First time caller, long time listener. With the day off, I figure I give back to this sub and give my general review/experiences with Dr. Avenessian and just try to go over everything as much as possible. TL;DR: She's got a great rep for a reason, just be prepared to call/hound people for it.

For demographics sake, I'm 35 (at the time of surgery) and 178 (at time of weigh in before surgery). Kinda fit. Balooned up a bit with COVID quarantine, full-time out for about two years at this point. Initially, I was gonna go with Dr. Ting, mainly because I heard good reviews and they were covered by my health insurance (UnitedHealthcare).

This started around Feb 2019, and I emailed about the program with the address on Mt. Sinai's web page. It took a bit to get a response, thanks to many calls and e-mail bombs, but eventually I got my first consult Oct. 2019.

Consult isn't the right word, it's more a intial screening with their in-house social worker, psychiatrist, and health professional (doctor). I live in New York State, so it was a drive to get there. Anyone driving there, there's a parking garage right near it that I aimed for (I was not NYC traffic prepared, so I just wanted a direction and not worry about parking).

Got out, and went in. Social worker is there to go over the plan for who's taking care of you, other bits in terms of logistics. I explained I had my husband come with me, so it was pretty benign. Then they brought me to their doctor (I think it's just a GP) and they basically gave me a physical. After that, the psychiatrist and a brief 15-30 minute session I was done. Whole process was about 2ish hours (most of it waiting).

One thing I want to say right off the back, I do like that their care plan for GRS is all-inclusive so to speak. If you need letters for your insurance, they'll give them to you no problem (I had one from my GP, so I just needed a psychiatrist one). Really cool.

After a few weeks, and some more hounding, I got the call and my actual consult with Dr. Avenessian was in June 2020.

Work work work, and the day came. It was in their 2U office which was small, but nice. Staff super helpful and nice. Initially I met with one of Bella's nurses who went over basic things and took base vitals. After that, I was told I would be in a video call via FaceTime with Dr. Avenessian to minimize the time needed to be in contact (this was during COVID). Needless to say, she is a absolute cinnamon roll. Super kind, understanding and sharp as a tack. Ask her anything and she'll answer.

As a aside, I've got colitis - which is essentially a more mild form of Crohn's and I was nervous about the effects of this. I explained that it was more localized in the left part of my large intenstines which made her a little more optimistic. However, she did warn that there is a chance they would need to put a colostomy bag. She's very sweet, and understanding, but she's not gonna sugar coat it if she needs to make a point clear. I liked that about her. After I sent her the papers from my GI explaining everything (including colonoscopy reports), she was more relieved that it wasn't in the rectal area (which would have complicated things to say the least).

She then came in and actually began to examine what she had to work with. She pulled on the testicles for elasticity and prodded the head of my glans to see what is sensitive since that would be the basis for the clit. She explained to me that she recommended tucking (I could never "figure it out") to help her with the asthetics. After that day, I did... or tried to, haha. Something to keep in mind if you don't tuck and you're going to see her.

We also talked about hair and such. At the time, I was about 5 sessions deep in laser down there and she recommended 8 or so by game time. There's hair down there, but I can't feel anything out of place or tugging inside, so she must have been able to scrape the follicles for any last bits so gold star there!

Few more weeks and phonecalls go by and I get the call.

"So, there's a opening in December 2020. Want it?"

The pandemic will die down by then, ha ha ha. Oh how naieve I was.

With date in hand, me and my husband got to work on the logistics. Through creative banking, I had about 8000 to work with. We intially ended up at a AirBnB in Manhattan across from FIT for 6 weeks (I know it's 4 weeks required, but I wanted a extra week before the day to get acclimated and a week after just in case). Weeks pass by and the day before, we see there's a Nor'Easter coming. We decided to go ahead of it, and stay at a hotel in the city.

This was mistake number one.

