MtF GCS and what to look for/ expect

[Kirsten]

Ok so I have been reading through a lot of posts here, elsewhere, watching videos, and have gotten a bit of feedback on questions as well. But I’ve gotta tell ya, nothing really matches up. And there isn’t much info on the pre-surgery stuff. So I figure this is a great place to start asking questions. 

 

I am personally still, I assume, a good year from GCS. But in a few months I hope to be able to at least look into booking with a doctor. Which brings me to my first questions. 

First is what are the questions I should be asking both my gender physician and the possible surgeons to be able to make an educated decision on who I should choose? Personally I will want to go with a full vaginal canal for penetration and also some clitoral sensation as well. (Not even sure if I’m explaining that correctly) Basically the closest I can get to a cis woman. I feel this will help my genital dysphoria most. Others may have other ideas so any advice from any form of surgery is welcome. 

 

Next is an easier one but still one that I’m curious about. The seasons require different chores, and offer different conditions. I have been told I probably won’t be able to choose this, but is there any benefit to certain times of year? Here winters are cool and dry vs summers that are hot and sweaty. Also snow shoveling vs lawn mowing for heavier chores. I don’t know if any of this would play into recovery at all, but it’s best to be in the know. 

 

Also regarding recovery, I’ve seen people say anything from 6 weeks till a work return to 6 months! I work construction so I need to be cleared to lift 80 pounds for a good portion of the day, climbing ladders with 50-70 pounds of heat and equipment (I’m talking 300’ cell tower ladders too), and pulling 2-300 pound manhole covers multiple times a day. Not to mention the circus that comes with 13 yr old and 4 yr old boys. 

So how long till you are on your feet and fully mobile? How long till it’s ok to get slammed by a 40 pound kid? How long till you’re 100%. 

Also for dilation, what’s the process? It’s another thing I’ve seen so many variations of. From 4x a day that include showers, baths, and a ton of cleaning to some douching and using the dilators. I’d love to have an idea, as would my wife, of how difficult it’s gonna be to start and how quickly it gets easier. 

I have a lot of other questions regarding feeling sensations pain etc but I don’t want to get too overwhelmed with information all at once either. But feel free to add anything else in that you think is important. 

Any responses are very appreciated and I hope this will help not only me, but others in the future as well. 

Thanks in advance ladies. 

Kirsten. ❤️❤️

[Kirsten]

That makes sense about the drying out part. I assume that’s also part of the reason for the excessive baths. I have seen a couple different dilation schedules that seem similar to what you’re saying. Clean tub before each time dilators as well before and after. Air drying etc. I assume yours is similar? About 90 minutes per round from what I understand? 

3 months sounds reasonable. Do you feel that you were ready and able to carry 60 pounds of equipment up a 300 foot ladder by then? That’s probably the hardest or most physical part of my job. Or something equally as daunting. Most people can’t do that anyways let alone after surgery. It’s a long hard climb that takes about an hour to an hour and a half usually. 

Ive heard others mention dr Brassard as well. That’s Canada? Although that’s not far I’m not sure that’s an option for me. What was the reason for choosing him? Or was it simply a geographical or doctor recommendation? 

I do appreciate the insight Mary. I’m a bit of a control freak with things. I can’t do anything without going over it 50 times first so this is gonna be a tough one for me I’m sure. ?

[VickySGV]

The main page here has a list of surgeons on it, and most of them have their own Web pages which describe the technique they use and explain why. 

The three basic types are the older two stage surgery where the vaginoplasty was done first and a few months later labiaplasty was done to create the labia minora.  The next form is the single stage where all of the above are done at the same time.  The third type which has lost popularity is the Colovaginoplasty which uses a section of the large colon to create the vagina.  A fourth new technique uses some tissue from the abdomen which is just a casing for the intestines and heals quickly, which the CVP does not. 

 

The single and two stage methods today both use a modified Penile Inversion technique which also uses scrotal skin to create depth, and some surgeons use the urethral tube tissue from the penis, which is a mucous tissue to create the labia minora, which helps to give some degree of self lubrication down the line.  My experience has been that it is the bare minimum for dilation., but others with that technique claim it does just great.  Dr. Brassard who was Mary's surgeon and Dr. Bowers who was mine both use it.  Again, find the doctors' names and check their web sites.  The two step surgery does take the longer of the methods to heal since you have two separate healing  periods.

