Part 1: Penile preservation vaginoplasty

120
u/TransThrowAway482618
Sun Dec 12 19:07:36 2021 UTC
*
(53 comments)

I have a penile preservation vaginoplasty with Dr Heidi Wittenberg and Dr Adam Bonnington in two days. Some people have posted about this procedure on here before, which was very helpful to me, and I want to pay it forward (even if I'm only comfortable doing so on a throwaway account).

The vaginoplasty will use the peritoneal pull-through technique, with robot assist. She'll also try to pull down some of the skin to set the stage for a labiaplasty in a year or so, although I'm not trying for a labiaplasty as part of this coming surgery as Dr Wittenberg says they tend to lose definition due to swelling and engorgement. My insurance also made me have a consultation with another (in network) surgeon (Dr Avanessian, who at that time had never performed a penile preservation vaginoplasty) as part of the process to get out of network coverage with Dr Wittenberg, and when I showed her Dr Wittenberg's website, she had the exact same things to say about loss of definition. So I trust that labiaplasty will only have good results with this particular surgery after recovery from the vaginoplasty.

Please feel free to ask me anything, and I'll do my best to answer the questions that I think are in good faith. If I feel like something is too personal, I'll do my best to let you know politely. Please don't push.

I'm not sure exactly when I'll post the first update, since recovery and drugs will probably get in the way for a few days, but I'll do my best to keep you up to date.

Going into it, the things I'm most anxious about are pain management and swelling. I hope the wound vac helps, but it does sound like it's likely to run out of batteries at some point. I've prepared as best I can for this surgery. I've done a lot of running, and now I can run a mile in just under 9 minutes. I've also been eating a little extra to help with the first days of recovery when I probably won't be up for eating much. Gotta maintain my strength.

There's also another thing I learned about at the preoperative appointment on Thursday, which is pulmonary edema, when your lungs start to retain fluid due to shallower breathing and other causes after general anesthesia. It can cause a high fever, and in order to help prevent that they're going to give me a breathing device that I'll have to use every 15 minutes when I'm awake.

Dr Wittenberg says that I'll probably need to sleep "starfished" and that lying down and standing will probably be the most comfortable positions. Even though it's important to get up and move around a few times every day, standing will contribute to swelling so I shouldn't overdo it.

Anyway, wish me luck on Tuesday, and see you for the update~ 💜

Surgery/insurance letters: https://www.reddit.com/r/Transgender_Surgeries/comments/svkzwf/surgeryinsurance_letters_penile_preservation/

Immediately after surgery: https://www.reddit.com/r/Transgender_Surgeries/comments/rhvm2w/part_2_penile_preservation_vaginoplasty_two_days/

One week post-op: https://www.reddit.com/r/Transgender_Surgeries/comments/rl9k2s/part_3_penile_preservation_vaginoplasty_1_week/

Two weeks post-op: https://www.reddit.com/r/Transgender_Surgeries/comments/rtqc44/two_weeks_postop_penile_preservation_vaginoplasty/

Three weeks post-op: https://www.reddit.com/r/Transgender_Surgeries/comments/rz0n0k/three_weeks_postop_penile_preservation/

One month post-op: https://www.reddit.com/r/Transgender_Surgeries/comments/s3bqzd/one_month_postop_penile_preservation_vaginoplasty/

One and a half months post-op: https://www.reddit.com/r/Transgender_Surgeries/comments/shbzhp/one_and_a_half_months_postop_penile_preservation/hv1n71z

Two months post-op: https://www.reddit.com/r/Transgender_Surgeries/comments/stb2xd/two_months_postop_penile_preservation_vaginoplasty/hx2o5sb

Four months post-op: https://www.reddit.com/r/Transgender_Surgeries/comments/u46lsd/four_months_postop_penile_preservation/i4tmdim

Six months post-op: https://www.reddit.com/r/Transgender_Surgeries/comments/vduiyf/6_month_postop_penile_preservation_vaginoplasty/icmfqzw

Twelve months post-op: https://www.reddit.com/r/Transgender_Surgeries/comments/zny3o2/12_month_postop_penile_preservation_vaginoplasty/j0jtnsv

Three years post-op: https://www.reddit.com/r/Transgender_Surgeries/s/cJqtg0fkc9

all 53 comments


17
u/Androgynoplasty
Mon Dec 13 09:59:12 2021 UTC
(11 children)

Congrats! I hope all goes well and I'm looking forward to reading about your experience and recovery.

