Bringing in the New Year: 1 year post op metoidioplasty and current thinking

Posted: January 4, 2012 in Bottom Surgery, Dysphoria, Growth, healing, international travel, Metiodioplasty, Phalloplasty, POC = People Of Color, post t, Post-op, Pre-op, School, Transgender, update

Well firstly happy new year to all of my readers new and old. In this year I will be doing a lot more writing as my mind will be expanded and as my priorities shift a bit giving me more room to express clear thought. I hope we all can embrace this year as a lucky one and surround ourselves with nothing but positively influential persons.

So as you all can see from the previous context of my blog, I have been a seriously busy and all over the place young man over the past year. It has been one of great learning experience and I’ve taken a lot of lessons from it. As contemplated in the last blog from Oct, I will be attending school for my BS in Psychology (no i’m not bsing in psych lmao, bach of science guys). I actually start class tomorrow, it’s one of those bitter-sweet feelings lol. I’m ready but really not ready for the homework, research, nor group projects; but this is what I must do in order to get where I want to be in the long run. I am happy to also announce that I will only be needing 1 year of general chemistry, organic chemistry, biology all with labs, and English to be accepted into med school at my 90 credit mark for my BS! It’s one of those unbelievable feelings, like anxious but nervous all at the same time lol. So looks like 3 more years are standing between myself and me officially using Dr before everything I say lol. Yes I will use it as soon as I’m a freshman! People ask me why I do that when it comes to things I have not yet finished, positive affirmation my friends. If you believe you will achieve, myself using the future notion of something in present speech or thinking usually brings it to pass over time. So I claim it now as mine and it shall be later with ease.

On another note, it has been officially a year since metoidioplasty. Well as of today over a year almost a year and a month actually but nonetheless I made it! It has been quite interesting to relearn my anatomy in ways I felt like would’ve happened in toddler years but as they say better late than never. I am very happy to say that I have yet to experience any issues post operative. I am very happy with this stage of surgery, yes stage as my original plan was always phalloplasty but I did metoidioplasty first for various reasons that are more so personally based then FTM generalizations. I find that my dysphoria level has dropped off significantly the only time I seem to catch myself being uneasy now is just around certain women. Nonetheless everything that I wanted to achieve with metoidioplasty I have and I am more than happy that I followed through with my own plan and did not let the opinions of others fluctuate my final decisions. It’s hard at times to become sound on things when you have and/or see a lot of opinions of what you should and should not do when it comes to your own personal benefit. I knew for myself I was not mentally, emotionally, or physically ready for the multiple stages of any kind of phalloplasty surgery. I knew I was not ready to deal with such a large scar, as this is one main reason I was not keen on double incision so it did take some time to prepare myself internally not just externally. I think a lot more guys should take time to do things so that they are not just physically ready but mentally and emotionally as well. Surgery is not just hopping on the OR table waking up and being done, there are processes of recovery and some are nothing nice to deal with. Having that in mind one with no will power will find themselves set in a mini episode of deep depression, so as you see you need to REALLY be ready for any sort of surgery and especially genital surgery. This is one of the reasons I do agree with people seeking counseling prior to lower, not  for the gate-keeper aspect of the process but more so for the idea of having a personal vent session to dispel certain tensions and/or fears one would have prior to surgery. For my next surgery I do plan on still speaking with a therapist just to have that vent session. It’s one thing talking to your friends but having someone outside of that totally not judging you gives you better room for expression, in my opinion. I can always say though if I pass on tomorrow I will be with no regrets on my surgical decisions.

Well the big deal of the year…

I am officially planning phalloplasty, no big surprise to those of you that have been consistently following. It’s not in the near near future, near near would be 1-2 years, I’m thinking of 3-4 years but things happen and time flies. I didn’t plan to be having metoidioplasty until I was 5 years on T but circumstances allowed me to move forward well before then so anything is possible. My goal though is to start first stage (which is technically second stage for me) between dec 2014 – feb 2015. I’ve mulled over multiple surgeons and multiple procedures giving me head aches like no other but making sound decisions in this process is one that MUST be taken into consideration. My decision has changed fluently about 5 times, but now I see it more as having plan A-E set in stone. I have a top pick and a bottom and ones in between that can replace top picks if circumstances of insurance or inheritance come into play. This is why I tend not to discuss phalloplasty plans so much as I would like to be 100% in who I am going to before I share with the masses. So far my plan A is about 90% soundly made but that slight 10% can be shifted if lower payment options fall through as I’m currently thinking that they will.

I am in between two different procedures as well. Forearm phalloplasty has hands down been the most recorded consistently having erotic and tactile sensation which is a major things for me. At the same time with this the idea of having such visible scaring is less than appealing. Even though more and more seem to be getting with the full thickness graft to relieve donor site morbidity, many are still using split thickness grafting which is known for healing, at times, indented. Being a physician I wonder how this would affect me? As well as this worries me about the dexterity of my donor arm, nerve endings, and range of motion with my fingers as these are all important factors when doing surgical procedures. So as you see these are VERY serious things to think about when considering forearm phalloplasty. I am honestly less worried about the scaring and more about function as I have been privileged to see phalloplasty and donor sites from several men of color. I am so happy that more men of color are sharing these things so that pre-op men can have a template to assess. It is really hard to see what you are getting into when you have no point of reference. Yes, there are many examples as a whole of phallic representation in FTM‘s but only about a handful that show how men of color heal after such procedures as people of darker complexion do heal differently. Then with the option of various scar creams, silicone sleeves, and vacu-therapy options i have no doubt that my arm would look just fine over an 18 month period post op.

