I want to answer this question but first I should give just a little background information for those of you who are unfamiliar with the different lower surgery options for trans men.
There are two main branches of genital surgery for trans men: Phalloplasty and Metoidoplasty. There are many pros and cons of each surgery and generally men have to weigh out the pros and cons to decide which main branch is right for them. Once they have decided which which of these two main branches they want to follow then there are tons and tons of options under these two main branches. I'm going to give you a very short list of SOME of the pros and cons of these two main branches of surgery. I'm going to keep it very simplified. If you want more details about the different options and you are a transgender man feel free to contact me and I will connect you with really great resources where you can learn everything you would need to know about lower surgery.
Metoidoplasty: taking the hormonally enlarged clitoris and using it to create the penis. Optional - urethra extension through the penis and scrotoplasty with testicular implants.
- Pros - statistically less complication, cheaper, natural genital skin color, very little scarring, natural erections, less risk of sensation loss/changes
- Cons - very small, to the point that sometimes peeing through your fly is difficult/impossible and possibly too small to participate in penetrative sex
Phalloplasty: taking skin from one area of the body and using it to create the penis. Optional - urethra extension through the penis and scrotoplasty with testicular implants.
- Pros - large adult sized penis which if done successfully is capable of normal penetrative sex and there is no problem peeing through the fly.
- Cons - riskier surgery (higher complication rates), results in more scarring then meta, a device needs to be implanted to make erections possible, higher risk of sensation change/loss, electrolysis is often needed because of hair on the donor site, much more expensive
(Please note again that these pro/con lists are not everything. These are very simplified lists stating only SOME of the things that really weighed in on my personal decision for my body and another person's pro/con list may be very different from mine. But I have certainly done much research on all the options available at this time. I have been researching for the last 7+ years.)
Now, on to why I have chosen simple medoioplasty and scrotoplasty with testicular implants and a pubic lift.
For one, I chose this surgery because I'm not 100% sure which surgery, Phalloplasty or Metoidoplasty is "right" for me. By having the metoidoplasty, I am creating a small penis and scrotum with testicles. Even though it will be on the small side, it is giving me the opportunity to have genitals that match who I am. For me, it's about looking in the mirror and having male genitals, even if they are small, I know it will make me feel so much better than seeing what I have now. By having metoidoplasty (meta) I am in no way preventing myself from later going on and having a phalloplasty over it if at some point down the road I feel that the meta isn't big enough for me to feel 100% complete. I honestly, really want meta to be enough. I love the sensation I have. I don't really want a lot of scarring. I also don't have $25K - $60k for the kind of phallo I would want. And for me, there is just a whole lot of risk with phallo that scares me. But at the same time, I know that if the meta doesn't relieve me of 'most' of my dysphoria I will someday have the phallo over my meta. Even if some day I do go down that road, I feel like the meta is the right decision for me at this time because I know it's going to make me feel so much more comfortable in the mean time.
I am currently not having my urethra extended for a few reasons. One being that if I do eventually have phallo, I do not want the surgeon to have to deal with an all ready surgically altered urethra. Urethra lengthening is arguably the one of the most risky parts of this surgery. Complication rates are pretty high. So I'd rather figure out exactly what will be the last step for my genitals before I extend the urethra.
In other words, urethra extension is very complicated and risky, and I have every intention of taking that risk some day, just not yet. If meta ends up being "enough" for me to feel whole then I will eventually save up money again and have a urethra extended through the meta. If I decide on phallo as my last stage then I will have the urethra extended through the phallo.
I really like certain aspects of the meta. Natural erections. Little scarring. Natural skin color. Much less risky to lose sensation. Obviously the small size is the one con that I have with it. But I really wanna give it a shot and see if this will be enough for me to be fully comfortable. And I know at the very least it's going to make me way more comfortable then I am with my body right now.
I am okay with being a man who has a small penis. I'm not at all okay with being a man who has the genitals I currently have. I know there are many other trans men who do not want genital surgery and are totally happy with how their body is and I think that is awesome. If you're one of those men, then good for you! But I personally am not okay with it on myself and I know that I absolutely need to have genital surgery.
