My Bottom Surgery Journey

Essentially a placeholder blog until my first GIC appointment. Where I'll muse and post about bottom surgery.

[mybottomsurgerydiary]

I got my first Bottom Surgery Signature!

Today I had my appointment at Charing Cross Gender Clinic to talk about bottom surgery - and after a quick discussion my clinician agreed to sign me off!

I was asked about my sexual life, whether I wanted children, and what type of bottom surgery I was considering - to be honest it wasn’t too extensive and I am so happy now! It’s a year wait till my next appointment when I’d be referred but I’m happy the ball is rolling!

[mybottomsurgerydiary]

Bottom Surgery Research - Risks

A study of postoperative men showed that on average, 25% had one or more serious complications of the neopenis. The ones reported consisted of: 

Loss of the phallus from either disease or blood supply issues

Cephalic vein thrombosis (blood clot)

Arterial ischemia (shortage of blood supply)

Infection

Distal limited necrosis (death of parts of the penis)

Hematoma

In the same study, chances of complications of the extended urethra were higher, averaging 55%. The most common complications reported were:

Urinary fistula (hole) requiring perineal urethrostomy

Urinary fistula (hole) with conservative treatment

Urinary retention (from stenosis or narrowing of the new urethra)

(Erectile) prosthesis change (from complications)

(Erectile) prosthesis explantation (removal of the prosthesis without replacement)

Overall urethral complication rate for RFFF phalloplasty was 31.5%; the overall pALT rate was 32.8%. The rate of partial or total neophallus loss was 7.8% for pALT and 3.4% for RFFF. Patients in the pALT cohort experienced significantly greater odds of urethral fistula (OR=2.50, p=0.024), non-urethral complications (OR=2.38, p=0.027), and phallus wound dehiscence (OR=5.03, p=0.026).

Donor Site Risks:

Wound breakdown   

Decreased mobility   

Hematoma     

Pain     

Decreased sensation      

Excessive scarring     

Hypergranulation, slowing down wound healing and raising risk of infection. 

Adhesions: A band of scar tissue that binds two parts of tissue together.

Long-term Complications        

Urethral stricture is a narrowing or closure of the new urethra caused by scar tissue or hair growth in the urethra. Strictures typically develop 6-12 months post-operatively. Symptoms include a weak urine stream, difficulty urinating, or a complete inability to urinate. If surgical treatment is not pursued, the patient will likely face a lifetime of repeated dilations.4

Postvoid incontinence or dribbling occurs in about 79% of Phalloplasty patients according to this study. 5

Wound contracture leading to distortion of surrounding tissues and contour defects.

Scars can stretch, become red and raised (hypertrophic), or grow beyond their original dimensions (keloid).

       Risks Associated with Penile and Testicular Implants        

Infection is the most common complication with implants. If an implant becomes infected, it typically has to be removed. Replacement can occur six months later.

Erosion is when the implant breaks through the skin. Surgical removal is required if this occurs.

Loss or displacement of testicular implants occurs at a rate of 2-30% and can increase the risk of urethral complications.6

[finntheinfinncible]

Today is a rather massive anniversary for me. I am now 5 years on testosterone! The time has absolutely flown by. The changes are incredible, the physical ones for sure, but more noticeable and astounding are the internal changes. To be no longer at war with my body but instead feeling like it is my home, is truly and indescribably wonderful. Of course, testosterone is not a magic elixir. Life still has its ups and downs as is its nature, but these all feel so much more manageable now I am at peace in my internal world.

Whilst 5 years feels like a big milestone, considering what has changed in those years, it’s still very early days in my transition. Certain aspects, such as the surgical part of my journey, are yet to come to an end. Other aspects, such as finding my new place in the world and getting to know my new body are ongoing. Life is an expedition, I’m very much enjoying looking back at the landscape I’ve navigated so far, the view from up here is amazing and I can see beautiful things ahead. However, the destination has now become irrelevant. I much prefer to just be present, to enjoy watching the scenery as it comes to life around me as I walk this incredible journey.

Thanks to all you lovely folk who walk it with me. Having you pull me up the rocky hills, cheering me on and celebrating each way-point, means the absolute world to me.

#transformationtuesday #selfmademan #vitamint #gendertransition #pictures #comparisonphoto #ftm #transgender #recovery #lifeonlifesterms

[mybottomsurgerydiary]

"However, the destination has become irrelevant. I much prefer to just be present" - THIS puts into words the effect testosterone has had on me

[mybottomsurgerydiary]

I'm coming to conclude that I definitely need bottom surgery... the next question is Phallo or Meta?

[spaced-nate]

Everyday I want phallo more and more

[mybottomsurgerydiary]

Bottom dysphoria

Just a quick exploration of my bottom dysphoria as I try and decide if Bottom Surgery is right for me:

Peeing sitting down can be really uncomfortable and upsetting for me - using an STP feels better but is a whole load of effort

Masturbating while I directly touch my junk very quickly becomes very horrible if I actually think about what's going on - if I dissociate it is just about manageable

My bottom growth makes me feel amazing and I love the way it looks

Packing day to day is super nice and really makes me feel more content. It is uncomfortable at times but the fact that I can feel a bulge and feel something between my legs is way more important than that to me

Not being able to feel my prosthetic during sex can make me very dysphoric if I become properly "present" in the act

Overall I feel "incomplete" and can't help but feel that having a penis would remedy that

[mybottomsurgerydiary]

Do I need Bottom Surgery?

Pros and Cons

I'm a month away from my first appointment to try and get a bottom surgery signature. I'll get another shot at this in a year - so I'd like to be relatively sure before I go into the appointment what I'd like. This is a way of making sure - these pros and cons may not apply to everyone but they apply to me.

Cons

Three separate surgeries - meaning three separate long periods of time off

The first surgery means a week in hospital

Recovery for both first and second stage is long. As I've proven to myself when recovering from top surgery - I am not good at recovery

The arm scar. If I get RFF phalloplasty this is unavoidable

The risk I'll lose sensation

Risk I'll hate it

Potential to be unable to have sex for a year

Huge risk of complications

Pros

Dysphoria would be gone. I'd literally have no dysphoria about anything.

I'd be able to swim/change in locker rooms etc without worrying about passing

Not having to use like four different devices to get round bottom dysphoria

I'll be able to feel sex!

Ability to orgasm without that coming with dysphoria

Feeling of being "complete"

Will allow me to "forget" I'm trans