Stage One Phalloplasty: Experience and Results
[Trigger Warning: Genital mention, surgery]
The following post documents the most memorable parts of my experience having phalloplasty along with my recovery.
I had Stage One RFF Phalloplasty privately on the 18th February 2020 under Mr Christopher from St Peterâs Andrology Centre at The London Clinic Hospital.
I arrived at the hospital at 18:00 ready for surgery at 9:00 the following morning.Â
I would be staying at The London Clinic for a week so I packed the essentials: loose joggers and a baggy shirt for when I would leave, my phone, laptop, dressing gown, toothbrush, deodorant, face wipes, dry shampoo, eyemask (so useful as there was always some form of light on), and laxatives (trust me, if you have a long surgery these are a must-have once you can use the loo).
Upon my arrival, I was surprised to see that the hospital was more like a hotel if you looked past the medical equipment. It had decent-sized rooms, a concierge service, and very good food from a broad menu that you ordered at the start of each day.
Anyway, that evening after getting signed in I had my pre-op checks, ordered some dinner and then spent the rest of the evening relaxing before turning in for the night. I didnât sleep particularly well due to the new environment and anticipation about having the surgery. The fact that I was having phalloplasty didnât set in until I was on my way to the theatre the following morning.
I was woken by a nurse at 7:30 who did some final pre-op checks on me before the surgeon, Mr Christopher, came to see me just after 8:00 to discuss the procedure. I was told that the surgery would last between 6-8 hours and warned of all the possible complications once more. Once he was finished, I signed my consent form and he marked on my arm the size the graft would be. Shortly after he left, the anaesthetist came in and discussed what she would be doing and I was presented with another consent form. Once that was signed she informed me that a nurse would take me down to the theatre in the next 30 minutes.
At this point, my nerves set in regarding being under anaesthesia for so long. Iâve never had any issue with aesthetic but this was the first time I was somewhat anxious about it, after all, thereâs a huge difference between being unconscious for 2-3 hours and 6-8. Despite that, I remained positive that the surgery would work out just fine and that I wouldnât have any serious complications. I reminded myself that I was fit, healthy, and in good hands. A positive mindset helps a lot, which was something that the nurses I chatted to emphasised.
A nurse came to get me shortly before 9:00 and I was escorted downstairs to the theatre that was, and I kid you not, the most horrific shade of bright green Iâd ever seen. I made myself comfortable on the bed and the last thing I recall was happily chatting away to the anaesthetist before waking up in the ICU with a nurse reaching down into the cast my arm was in asking if I could feel her touching my hand (I could).
I was in theatre for seven and a half hours.
To say I had some brain fog upon waking up would be an understatement but I was in good spirits. My arm was held upright in a purple sling (and would be in that position for the next week) and I was hooked up to all sorts of things including a morphine administration button. In all honesty, I was never in any real pain as if anything started to ache I was quick to nip it in the bud before it had a chance of getting worse. Mr Christopher came to check on me not long after I woke up and informed me that the surgery went very well which was a relief.
After just over an hour in the ICU, I was wheeled up to my room where I asked for my phone and was quick to let my partner, mother and friends that I was alright before dozing off.
For the first four days, a nurse would come to check my blood pressure and the circulation in my phallus every four hours (then every six hours after that). The circulation was checked using a doppler and thankfully there was the sound of a heartbeat when it was held there meaning that the artery was supplying blood to the area. It was such a fantastic feeling being able to look down and see something there (that, in my mind, was always supposed to have been there). The phallus itself was supported from underneath by some padding to keep it at an angle to allow for a steady blood flow. I was told Iâd have to keep it upright for three weeks.
I was woken early for breakfast, and although my appetite wasnât fantastic I did my best to eat what I could. I was told that I would be bed bound for another day and little did I know how frustrating Iâd find being stuck in bed.Â
Now, youâd probably think that the pain in my arm and groin would be atrocious, but youâd be wrong. I had no pain in my arm and only a dull ache in my groin that was easily kept under control by the morphine. If anything, it was the staples in my bottom that were by far the most uncomfortable part of this whole experience in and out of hospital until they were removed two weeks after surgery. Trying to make myself comfortable with staples digging into my backside was a never-ending challenge.
In the afternoon, my partner, mother and best friend came to visit me for a few hours which was great (it was good for them too to see that I was fine as well). I was sad when they left, but I had my laptop and plenty to watch to keep me occupied.
I had a rough night's sleep which wasnât helped by a tension headache that was likely caused by the position my arm was in. Thankfully the physio came to visit me and helped me work my arm a little which helped and I was instructed to regularly move my hand to keep the circulation going.Â
By this point, I was already fed up of being trapped in bed, there was never a comfortable position to do anything (even sitting up was uncomfortable) especially with my arm stuck in one position. The nurses did come to give me a bed bath in the afternoon which definitely improved my mood and after dinner I was later told that I would be getting out of bed tomorrow which I was looking forward to.
This was the day I got out of bed and it was such a relief. After breakfast, the physio and a nurse came to unhook me from all sorts of cables and assist me in standing up. Once on my feet, I went for a walk around my room and up and down the hallway outside. Apparently, I did extremely well getting up and moving around so much as a fair amount of people who undergo the same surgery struggle with mobility, so knowing that I was doing so well was a great boost to my morale.Â
I was able to finally sit at a desk too which was so much more comfortable than the bed (though the staples still caused a lot of discomfort even with me sitting on a pillow). My mother also came to visit again and was there to help me with some more walking about. Just before dinner, I had the catheter removed and was able to go to the loo.Â
Pain wise, today was when I stopped using morphine as the oral painkillers the nurses provided me did the trick. As for my phallus, the doppler kept showing that there was a pulse and whenever it was inspected by the surgeon or nurses I was told that it was healing very well and there was no cause for concern.