Another lesser reason for why I felt meta now was a good choice, is because just in the last 7 years of reasearching genital surgeries I have seen the surgical techniques improve SOOOO much. Which makes me wonder, what will the surgical techniques be like 10 years from now? If I have meta, and it can at least hold me over for a while, by the time I'm more financially stable (or maybe health insurance finally gets on board) and I can afford a phalloplasty, I bet phalloplasties will be amazingly awesome by then, even more so then they all ready are. But to think about not having surgery for another 10 years, I just can't even fathom that.
Some might say, but ur wasting more money by having a meta and potentially a phallo on top of it. I don't see it as a waste because I can't deal with my body how it is right now. Another thing that goes into my decision is, if you have a phallo and don't like it, you can't say, "okay I change my mind, give me a meta", but if you have a meta first, you CAN later change your mind and say "give me a phallo". So with this surgery, I just see it as a step to figuring out exactly what my wants and needs are. I "want" a big huge penis. lol But do I "need" it to be comfortable is what I'm trying to figure out. And at this point, sensation and natural erections is outweighing the risks of having a phallo.
Again, I certainly haven't ruled out phallo by any means. After seeing some phallos in person I was actually pretty dead set for a while on having a phallo. Because they were magnificent in person. I swear, pictures don't do them justice. If you're a trans guy and you ever have the opportunity to get to a conference where they have lower surgery show and tells be sure to check it out. Anyways, I've also seen some cute natural looking metas and although they're small, the benefits that they offer might be more up my alley. So yada yada that was a very long winded response on MY thoughts and feelings for my own body and why I have made the decision on simple meta.
If you're wondering why I've chose to have testicle implants and a scrotoplasty, well that because I want balls. lol not every trans men has that done and I can't really speak for their reasoning behind it because I'm not one of them. I want them. I feel like I am going to need them to feel comfortable with my genitals.
If you're wondering why I'm having a "pubic lift" which is basically when they cut across your lower abdomen (in the pubic region) and lift up your skin and sew it shut. I'm having that because it pulls the penis and testicles more up front on the body to a more masculine positioning so that the penis and balls are not so in between the legs. If you've ever noticed on a female bodied person the genitals tend to be located lower on the body then on a male bodied person. So the pubic lift is to correct the positioning of everything.
Okay, well, I'm going to post this, I really need to go back over this to check for spelling errors and revise this draft but for now I'm going to post it and I'll edit it soon. I am having surgery tomorrow morning. I'm a little nervous! But mostly I'm just a bit scared of being in pain. I know my surgeon is going to take good care of me. I'm very confident and comfortable in his abilities. I'm being very realistic about the results I can expect (i.e. I'm not expecting to wake up with a huge penis. lol) so I'm not too worried about being disappointed aesthetically because he's a great surgeon. But when it comes to pain, I'm a big baby! So that's what I'm worrying about. lol And just having surgery in general is a scary thing. But I'm crossing my fingers and overall I'm really really excited for tomorrow. :-)
I will be sure to write about how healing goes. I'd also like to write about why I chose this particular surgeon, among other things soon.
Hi, I'm having the same surgery (simple meta + implants) in the fall and wondering about the recovery. I know you wrote about it but specifically I'm wondering how soon I can expect to be able to sit for a few hours. I'm hoping to return to school (basically just sitting and I'll have a ride home) after a week post-op. I've heard from others it's hard to sit fully upright but how about sitting in general? And walking? Should I tell people I pulled a muscle or something?
ReplyDeleteThanks for making this blog to inform others with your experience!
Everyone's body is different but I'm going to be bluntly honest here and base it on my experience, if you have a similar healing experience to me then it might be helpful to hear this. Simply put, there's no way in hell I would have been able to go to school 1 week post op and pretend like I "pulled a muscle." That being said, I also had the pubic lift (aka mon resection) at the same time so that greatly impacted my pain and discomfort. The tightness from the pubic lift made me unable to fully straighten up, so to sit I tended to hunch forward which made me lean towards the balls which were still in a lot of pain. So sitting 1 week post op was terrible. Walking, was also terrible. I was walking like a cowboy from the balls and slightly hunched forward because of the pubic lift. If I was going to attempt going to school, I would first of all just say that I had major surgery and didn't want to talk about the details because the shape I was in there was no way I was going to be able to pull off any other excuse. Secondly, I would also buy a nice foam donut pillow from CVS and sit on that and put your feet up on a chair in front of you and lean back so you don't put a lot of pressure on the balls. Also take OTC pain meds to reduce inflammation since you probably wont want to be using ice packs in class. Sitting is really not going to be fun at that point. Sitting was the hardest part. Laying down and standing are much easier. So you might also need to take periodic breaks standing. I think you are greatly underestimating how uncomfortable and swollen the testicles will be at 1 week post op. I'm 25 years old and I'm a fast healer. But oh boy! Don't get me wrong, I managed the pain just fine by using ice, medicine, and taking it easy on my body allowing myself lots of rest. That kept it all manageable. But when I pushed myself too much, I knew it, because everything would start to ache really bad and become insanely uncomfortable.