My other option is MLD Phalloplasty. I was going to originally go back to my original surgeon but as things progress I believe I may go to another team for phalloplasty. Not due to any lack of anything with Dr. Miro as he and the team are beyond excellent but more so due to style variation and aesthetic value. I like Dr. Rados out come and his glansplasty is also to my liking. Now there is some stipulation regarding sensation within MLD phalloplasty. Those that go to Miro have reported little to no sensation throughout the phallus itself more so the sensation is found at the base of the penile shaft and whether or not by the patients discretion the orignal neophallus is embedded or left minimally exposed so this also determines a degree of sensation. The same minimal exposure can be done with Rados’ MLD technique but the thing that makes a difference in the matter is the connection of the femoral artery and the inguinal nerve. There is however still controversial statements when it comes to this as I have talked to both Miro and Rados and get two different accounts on whether connection of this nerve gives sensation. Miro is very much set that this anastomosis is not medically possible. He states:

Due to the fact that the nerve used is a motoric nerve, meaning that it gives the contraction to latissimus dorsi muscle. Something that is motoric can not be anastomosed with a sensitive and to give a result.

Where as, Rados is quite set on his way of doing the connection of such nerve to nerve anastomosis and has had result. Speaking to the patients I know that have gone to Rados there is a report that such connection has allowed more than sensation at the base of the phallus but up the shaft and to the head. There was also clear feeling stated of the erotic nature which also has led me to ponder what is really going on with this. Honestly speaking, it may just be variance in what one was taught before and what one was taught after. There are many surgeons and doctors that believe til this day urethral lengthening is a waste of time and nothing but complications when there are multiple studies that disprove this logic. So as time goes on I will see whats what, as I have more access to patients of both surgeons over the next few years and it will be about a 7000 euro difference in teams. I also like the fact that Dr. Rados will be and has been actively working with a surgeon from the Chicago area and will be learning some of his mircosurgical techniques to apply them to MLD as well as teaching the surgeon how to properly perform MLD so that possibly it can be offered here in the US as an alternative. Even though that would drive the cost of MLD sky-high,it would give chance for insurance coverage as well as alternative options to procedures and great for Serbian patients needing a good follow-up surgeon stateside. I think by Rados learning and fine tuning microsugical aspects, by the time I’ ready for stage one MLD‘s sensation ratio maybe rivaling forearm in great leaps and bounds. This is why I’m really not rushing a thing as time and patience will bring me exactly what I want and need. I would be staying in another apartment while in Belgrade, this time I found a few on my own that I favor, one less than 10 minutes from the hospital that Rados uses. Not badly priced but very nice and modern, 50 euros a night, I’ll be there 7 days each time after leaving the hospital. I plan to have my scrotum pulled forward more  to allow a bit more natural hang and also am upsizing my testicular implant size to accommodate the new phallus size. The one thing I do like the most about being post op meta then going to phallo is that when I come home from that stage I will have a package viewing to the untrained eye as natal which is very important to me. Not that I’m going to run around flashing folks but I do plan on being one with the gym and showering is a part of the atmosphere especially if I’m doing so between classes or have a presentation shortly after a workout.

I will have settled soundly by summer on who I will finalize with and from there continue saving. I’ve already started and have figured down to the cent how much each stage is going to cost plus any expenses outside of that. I could be looking at 15K total or 42K total, it is solely dependent on what team is chosen and why. Ideally I would like to be done with either surgery prior to admission into medical school as I know it will be a full course load it’s already going to be one hell of a task to balance working and school I would seriously rather not balance stages of surgery, recovery, travel, and time off on top of that. If anything in that stage of my life I want to be settling into my first house, even though I plan on being in real estate well before then lol. I’m already sick of rental properties and their craptastic regulations so I’ve began looking for the purchase. So technically you can also say I’m double saving but I know there’s first time buyer programs I more than qualify for. Just so much to think about when it comes to the next few years of my life.

On another notice…

I am nicely settled in at my new apartment. I love it here actually and you can see what it looks like on my YouTube channel. I did a nice little walk through  of my bare naked place lol. Just glad to be back in Houston, sucks that I’ve been away for so long but such is life when you have things to do. I do think this is where I will be for some years as I don’t see too much of anything sparking my interests enough to make me move. Plus my med schools of choice are all within 10 minutes of me so that’s also a BIG factor in the midst of things lol.

Over all I’m doing A-OK, and I will be letting you all know more of whats going on as the year progresses. Especially next month as it will be a great month of celebration seeing as though it’s my birthday. Can’t believe I’m soon to be 24, feels like I was just 20 taking my first T shot but hell I’m also going on 4 years of T which definitely feels odd lol. Time surely flies when your really not focused on how long but where in fact your going.

Well ladies and gents I have work to do, so until next time…


  1. sean says:

    good to see you doing great and still focused..congrats bro ,may peace always be with u

  2. Heather says:

    Is there an e-mail where I can message you personally. Because I also reside in Houston and there are many great doctors here in the Houston area.

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