have another thinner catheter (called supra-pubic catheter) placed in your bladder, coming out of your low belly; you then void through that one for around 15 days - At that point (15 days after surgery) it is still too early to try and void through the phallus itself, neo-urethra needs to settle; That 2nd catheter is not obvious to use at first but with an effort on the stomach muscles, piss will definitely come out, the flow is quite slow (remember that catheter is quite thin compared to larger ones) and is very convenient for immediate post-op - Keep it for 4 weeks post-surgery -And you can wear under shorts and pants without discomfort, best is to stick it along your leg with a piece of medical tape.

TIP - If you encounter difficulties peeing I recommend some.. whistling! It relaxes internal muscles and helps ease up , try it -

Then comes the day where you want to start peeing with your neo-phallus, and that's were Miro skills definitely comes into play, urethra extension is a very delicate process and was a success as far as I'm concerned. Remember that at stage 1, the urethra can only be extended up to a certain lenght , 1/3rd to half up the phallus, and hole is created at the back (like shown on the photo) , under the penis.

That area created around the new urethra looks very sore at first sight, skin needs time to gently close down , and it will (count at least 6 weeks).

I can definitely pee standing up, i haven't experienced any pain since the surgery on that matter; important to drink clear water so your piss stays healthy and clean -

Neo Phallus  - 2 n 1/2 months post op

TIP  One thing that helped a lot especially on immediate post-op mode was to go under a shower for first piss in the morning and use the shower head to soothe area while peeing -

DONOR SITE

Ok so that's what's my side looks like after 2 months n half following the surgery - Site couldn't be totally shut down , leaving only a long side-scar;

Miro had to perform a free skin-graft, skin was too tight to put it back together - That's called donor site dehiscence, it happens in very Few cases  they manage to shut and sew a nice long line in 80% of cases , and you get warned that it could be a consequence of the intervention, depending on your body , muscles shape and skin elasticity - The more athletic your body is , the trickier it gets to close back totally -  It is all the more safer if you take at least 2 months to prepare the area through professional massages and skin stretching;

I had  around 20 sessions of it prior to my arrival in Belgrade. Skin was looking elastic enough, still i knew mine was quite adhesive and that muscles might get in the way..I was half-prepared to it so didn't get too upset and best was to handle after-care so it would stay healthy and clean. As abrupt as it can look to the eye, it is totally Numb, no pain at all, a bit too close to the armpit maybe but hey nothing can come too easily I guess - So the one detail i had to deal w/th post-op being that instead of taking some skin out of my thigh (which would have been yet another sore area on my body) I was told that graft was made from what was left of the vulva, meaning in short that i got a piece of vagina patched on my side, is that cool or..scary? All depends on how u look at it -  I'd like to insist that it is one of the most important step Prior to surgery to actually take the time to prepare donor site area, with (at least) 6 to 8 weeks of massages - depending on your skin elasticity -
  MLD Phalloplasty Massage video
+ Some Good Infos on  musculocutaneous-latissimus-dorsi-flap.htm To Copy/Paste in Google ..!
SEE LINKS @ bottom page

TIPS :  I chose not to get mad about it and am actually quite okay with the idea, i still have the possibility to cover it with a tattoo once it'll be tottally healed and safe -
+ I double-checked the information: there is a point where your skin reaches maximum elasticity, and i had done what was necessary, so it is neither a medical failure nor negligence on my part. It is only one eventuality that you have to be ready to deal w/th, still i insist it rarely occurs-  

5 MONTHS POST-OP HUNCHES

How about a short view of the results and of the general feel towards that new set of genitals -

Seems relevant enough to communicate as for informative purpose to those who are also aiming at phallo; I shall get a little graphic indeed -

Penis size is definitely fine , I have no doubt that the insertion of an erectile implant will be possible;

penis girth got more acceptable , in the sense that it felt really "fat" at first, and sligthly exagerated,

but that has settle along w/th the scarring, it got less thick and  more realistic -

As for testicles, that's  what i want to be talking about really; 2 things that have become obvious by now: they're quite rigid and hard to the touch, more than natural ones, and they won't go lower, one is closer to the base of the penis, and it doesn't feel like it's ever going to loosen enough to drop..

Scrotum construction can be done using different methods, mine was created all "at once", w/th the insertion of permanent medium-size prostheses, without any preparation of a scrotal bag;

Prostheses come in different sizes and you have the choice between permanent ones , (that are too rigid in my opinion, but that could suit guys that want harder balls) and expanders siliconthat you fill w/th e and that gradually strectches the skin - (over a period of several weeks ) - 

Some surgeons also prepare an empty scrotal bag for prostheses to be inserted later -  one of the advantage being that post-op pain is probably less intense and time of recovery shorter, but requiring added pre-operative organisation.