The Roxy, hotel we stayed at? Super cool and nice! Totally recommend if you're going to the city for a few days and are looking for something that you just need a place to sleep but is still pretty fun and nice. However, when we went in, we got pulled aside by a NYPD officer asking us to do a COVID screener test. I was exempt because I'm a resident, my husband, who came from Maine, did not.

We weren't too worried. We figured that we just get to the AirBnB and we can test out of quarantiene via in home tests via SpeedySticks. Mistake number two. They apparently changed the guidelines for quarantine, where you needed to have a clean test before you come to the city, and two-three days after. So, my husband was basically quarantined and I got to work stocking the kitchen and doing errands.

All this time, NYPD was texting my husband, calling, and making visits to the apartment we were staying at. Shit was no joke, they expect you there if you're quarantined. Unfortuantely, it meant that he couldn't visit me in the hospital which sucked, but hey. Roll with it.

Then two days before my surgery, there was a gas leak.

I go over and confirm it with my husband, and get on the horn with the AirBnB host who's across the globe. He sends up a worker in the building and he can't smell gas. We look at each other like, "y'all have a cold how the fuck you can't smell that." The super comes in and we're arguing with him, and he turns off the gas to the apartment.

Suprise, suprise, the smell stops. Pinhole leaks are no joke.

Thankfully, my husband was already on the fucking ball and was able to get the majority of our refund and managed to get to a Holiday Inn on the Lower East SIde for a little cheaper. Unfortuantely, we had to throw out about 400 dollars worth of food, drinks and other things, but hey, chicken fried pussy benefits no one.

I get the bowl prep, and it's basically the size of a bleach bottle. Added the flavor packet and went to town for the day. Wasn't "great" but was expecting a lot worse. Also did the whole special scrub thing. Nothing special. Just expensive soap.

Then it's the 14th, game time. Get a uber over to Mt. Sinai NYEE (where they actually do the surgery, I thought it was Union Square) at 5:45. Sign some papers, and travel up to the second floor where I got put in the pre-operating room area, got undressed, put on the gown and talked with the surgical team, and Bella herself who went over last minute questions. Again, pure cinnamon roll.

Sidebar, I'm fairly certain someone in the "room" next to mine was getting GRS too. So if you're reading this and you were there on the 14th, heya.

Walk to the OR (which was weird), and laid down. They hooked me up and before I knew it, I was awake in recovery.

"Everything looked great, went great, great depth."

"Do I have a bag?"

"Nope! Went smoothly!"

With that a sigh of relief (I was pretty lucid and cognizant), they wheeled you up to your private room for the next 4 days. Guy came in with dinner, and I scarfed it down, being careful of dairy (it aggrivates my colitis). Be sure you're firm and let them know if you've got any food restrictions. I'm super paranoid when it's ordering out and there's no ingredients listed. For the record, if anyone else has the same issue, eggs were good to go.

Room and the staff were super nice. They kept me with a steady supply of drinks while they came in and out to give medicine, and all that jazz. Wasn't any real pain at all. Probably because of the constant Ibproufin, Tramadol (and yeah, shit burns for a few seconds when they put it in the IV, so be ready) and Tylenol they were given.

Only complaint is the TV channels were... less then lacking (fine if you want the news, or watch Colbert or something). Be sure to pack a charger with a 10 foot cord. I had that and a power brick for my other stuff (I brought a hacked Fire for manga, 3DS and my phone). Just a friendly pro-tip.

Each day, they'd get me up. First to just stand, the next day to the window, and the next day to the door and back. As someone who doesn't like to stand still, those moments of "freedom" were amazing. Bella's team would come in, but due to the holidays, she was only there two days out of the four I was there. Not a knock, just something to keep in mind. Just be firm and open with any questions. That's what you (insurance) is paying them for.

Thursday rolled around and I was released in the afternoon. We were able to manage a escort for me (which sucked, I could have done it [painfully] myself, but insurance and all that jazz) to get me back to the hotel and boy that initial uber ride was rough. I did a Uber Comfort, and got one of those big ass Escalades. Was not a great time getting in and out, especially since I had my two new best friends: Mr. Catheder and Ms. Wound Vac.