 

Different surgeons have slightly different post op-op recovery routines, and your surgeon will give their own, but they work.  Dr. Bowers had me on three 20 minute sessions with only a single dilator per day, only minimal showering until my sutures dissolved, but general cleanliness only other than that.  Marci did require that I had a Gynecologist ready to take over when I got home, and luckily I did, because it turned out that I was allergic to the vaginal antibiotic that I was to use along with my lubricating goo!!   You may also develop a condition called Granulation which is your own body's reaction to healing of deep wounds and is a matter of genetics for the most part and is well known as a "complication".  Granulation can make dilating painful until it clears up as one of our members here found out.  It is usually treated by your Gyno with silver nitrate. 

 

For me, I was not on any work or activity restrictions per my post surgery instructions. but it took me about four months to get my stamina back for the heavier physical exercise. My verbal instruction from all of my doctors and health care team was "listen to your own body - carefully".   For my time between surgery and removal of the packing I was in a Marriott Courtyard hotel room on the second floor, with stairway only access and the trip up the stair was exhausting the first two days. It did take me about 6 months for internal healing to take place and about another 5 months to get my nerve endings fully re-mapped but it works, and my Gyno puts me well in the range of normal.  I have a bunch of postings here in this Forum on my recovery issues back in the February - November 2013 period that give some of my up and down adventures.  

I hope this does not scare you too badly.  

[VickySGV]

OOPS -- My healing dilation schedule was three times a day for the first 90 days, it went down to two per day for another 90 days and then down to a single per day.  I am 5 years post and can get by with several days in between without problems today.  I did increase my dilator size at two week intervals right at first.  I am older and do not heal as quickly in some ways, but  younger people who do heal rapidly will need more dilation time.

[Kirsten]

I’ll have to do some searching to find that stuff. I’m not sure if it’s because I am on a phone or not but I can’t seem to find the doctor list. Or your old posts. But there are a lot of pages to search through that’s for sure. Lol. 

I am a pretty good healer as far as I know. I hope that single stage is going to be my option. Especially with my kids. I can’t be expected to be unable to keep up for long. They won’t care at all. Lol. Well maybe the bigger one but the lil guys go go go always. 

That was a lot of good information to start looking at for me Vicky. Than you very much. There was about 400 questions bouncing areound in here. Now it’s like 700. Haha. I’m very glad I started asking this early. Now time to do some more research and look through all I can and hopefully find some more answers. I’m sure I’ll have more. 

I never realized that dilation is a lifelong chore either. Would masturbation using toys work in place of the dilation? Or sex? It’ll always be toys for me. My wife doesn’t have the plumbing for anything else. Lolol. Sorry if that’s too graphic for the rules. I’m often confused as to where that line is here. ??‍♀️

[Jani]

4 hours ago, Kirsten said:

I never realized that dilation is a lifelong chore either.

No one said this was a free ride.  Ya gotta pay, every day!  Although you will go to weekly sessions eventually. 

 

4 hours ago, Kirsten said:

Would masturbation using toys work in place of the dilation?

In a word, the goal is to provide enough stretch to maintain depth and width.  

 

Your question count will continue to rise!  400, 700, 1000...

[VickySGV]

This is a link to our main page where the data bases are accessed, and it gives options to search locally to you.

https://www.transgenderpulse.com/

 

These links were on Page 5 of the entries for the Post Op Forum and later ones are on the page and up to about page 3 with more of my light hearted by serious observations about healing.  Open this forum and go to those index pages, we had about 3 of us all under the knife in that period and some of their stuff is good too.

 

https://www.transgenderpulse.com/forums/topic/52994-greetings-from-san-mateo-ca/

https://www.transgenderpulse.com/forums/topic/53849-always-_______-never______while-dilating/https://www.transgenderpulse.com/forums/topic/54289-two-months-yesterday/

[BrandiBri]

Oh, Vicky, those first two posts were hilarious!! I'm having trouble typing this because I can't stop laughing! I hope to get my GRS so I can enjoy that symbolic hotdog! I probably won't get to sleep tonight just thinking about it. And the pictures in my head about flying dilators...

 

Hugs,

Brandi

[Kirsten]

Thanks Vicky. That’s great information. I would say my curiosity and intrigue of post-op is growing. 

It does seem like the operations themselves, although really graphic and disgusting (watching the videos is worse than any horror film I’ve ever seen) is pretty straightforward. The YMMV is definitely all over the ballpark too. But I can see why. So many differences both in techniques and age and simply self condition play huge parts. I’m not even going to try to plan for time out of work or any of that. I think I’ll just try to save up as much as I can to cover my ot hours and ?? For when it’s time. 