Some people have posted about this procedure on here before, which was very helpful to me, and I want to pay it forward (even if I'm only comfortable doing so on a throwaway account).

I'm glad I was able to help so many folks by opening the door with my post sharing my experience a few years back. It's really awesome to see folks 'paying it forward' to continue helping others.

9
u/rya_nc
Mon Dec 13 22:34:07 2021 UTC
(3 children)

Your post was super helpful to me, and if I haven't already thanked you privately... thanks!

I've been trying to be super open about my surgery "on main" in the hopes that it'll help normalize the option.

6
Mon Dec 13 22:42:44 2021 UTC
(2 children)

You and everyone else are very welcome! <3

I appreciate you and everyone else talking about your surgeries as openly as you are! I wish I could have been more open on my 'mains' here and in other places but I needed to keep my surgery talk separated for safety reasons due to being the first person to talk about it and getting a ton of unwanted attention in doing so. Maybe someday when it becomes more normalized then I can open up a lot more.

7
u/rya_nc
Mon Dec 13 22:50:37 2021 UTC
(1 child)

Honestly, I feel comfortable talking about it on main because:

1) Through a combination of luck, luck, talent, luck, hard work, and luck, I'm in a position to be able to weather a long period of unemployment without a problem.

2) My current employer has been super supportive.

3) I work in a field that, in general, has a lot of very openly queer people with high end jobs.

People have been way more supportive than I expected about the whole thing - lots of "wow, it's really cool you were able to get that done!"

Sorry to hear you've gotten unwanted attention. Hopefully that's tapered off at this point?

6
Mon Dec 13 23:09:18 2021 UTC
(0 children)

It comes and goes. Every now and the folks that want trans people to not exist will stumble on my posts and the attention balloons up again for a bit as they circulate the link and express their shitty opinions to each other and sometimes me. Even some trans folks have also decided our surgery is to be demonized, the worst thing ever, no respectful trans surgeon would ever perform it, etc. It's been interesting seeing reactions from all sides.

I knew going in that speaking up would get that kind of attention. The cost of pushing the door open for other folks, I guess. I'm just glad I could do it.

Worst case scenario, if I ever needed to for safety I could just disappear but I don't want to do that.

5
OP
Tue Dec 14 05:52:39 2021 UTC
(2 children)

Thank you! And thanks for putting up your original post, which kick-started this whole thing for me 😊

4
Wed Dec 15 12:21:17 2021 UTC
(1 child)

It's Wednesday morning, so you're either asleep right now, or if you are like I was, you are wide awake with nothing to do but lay there and ponder literally everything while floating in and out of reality having chunks of time turn into swiss cheese due to the meds you are on post-op in recovery.

First off, congratulations again! Second, you should start having more solid memories in a few hours from now if you aren't already starting to feel a bit more aware of everything. Third, take things easy and don't worry about updating us or replying if you see this, just relax and enjoy the sunrise if your room has a window, and don't worry about the outside world, just focus on yourself right now. Have a good recovery! <3

4
OP
Wed Dec 15 23:15:42 2021 UTC
(0 children)

Thank you very much for your kind words 💜

5
Tue Dec 14 12:30:07 2021 UTC
(3 children)

It was thanks to you that I even found out this was possible. Once I've had my own operation I'm going to endeavor to be open about it to try and help normalize it. I want to be a part of paving the way that you've shown to so many

3
Thu Dec 23 01:51:46 2021 UTC
(1 child)

I feel the same. I will too.

2
OP
Fri Jan 14 22:51:38 2022 UTC
(0 children)

Aww, thanks 💜

2
OP
Fri Jan 14 22:51:20 2022 UTC
(0 children)

Aww, that's really sweet of you 💜

6
u/rya_nc
Mon Dec 13 22:30:15 2021 UTC
(2 children)

Definitely wishing you the best of results!

I had similar surgery with Wittenberg just under three months ago, and the swelling was pretty bad. No loss of depth so far, though, and I've been working up to bigger dilators. Sizing up is a pretty slow process, it's taking me a couple weeks between each size, but it seems like it's going well.

I definitely lost a lot of definition of my labia, but Wittenberg told me ahead of time that pretty much all of her PPV patients have needed revision, so I basically just told her to set me up for a revision.

Please feel free to PM me if you have questions.