DeleteSo in your situation, are you having the pubic lift? If not, then you might be in less pain and have less swelling then I did. It also depends on what size implants your doctor uses and how much skin you have down there (it will depend on how much is getting stretched). Your age and health also effects how long you heal. Also people have different levels of pain tolerance. So maybe I'm just a big baby and you'll be fine. lol
When you have surgery, if you think of it, comment back here and let me know how you're feeling at 1 week post-op. I'd be interested to hear how you're doing. And I'm sure other followers of this blog would like to hear about healing from another guys perspective.
Congrats on your upcoming surgery!!! Good luck.
One more thing, I was not driving 1 week post-op. I did not feel comfortable driving because sitting with my legs even remotely close together (in order to use the pedals) was not feasible. I also was still intermittently taking the narcotic pain medicine that was prescribed to me so driving was not an option at 1 week post-op. Don't get me wrong, I went out, I just had friends drive me. And I brought a big fluffy pillow everywhere with me. Everyone probably thought I had hemorrhoids but it was necessary. I can almost guarantee you're not going to sit up in a chair without a pillow 1 week post-op. The stitches haven't even begun to dissolve at that point. And sitting on very swollen stitched up testicles is not pleasant. The pillow only makes it barely tolerable.
DeleteThanks for your detailed answers. I am having small implants, stretching in preparation, and not having the pubic lift so hopefully that will help a little. I can probably tell people I had surgery for a hernia. I'll make sure to get the foam donut and lean back. I have an inflatable one but it's not that comfortable. Yeah, I expected sitting to be the worst out of any position. Out of curiosity, what exactly is it like when your balls hurt? Because the balls themselves are not sensate. Is it the stitches that hurt? Oh, and how is urinating?
DeleteI am hoping for the best but if I can't return to school that early I won't be in trouble or anything. I think maybe I have a high pain tolerance but slow healing. Because I've never taken OTC pain meds or narcotics past the first day for surgeries, but I always bruise so much and it takes weeks to go away. I suppose I should take them anyway for the anti inflammatory effects.
I will be sure to put an update when I'm post op! Thanks again for the reply.
I don't know if people use donut pillows for hernia surgery. I think if you say you had surgery people will not push for details unless you are very close with the people in your class. But do whatever you think will work best to appease their questions.
DeleteBall pain was just a throbbing aching pain. The actual implants they insert are not sensate but the skin covering them is certainly a sensitive area and after that skin has been cut open, stretched out, and stitched up they swell like crazy and throb and ache especially when you move around a lot. The stitches themselves also hurt and can be uncomfortable but the real pain is the throbbing ache of the whole scrotal area from the trauma of surgery.
Urinating burned for about the first week. It was worse the first couple days but got better and better every day. Imagine all these fresh stitches down there from surgery.... and then imagine peeing all over them. It burns. lol Have you ever got urine on any broken skin before? Because that would give you an idea of what it feels like. It was unavoidable to not pee on my stitches because my doctor removed all of the inner labia that was down in that lower area. Don't get me wrong, I'm glad he did because I definitely didn't want it there anymore but it resulted in sutures right next to where the urine comes out so with the swelling down there it was unavoidable. I used unscented baby wipes and dabbed the area after every pee. I also had to wipe my thighs down after every pee cuz the piss was going everywhere no matter how I positioned myself. lol The thighs getting wet was just the first 4 days. And your anatomy and amount of swelling might make it different for you. Different people naturally have different positioning so that might make peeing different I'm just speaking of my experience.