This phantom limb thing is so interesting. I always imagined it would feel a little like being tucked and taped but with more pressure? But the itch thing is really weird. Who am I kidding it’s all so weird. But in a good way. 

I have a few months still until I see my doctor again. March I believe so I want to start looking into doctors. I am going to go to first event which is a trans conference in January. Hopefully I’ll get to talk to some doctors there. And there’s so much information online as well. 

Ill try to post any helpful links I find here as well. Maybe they’ll help someone else down the road.  

Flying dilators. ??

 

[VickySGV]

52 minutes ago, Kirsten said:

 I am going to go to First Event which is a trans conference in January. Hopefully I’ll get to talk to some doctors there.

 

It was not First Event. but I met four doctors at a similar event (at the time about all who were doing GCS in the U.S. on a regular basis). I eliminated two of them on the basis of personal impression, and came back the next year and got better acquainted with the other two and one more.  At that point, I did decide on who I wanted to have surgery with, but held out another year to check on two out of country surgeons who were marginally cheaper after considering a bunch of things. Both of them rejected me as a  potential patient due to age and diabetes.  I re-checked vial E-mail with Dr. Bowers and sent in paper work and $$$$ and the 11 month wait period began, but was shortened by 3 months when a cancellation gave me a chance to have it near my natal birthday.

 

I did not have "phantom limb" really in the sense of a person who has actually lost a limb.  Nerve bearing skin had be  re-positioned a bit, and my brain needed to manually "re-position" it by realizing that if I inserted my dilator, the feeling was telling me it was closer to my belly button than down further.  As I consciously connected the feeling to the right place it became automatic to feel the dilator going into my vagina and not the tip of my re-purposed penis.  A bit like moving to a house down the block and having the postman get confused easily with mail delivery. 

 

I have wanted to go to FE and maybe this will be the year!!  

[Lorraine]

So l am far from an expert on this subject having experienced only two of the four surgical techniques  mentioned above, personally.  l have found colonvaginoplasty light years ahead of the decades old technology which was  developed in the late 1940's and has been the technology of choice even into the present. 

I think the major difference is that once the initial healing process has run its course, the end result has the distinct advantage of having the vaginal canal made of tissue essentially identical to the inside of your mouth. It is similarly stretchy, and moist having the further advantage of actually becoming almost sloppily wet during sex.

I would invite anyone else who has undergone this procedure to step forward to share their own personal experience so that those who are considering this major surgery,  which ever technique they choose,  would have the benefit of first hand knowledge as opposed to hearsay. 

[Lorraine]

Also, l guess l should also mention that because l have been enjoying regular sex since about 18 months after my initial srs in the early 70's, l haven't dilated in decades.

[MarcieMarie12]

8 hours ago, Kirsten said:

The YMMV is definitely all over the ballpark too. But I can see why. So many differences both in techniques and age and simply self condition play huge parts.

 

Another big part is the discipline it takes to dialate. Following your doctors instructions and not pushing to hard is paramount to a good recovery. 

 

I had Dr. Rumer in Philidelphia and had great results, both in looks and function. My dialation schedule was not bad and had little scarring. I was glad about that because the silver nitrate used to reduce it was very painful.... 

[Kirsten]

I took a big hit in this department today when my therapist let me know she has parted ways with me and I will no longer have my letter from her. She is an evil woman. So I have to find a new therapist now. And start that process all over again. Although I don’t think it’ll be nearly as difficult this time with how far along I am now. But it’s still very rough to get knocked back like this. 

 

I have realized lately that this surgery, although extremely important to me, is not a time sensitive thing either. It will come when it’s supposed to. Maybe this happened for a reason. Or maybe that therapist is just some really bad words I’m not allowed to say here. Either way karma has blocked my way. So it’s time to find a new road. 

 

I had a question though. Hair removal. How bad is it?! Compared to face I mean. The thought of it scares the cream filling right outta me to be honest! ?. But maybe it isn’t bad? Idk I can’t see how it wouldn’t be. And how long does it take to get to the level needed? Weeks? Months? Ugh I don’t even like asking. Lol. Yeah ok. Well that’s all. I hope I’m just being silly.  I am right!? ??‍♀️

[RithiaAllen]

What horribleness! Did she say why?

 

I didn’t have to do body hair removal so I couldn’t say but I did pluck my genitalia in preparation for SRS and it wasn’t painful. I was able to do it for hours on end. Then electrolysis down there wasn’t bad either.