Finally get to the hotel and I greet my husband with a very wet shart. Honey, I'm home.

Week 1 was just me trying to get used to everything and hoping that when I have to go to the bathroom, I don't force pooping out. I found the best way to handle it is do a kind of lamaze breathing sort of thing to try and contract your stomach muscles and not force anything out. No nausea, but every time I'd try to go to the bathroom, I was extremely dizzy and was getting chills. Needless to say, you're going to have zero stamina. As someone who does 15-20 mile hikes and exercises like 2-3 hours a day, it was a fucking check. Stay your ass in bed. Keep the fluids going. Eat good food. The one thing with being in NYC and not having a kitchen, we more or less ate out every night. For my dairy free people, here's some brief recommends:

Erin Mckenna's Bakery - REAL VEGAN COOKIES AND ECLAIRS. Good shit. Expensive, but I can't get these things everywhere. 10/10 big recommend.

Sugar Sweet Sunshine - Cupcake game on par. According to my husband, the cupcakes and banana pudding were great (non-vegan).

S'MAC - If you can't have dairy free, try this place once. Daiya this ain't. UNF.

The Halal Guys - Never had this type of food before, but the platters made me a fan. Weird MVP? The fries. Really good fries.

Wolfnights - Their carnivore wraps are amazing and their sweet potato fries? On point.

Faicco's Italian Specialties - I love a good sub and fuck me. Best subs I've ever had. Side bar, these are NY Subs, so it's like 10 pounds of meat with a hint of bread. Fucking worth it.

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Week 2 I finally get the packing and cathedar out! Something I didn't expect/wasn't expecting, was the packing "inside" my clit. Wasn't painful, and was taught how to dilate. Things were still going great. No real wound seperation, everything looked good for two weeks out (aside from usual swelling and incision marks). Dilation isn't bad. At first I didn't even mind it, even looked forward to it, because I take care of everyone, I'm running around, I never made any time for me. So it was nice. What I'd do (and a big recommend) is use doggy pee pads and lay on top of them for easy clean up. I got the extra large which was probably over kill, but I'd rather not sleep in lubey dischargey sheets. Also picked up Sugrilube. Expensive, but compared with briefly trying stuff like KY, I like it a lot better. A 4 pack will last about 2 weeks... ish. I know I overkilled on lube, but rather be safe then sorry. It was pretty surreal though. I worked my ass off and was able to get this. Yeah, I had the brief "oh shit, I actually did this", but it was immediately resolved with a sense of normalicy, or even that it wasn't that special. It's just how my body was supposed to be - and that just freed up so... so much of my mental bandwidth. The mental results were almost immediate. Hubby again, being VIP, would check my catheder bag and empty it almost every three hours (the surgical team said it could be like 6-8, but he wanted to be sure). Needless to say, he got a very nice gaming chair out of the deal. Wound vac itself was pretty quiet. Barely any discharge. Just did it's thing.

Also side bar, that first shower. God, it's magical. I can't "wash" down there, but I can soap up a towel and hands and gently pat around the area and incisions.

I'm not sure if it's because of my insurance, but they would also send traveling nurses about once a week at this point. It was nice in that if I had questions about how something looked downstairs, they could answer, but it was one of those "ehhhh" sort of things. Not a waste, but something I could do without (my husband doubly so as he's a late sleeper).

Week 3 came by and I moved up to the blue. Went for my second followup with the PA/Surgical team to go over things and they said if I felt good, I could move up to green. At this point, I was doing a mix of 5/10 minutes purple, and 5/10 minutes blue.

Week 4 I get a little bit more adventurous, and am able to walk around. Maybe a mile outside, before I come back. Needless to say, it's me shuffling on the ground as the incisions in the creases of my thighs are super swollen and am nervous about wound sepeartion (around week 5ish, right before I leave, I did have some - but it was so small, I sent pictures to Dr. Avenessian and she was like "naw, you're fine girl").