I hardly took any medicine for top surgery at all. I even refused narcotics immediately after coming out of top surgery. I think in comparison to most people I have a very high pain tolerance. And I sure as hell took narcotics for this one. haha but again, I had medium implants, very little skin that had to really be stretched, and I had the pubic lift, which really added to the whole healing process.Because of the pubic lift, I had a drain tube which adds to discomfort.
I also almost never bruise. I had very little bruising with top surgery (and I had keyhole which usually results in a lot of bruising) but for lower surgery I had a ton of bruising in the testicle area and taint area.
I'm one week post op today. I went to Dr. Brassard in Montreal and stayed at their recovery residence for 3 days post op. I ended up going back to school at 5 days post-op, but just for one day (sponsored by oxycontin), and I'm going in for a half-day tomorrow. I'm lucky that my program schedule accommodates this. My cover story is that I had a hernia, and nobody seems to be questioning that.
ReplyDeleteLike you, I had lots of ball/scrotum pain. My implants are size S, 8.6 cc's. One implant feels like it's settling in more easily and with less pain than the other. But both are very tight still. Peeing was affected by the swelling but by now it's more predictable and I only pee on my leg occasionally. Lying down is comfortable, standing is momentarily comfortable, and sitting is never comfortable. I have been finding ways to sit on my back, my side, my knees, *anything* but my ass.
My dick itself is swollen quite large as if I were constantly pumping. When I stand with my legs together, my dick and balls are all high enough to be visible. I did not have anything done to my mons, so this was a pleasant surprise. I expect it'll look a bit less impressive once the swelling goes down.
Anyway, thank you so much for your documentation and advice. There's so little out there about this surgery. I was intent on avoiding urethral work because I have pre-existing urinary problems (on and off). I think this procedure is a great alternative to the full meta if you don't care about peeing standing up--cheaper and safer with really similar aesthetic results.
Congrats! Happy healing. Thanks for letting me know how you're doing. Glad to hear it's going well and I hope you heal up quickly. Ya it sucks when the swelling goes down and your dick gets smaller lol but I'm sure you'll still be happy.
DeleteThanks for the good wishes. I forgot one thing, did you ever experience this pinching feeling in the skin between the two balls? When I put my legs together I feel what I think is that. Makes me worried that the skin is being compressed too hard. But there is no bruising in that area.
DeleteI was reading about your recovery--At what point were you able to walk normally for short distances? Was it three weeks?
Hey, I never experienced the pinching feeling between the balls sorry. So I'd ask your doctor about that.
DeleteI think I was walking fairly normally at around the 3-4 week mark roughly, yes.
Hey, I have a weird question about underwear. As I'm healing my balls are still tight and sometimes tender. Boxers are hell because of the seam right down the middle. Briefs, because they're knit, feel scratchy. What underwear worked best for you post-op?
DeleteCongrats! Happy healing. Thanks for letting me know how you're doing. Glad to hear it's going well and I hope you heal up quickly. Ya it sucks when the swelling goes down and your dick gets smaller lol but I'm sure you'll still be happy.
ReplyDeleteThe surgery can lead to major scarring
ReplyDeleteThe penis could end up becoming so scarred that it outright ends up being disfigured as a result. The result of this can be due to the cutting of the penis and its inability to heal properly in the aftermath of the operation. full prosolution review here
Researchers found out that the maca supplementation increased semen volume noticeably. Sperm count and motility also improved. As a result, the researchers concluded that maca supplementation is an excellent choice for the men who would like to improve their fertility and increase chances of getting a partner pregnant.
ReplyDeletebest vigrx plus website
If you want to try stretching, you may want to go through a diagram or an explanatory video. Getting the technique right is essential for preventing injuries and boosting the effectiveness of the exercise.
ReplyDeleteTo boost the effectiveness, you can also consider trying natural male enhancement supplements alongside the routine. fuller prosolution plus
Did you feel that the implants shortened your length? I got a full metoidioplasty with UL a while back, thankfully with no complications. I’m big enough for penetration but still feel it looks weird without implants. But I’m worried about losing length. Do you feel like your tip to base length shortened due to the presence of balls?
ReplyDeleteI should clarify that the first surgery included no implants. I think that significantly reduced my complication chances to not get them at the same time
DeleteNot sure if you still check this blog but could you remove the OBVIOUSLY cishet targeted ads from the comments? They're just insulting to what you're you're obviously trying to do for the community and dysphoria inducing. Thank you.
ReplyDelete