I had all the remaining drains and tubes removed today and began walking up and downstairs with the physio with no issue.Â
I spent much of the day trying to eat more, binge-watching shows and documentaries and getting on with some writing (I got a surprising amount of writing done despite being down one hand!)Â
Today was also the day I had my first shower with the aid of one of the nurses and getting cleaned up properly was wonderful.
This was my last day in hospital, by now, the nurses only came to give me my pain medication (just Paracetamol and Ibuprofen) every four hours or if I called for them. Above all, I was looking forward to going home, being with my partner, and sleeping in my own bed.
Discharge day and the day I saw my arm for the first time.
I had breakfast as usual, then not long after that a nurse came in to remove the dressings on my arm to let it air for a bit before redressing it so I was ready to leave. I wasnât horrified by the sight of my arm, but it was still a shock that made me a little queasy at first as itâs one thing to see pictures of the graft and another to see it on your own body. I was given an antiemetic which helped the nausea subside in a few minutes and then I was left to my own devices for an hour.Â
The graft was purple and raw as expected and was longer than average due to me having thinner arms. Mr Christopher made it clear before surgery that he would need to take more skin to make the phallus an appropriate size and width because of the lack of fat on my arm.
My arm was redressed with Mepitel, gauze, and bandages and I was given a sling to keep it up at an angle. I was then provided with a bag of medical goodies (namely lots of Mepitel, bandages, gauze, tape, and a supply of Paracetamol and Ibuprofen). I was also instructed to send weekly photo updates to the surgeon so that he could advise me if anything needed to be done, luckily I had no complications with it.Â
My mother and partner came to pick me up at 13:00 and it was such a good feeling to be finally heading home.
After leaving the hospital I thankfully didnât have any issues with pain as taking Paracetamol and Ibuprofen every four hours did the trick. I only needed a lie down once during my first week back home, but other than that I was up and about as much as possible when I wasnât at my desk as I was eager to get back into my routine.Â
Mobility wise, the only things I struggled with was trying to put on socks and getting clean which my mother helped me with. Now, just because I was so mobile doesnât mean that recovery was easy. I was exhausted both mentally and physically almost all the time. Being up and about for longer than ten minutes was tiring and I needed a sit down to recover afterwards.Â
Sleeping was awkward as I had to try and keep my arm elevated so I made use of two pillows to keep it as upright as possible at night. During the day I just held my arm upright when at my desk or kept it in the sling. The staples in my bum remained by far the most uncomfortable part of my recovery as sitting ached, using the loo ached, and lying down ached. I couldnât wait to get the damn things removed.
I returned to Harley Street two weeks after surgery for a check-up and to have my arm dressings changed and staples removed. My phallus was healing nicely and my arm had improved a lot in just one week much to my surprise, it just looked like raw skin with some blistering (which was normal). All in all, everything was healing well, all I had to do was make sure the dressings were changed once a week at my local surgery.
As for the staples in my bum, they were removed one by one, but luckily much of my backside was still numb so I could only feel a few of them being pulled out. Once they were all out I was so much more comfortable, I just had to be careful not to rip the incisions, keep them clean, and redress them with the plasters I had as needed. The only issue I had was a small tear about an inch and a half long and half an inch deep close to my inner thigh which did heal up after another week and a half.
I mentioned earlier that I had to keep my phallus elevated (which unfortunately made it look like I had a permanent erection so travelling necessitated a long coat) so it was so great being able to remove the padding once I was three weeks post-op. Being able to let it just hang in place without the underlying fear of anything tearing was wonderful. All I had to do now was leave the last of the incisions (underneath and on the tip) to heal and to have my weekly check-ups. My phallus was healing well too. I had scabbing along the incision sites but they were improving by the day.Â
After a month had passed, I returned to Harley Street where a nurse slid a tube down my phallus to make sure that I hadnât developed a fistula that would block the neo-urethra - I hadnât, but even if it had it would be corrected during Stage Two. I then had water squirted down my phallus to make sure that it went all the way down and out without issue. I was instructed to do this regularly to make sure the neo-urethra remained unblocked. I was also given permission to soak my arm in saltwater twice a week to lift off the scabbing. I still visited my local nurse until the 30th of March for a weekly inspection of the graft, but outside of those visits, I would redress my graft once a week on my own after a soak and airing time.
As of today, Iâve healed up extremely well and couldnât be more pleased with the results so far! My phallus looks like I was born with it and it is a decent 5â long (which is what the surgeon aims for).Â
Regarding my arm, I did have stiffness and swelling in my hand, fingers, and wrist that finally eased up after three months (exercising it and taking Ibuprofen regularly helped) so everything is back to its original size now and has full range of motion.
Sensation-wise, I started developing a tingling feeling on my phallus when it was touched at around two months after surgery which has since spread to the tip. Itâs not a tactile or erotic feeling, but more of a sharp nerve sensation that is often displaced. The stinging does mean that the nerves are alive and will hopefully develop more sensation over the next two years.
Now all that is left for me to do is wait until I can book Stage Two which I should have had in May-June, but due to COVID it has been postponed like all other non-essential surgeries. Despite needing two more surgeries, I remain optimistic that I'll heal just as well as I have done already!
I hope this post was helpful and as always, if you have any questions, feel free to send me a message and I'll do my best to answer them!