2
OP
Tue Dec 14 05:59:14 2021 UTC
(1 child)

Thanks for the best wishes and offer to PM! I'm glad to hear it's mostly going well for you so far, and I hope you can get your swelling under control~

I'm almost certainly getting a revision in about a year too, although I might not be able to get insurance to cover her a second time. On the other hand though it might be better to get a specialist in plastic surgery for the exterior anyway (Dr Wittenberg's specialty is gynecological surgery, iirc).

3
u/rya_nc
Tue Dec 14 08:55:28 2021 UTC
(0 children)

Swelling's fine now. I live in the UK (though a US citizen), so as a matter of convenience I've been planning to find a surgeon for revision in either the UK or western Europe, especially since I'll be paying out of pocket.

4
u/thewisewitch
Sun Dec 12 22:48:49 2021 UTC
(1 child)

Good luck, let is know how it goes. Hoping for the best possible outcome.

3
OP
Mon Dec 13 01:58:23 2021 UTC
(0 children)

Thanks! I'll definitely post updates as I'm able to.

5
u/nudemanonbike
Mon Dec 13 02:57:40 2021 UTC
(4 children)

Did they have anything to say about function post-recovery? I've read a lot on here about it, but I assume that they've got the most up-to-date information

4
Mon Dec 13 16:04:38 2021 UTC
(2 children)

I had PPV with PPT with Dr Wittenberg a year ago. Penile function was unaffected. I had problems with vaginal tightness though, so I don't have much to say about receptive activity.

4
Mon Dec 13 16:26:56 2021 UTC
(1 child)

Very interesting! I hope that improves for you :(

Is that the type of thing that they can retouch during the labia revision?

4
Mon Dec 13 16:59:43 2021 UTC
(0 children)

It will probably take a separate revision surgery, unfortunately.

3
OP
Tue Dec 14 05:45:42 2021 UTC
(0 children)

I was told tightness could be an issue if I get an erection during receptive sex, but I'm not really worried about that so much. Otherwise, the usual changes associated with orchiectomy.

5
u/Prototype1250
Mon Dec 13 16:05:31 2021 UTC
(1 child)

Congrats! It's always special to see someone reach such a milestone in their journey. :)

1
OP
Tue Dec 14 05:53:31 2021 UTC
(0 children)

Thanks!

3
u/tamzinblake
Mon Dec 13 04:39:11 2021 UTC
(1 child)

good luck! i just had one of those and it went great

1
OP
Tue Dec 14 05:46:36 2021 UTC
(0 children)

I'm glad to hear it! I'm anxious about the recovery myself so it's good to hear about good experiences.

3
u/blondetrans
Mon Dec 13 21:31:07 2021 UTC
(1 child)

Good luck. I am so curious how it goes for you since this is something I have at least thought about doing. Update us when you're ready.

1
OP
Tue Dec 14 05:54:30 2021 UTC
(0 children)

Thank you, and will do!

2
u/USER-NUMBER-
Wed Dec 15 06:59:34 2021 UTC
(1 child)

Hope you're doing well now!

1
OP
Wed Dec 15 23:14:41 2021 UTC
(0 children)

Thank you!

2
u/Telesto2775
Fri Apr 15 03:46:19 2022 UTC
(2 children)

Wait so in the future I really want to get this done, but the only question I have is, can I get ovaries and all that jazz? Or is it just a vagina?

2
OP
Fri Apr 15 11:46:18 2022 UTC
(1 child)

Just a vagina

2
Fri Apr 15 22:16:45 2022 UTC
(0 children)

Oh ok thanks

2
u/subbaga93
Sun Jul 31 23:38:37 2022 UTC
(6 children)

Where is dr whittenberg located? I had someone ask me about peritoneal earlier.

2
OP
Mon Aug 1 01:30:52 2022 UTC
(5 children)

San Francisco, https://www.mozaiccare.net/

2
Mon Aug 1 02:17:50 2022 UTC
(1 child)

Cool. Will they do GRS if you want to stay male? Most surgeons in the US want to make you dress as the opposite sex and take hormones for a year...I didn't want to do either. I wanted to stay male.

2
OP
Mon Aug 1 11:33:31 2022 UTC
(0 children)

They want three letters of support, and follow WPATH, but you should message them and ask because the WPATH standards have been changing.