I also know that it is possible to change inital prosthetics for larger (or smaller..) at a later stage in surgery,( which I intend to do myself ) -

6 MONTHS POST-OP - PARTNERSHIP N GAY SEX

Right, so am back after a short period of standby - living - after several months away and separated from my present partner since pre-op last year -

Not sure how we managed that one but fact is that we've stuck together , regardless of the distance and unplanned events, added to the surgery that came after and w/th which I definitely needed to deal by myself.

I'd invited him on the 2nd week of my stay in belgrade, on immediate post-op mode, and he was awesome taking it all in , got to meet Miro and her assistant, and even helped to change donor site's bandages - We'd lived and travel together prior to the surgery but I was finding it really difficult to actually share the same space , considering the distance I'd already taken from my body long before i met him. I made a point not putting that aspect of myself too central as long as we were together but had to give it a break at one point so i could focus and deal w/th my own physical issues without the pressure or daily effort that comes w/th keeping up a close partnership.

There is no major difference in the way we relate to each other now that I've had phallo, except maybe that I can now appreciate the idea of sharing the same space, and that i can wake up with the tranquille reassurance of having achieved what had become the number one priority in my life.

Change of genitalia is a relief and has definitely lifted dysphoria - the anxiety and the anger that comes w/th it.

Sex is possible to a certain extent - remembering that I'm only first stage post-op and that insertion of an erectile implant should definitely heighten up the way I can use my new junk;

There is not so much sensation along the penis, it is more like a mental satisfaction as well as the shape and volume that comes into play -

However my partner managed to make it quite alive and slightly rigid, more than i would have expected at that stage of the surgery, flacidity does vary to a different level, and, hot water (like after a soak in a bath..) seems to make it firmer too - 

Penetrative gay sex is not so much conceivable right now, I feel quite keen on waiting for further intervention, 
Oral...well depends on guys, will wait for glanplasty for this one too.

    

10 MONTHS POST-OP - STRAIGHT SEX

hey guys, haven't been writing anything for last couple of months, not so good...
I might be a happier guy now that surgery happened last year, life is still the same uphill struggle !
Am still looking forward to stage 2 , especially for the clitoral covering, this is such a pain in the ..
I am loathing the sensation, really feels like unfinished work, I had to stop wanking because of that -
For years one of my prior issues alongside gender change was having a roof over my head -
I find myself travelling a lot, doing some back n forth between the country I grew up in and Uk just to try and fit somewhere and not be in someone else's place - daily survival is taking a lot of space in my schedule ..... am i trying to justify how come I still haven't been able to put stage 2 in motion?
Probably yes..
Anyway that blog is not about sucking issues like daily living, it's about the surgery and post-op impressions....so...... lets get back to it!

Last post was about gay interaction, which won't be possible until insertion of implants, like i said previously, penetrative gay sex is not that obvious, you need more rigidity -
However, my partner likes my cock and it definitely makes a difference to the way our bodies can relate - 
Still, I am quite obsessed with penetration to be honest, so I had to have a try w/th a woman, before that need to "get inside" would become frustrating and overwhelming to the point of dumbness..
I had not been with a woman for at least 2 years and it wasn't planned , I had no idea it was going to happen just a few days previously -
We spent a couple of nights together and took our time -
She was at that stage where she'd got really bored of regurlar sex w/th cis-guys, so she was quite happy being with a non-cis one and reciprocal experiment  was fine w/th her too -
It took me 3 sessions before I could actually get into her, w/th my knickers still on, for support -
Condoms are an issue if you don't have the XL size (!!!), standard ones are way too tight and i broke a dozen of them , trying to shove it in ...
But ......it does help a little for more firmness in the shaft - 
About firmness , it does vary, my penis goes from flaccid state to more rigid (never to the point of being "hard") and thickness changes too , along w/th tactile sensation -
Some guys choose Not to have any sex between stage 1 and stage 2 , i would easily be that type that prefers not to have sex at all than using a semi-rigid phallus ... still, there is no way I could spend so many months without having a go at it..
but hey thats also why I'm still living by myself , being prior surgery is ....undefinable.... and after that, being "in-between" stages is not a walk in the park neither, especially when you still have to make the cash for it to happen -
Coming back to that girl, we had good sex, respect and affection were present,
 and it's like a healing process to be able to share that with someone that you hardly know -
If I got one advice to give to anyone in such situations, bottom line is to Take your time , there is no need to rush anything, to feel uncomfortable, you're allowed to spend the night with someone without having to "perform" absolutely -
Once that trust is taking place, the body follows too, sex doesnt work if the brain interferes too much..

TIP: To achieve firmness, I used 2 condoms one over the other + a cock ring @ the base of the phallus
2nd TIP: To draw a glanplasty , I cut off the condoms at the head
to make it look more realistic n give it a cool shape