 

It took months.

[Kirsten]

1 hour ago, RithiaAllen said:

What horribleness! Did she say why?

 

I didn’t have to do body hair removal so I couldn’t say but I did pluck my genitalia in preparation for SRS and it wasn’t painful. I was able to do it for hours on end. Then electrolysis down there wasn’t bad either.

 

It took months.

She did not. She simply said she wasn’t taking on any new patients and had moved to a new group. I reiterated the importance and the fact that I had been seeing her since the start of the year. But she simply repeated her original statement. 

Once I find a new therapist I’ll be asking them whom I can report her to. And I gave her some nice reviews online. Just despicable you know. You rely on someone for an important thing and they totally flake out and ruin things. 

 

Well thats good it seems like the electrolosys down there would be awful. I hope that it doesn’t bother me either. 

[RithiaAllen]

1 minute ago, Kirsten said:

She did not. She simply said she wasn’t taking on any new patients and had moved to a new group. I reiterated the importance and the fact that I had been seeing her since the start of the year. But she simply repeated her original statement. 

Once I find a new therapist I’ll be asking them whom I can report her to. And I gave her some nice reviews online. Just despicable you know. You rely on someone for an important thing and they totally flake out and ruin things. 

 

Well thats good it seems like the electrolosys down there would be awful. I hope that it doesn’t bother me either. 

Everyone has a different level of pain tolerance. You can get an idea of what it will feel like by taking a tweezer and plucking a few of the hairs out on your scrotum. Electrolysis will hurt a little more but not much more.

[Kirsten]

Words I never thought I’d hear. ???

[RithiaAllen]

Just now, Kirsten said:

Words I never thought I’d hear. ???

?Lol you asked. ??

[Raven1981]

I have a question for anyone who wishes to answer that is POST-OP.  When it comes to doing electrolysis to prepare for GCS.  Is it best to get rid of all the hairs down there, or would it be easier to get rid of as much as you can and then have the doctor scrape out the rest of the hairs from the back side of the skin when you are under?

 

I

[VickySGV]

55 minutes ago, Amy LeBlanc said:

I have a question for anyone who wishes to answer that is POST-OP. 

 

This will depend on the surgeon and what they recommend, not on the patient so much.  Dr,. Bowers does the sub cutaneous scrape as part of her technique and says so up  front.  If you have electro, it is your money and she will still do the surgery on you, and probably scrape off the dead follicles anyway.  Her reaction, which I saw during a presentation at a conference was simply a shrug and "its your money" response to a person bragging about how they already had it done. I did not have electro and I have not had a single hair problem.  What I do have painful memories of was that she had me shave the area around the site the night before the surgery and the regrowing hair after the surgery added itchy and prickly to a swollen and tender area that made things uncomfortable for several days until it became long enough to soften.

 

Be sure of what your prospective surgery team wants though and do it.  It was a couple of thousand bucks that I saved.  I did have to pay for all of my own surgery and lead up.  A year later my insurance group covered all of it, damn!!

[Kirsten]

That’s really awesome info. Thanks Vicky. I’m hoping to start my electrolosys next week and I was planning on starting that area as well as my face, but I’ll hold off now. 

Also can I just say that scraping things off from the inside sounds like one of the most awful things ever! ?lol. 

[VickySGV]

Just now, Kirsten said:

Also can I just say that scraping things off from the inside sounds like one of the most awful things ever! ?lol. 

 

You are well under the influence of anesthetic when it happens.  If you happen to find one of the time-lapse films of the surgery being done, it would be at the last 1/3 from a surgeon who does it.   The animated pictures of it happening are actually worse to watch than the ones on real patient, but they can be interesting.  I saw the same film before and after, I think it weirded me out worse AFTER my surgery.

[Kirsten]

So I went on the prowl. Seems like that’s a very specific to the surgeon thing. Some say it weakens the follicles and makes the scrape less effective. But it seems like most still recommend the electro for at least 1 year prior to surgery. But still do the scrape as well. Did you use dr brassard? Seems his name comes up a lot as one that says no way. But many of his patients say they have hair issues too. I saw some things that say 2 years of electrolosys prior to surgery as well. Ugh. 

[Raven1981]

Thank you Vicky.  I know that I plan on going with Dr. Ley at the Meltezer clinic here in PHX.  From what I am told, you don't need electrolysis, but you do need laser on it and Dr. Ley does the scraping. 

 

Thank you