Week 5, is the final post-op visit and I get to see Dr. Avenessian. She's thrilled things look good, and we talk about results. Apparently, I got about 6-7 inches which explains how far I can get in me with the dilators. At this point, I explain that I've been doing one dilator for 20 minutes, and she wants/recommends me to use all of them. I also ask about douching, and the papers they give you? Not accurate. ASK BELLA, OR WHOEVER YOUR SURGEON IS FOR PROPER CARE. She didn't recommend douching (which made me feel like a idiot, because I bought plenty), but did recommend a detachable showerhead or in my case (since it was a hotel) a peri bottle. Basically a upside down squeeze bottle with a angle at the end for your hooha. She explains she wants to see me roughly 3 months out, then six, then a year. In three months, I'm cleared to drive, four for sex. Yay.

A few days later, the train ride out. Was suprisingly not too bad to move. It was still a struggle, and I was shuffling along, but the train ride was smooth ad there was next to no one there. The donut they ask you to have with you? Yeah, they mean it when they say it's a life saver.

We get back, and I'm beat. I got up early that day to get a dilation session in, and get my last two done and fall asleep. For the rest of the week, I'm just getting back and used to being upright and not in a small hotel room. It's hard to bend over, and I'm still being extremely careful with my movements - but hey, tylenol and ibproufen are your friends. Never had to touch the Oxycotin, and even with the over the counter stuff, it wasn't a "I need this now or I'm gonna be miserable." Still, I kept a regular schedule. They call it pain management for a reason. Don't let that shit get worse.

The wound seperation on the creases of my thighs are concerning, but again, Bella doesn't give it much mind. Results are getting relatively less swollen (to the point where I have to mentally associate a new landmark point when I'm fully "in" for dilating). Things are going relatively well. Yeah, there's a bit of uneven swelling in the labia which makes things look like they're droopy, but it varies on a week to week thing. Gotta let the process complete.

Week 7, I'm back to work. Back to work is a relative term. I'm a software developer, so it's me in bed with a lap desk (elevated so it's not on my groin, obviously). Things are pretty normal. I could have probably gone back home at week 4 no problem, and back to work a week earlier, but I needed the time. Not only to get acclimated to home, but to get acclimated with dilation (since when I last saw Bella, she moved things up from two to three times a day).

At this point, I've hit what I kinda like to call "the wall" with dilation. I can see it with other people too where "god I've got to plan everything around my dilation" and yeah, 30 minutes a day per session, but there's set up, clean up, and warming yourself up to make sure you're at depth before the timer starts. It can take a hour to 90 minutes sometimes (though I'm at week 9, and I've got it to a hour consistantly). I do mine when I wake up, after I finish work, and before I go to bed. Finish the process and shower. It's a ritual of sorts.

So, how are things now? Around week 8 was when I felt more comfortable bending and picking things up off the ground and my stamina is slowly but surely getting back. Dr. Avenessian is very much team "baby the area". I went grocery shopping with my husband a few days ago in Walmart and when I got back, I was absolutely exhausted. But hey, I can pick things up off the ground, can cook for myself, and at least for quick trips, I don't need the donut as a passenger (haven't driven yet, but I could if I needed to). Wound separation is healing pretty good, and just taking it easy, but trying to stay active (walking in place for half a hour playing video games, et al).

All in all, am a big fan of Dr. Avenessian and while there's some hiccups in the process to get the ball rolling, when it finally does get rolling. It's great. Dr. Bella is a treat and she's EXTREMELY prompt in responding to e-mails. Considering in the weeks and months leading up, I'd browse here constantly to figure things out and essentially "prepare" myself for the worse outcomes. A small little bit of wound seperation? I'll take that if that's the extent of complications. 10/10, would get it chopped off again. Apologies for not sharing pictures. Not the most comfortable with that.