2
Mon Aug 1 02:21:07 2022 UTC
(1 child)

You mentioned they asked your nsme and pronouns. What pronouns do you prefer? Are you transitioning totally? I have to say this is amazing they will do PPV surgery and your insurance helped. Everything has come a long way.

2
OP
Mon Aug 1 11:35:23 2022 UTC
(0 children)

Other than keeping my penis, I'm transitioning to female pretty much, hormones etc. I use she/her these days.

2
Mon Aug 1 02:23:59 2022 UTC
(0 children)

Sorry for all of the questions. I'm loving this group. It is fascinating.

2
u/BiidLakLbe
Tue Aug 16 22:13:24 2022 UTC
(1 child)

Congratulations for having this surgery, It looks amazing and strangely, Ive wanted this many years ago, but wasnt available or thought of then. I want to have this surgery, but need to find a surgeon that is not too costly.. Hopefully someone may know of an affordable surgeon. Yes I also would gladly share my experience afterwards.

1
OP
Wed Aug 17 03:38:04 2022 UTC
(0 children)

Thank you, and good luck making this happen for you!

2
u/transthrowaway010
Mon Dec 9 06:40:59 2024 UTC
(2 children)

thank you for sharing this being something, for quite awhile now this has been something that i’ve wanted, but didn’t know it really exist, but upon some googling, then finding your page, it gives me good hope into thinking it’s something that i’d like to get done.

there are some concerns i’ve come across, such as the fact i might not be able to ejaculate anymore, but i see other posters say they still can?? if so, and if the urethra is moved (does it have to be??) how does that work then… as i mean im okay either way its its moved or not and i get urine would follow that but it’s just sooo confusing to me at times.

i also understand that you can keep your scrotum however it’s recommended you don’t… then with that you’d have to go on some form of T??

please forgive me of some of this doesn’t make sense, and thank you.

3
OP
Thu Dec 19 22:11:50 2024 UTC
(1 child)

Thanks for your questions!

there are some concerns i’ve come across, such as the fact i might not be able to ejaculate anymore, but i see other posters say they still can??

I think this has way more to do with the effect of estrogen on your body than anything else, but I don't produce much ejaculate anymore. It is more of a dribble than a squirt, if you will. I don't think the surgery is what affected this, though, rather because I have been on estrogen for five years, and don't produce much testosterone anymore.

if so, and if the urethra is moved (does it have to be??)

I did not get my urethra moved at all.

i also understand that you can keep your scrotum however it’s recommended you don’t… then with that you’d have to go on some form of T??

I kept my scrotum because I cared more about keeping sensation than aesthetics - it has shrunk a lot over time because of the orchiectomy, but it is still there. I haven't heard any recommendations to remove it.

I did get an orchiectomy, meaning my testes were removed. Some people require taking a small amount of T when they have an orchi, but it depends on your body. My body still creates enough T to be in the normal female range, so I don't need to take T at all.

Best of luck on your journey! 💕

2
Wed Jan 8 01:50:45 2025 UTC
(0 children)

okay!!! i really appreciate your response tysm. I mean don’t even know if i’d want a orchiectomy if that’s possible, as that’s actually what i was referring too earlier. As for me the desire of this more comes too I guess sensation and function more then looks?? like it’s all soooo new to me. Yet also also if i do get the orchi with this i understand that tucking is simpler too even.

I know it’s all over the place and hoping you can understand that all but that’s the thing it was kinda just a a dream of mine i’ve had in the bs k of my head for years that i thought was not realistic, but to be learning it IS REALISTIC is honestly just amazing and really has some gears turning.

anyways thanks again for replying!! take care!

u/[deleted]
Sun Dec 12 21:20:54 2021 UTC
(1 child)

[deleted]

2
OP
Mon Dec 13 01:52:36 2021 UTC
(0 children)

Thanks!

u/[deleted]
Tue Aug 9 09:45:47 2022 UTC
(1 child)

[removed]

1
u/Voido1
Sun Aug 14 13:27:53 2022 UTC
(1 child)

may i ask you a question Why when you stopped taking spiro you returned to using diodrent and where do you use it ?

2
OP
Sun Aug 14 13:48:25 2022 UTC
(0 children)

I think my T went up because I needed to use deodorant in my armpits.

u/[deleted]
Sun Sep 25 12:53:00 2022 UTC
(1 child)

[deleted]

1
OP
Sun Sep 25 14:56:50 2022 UTC
(0 children)

Thank you! I'm so glad you got something out of them. I just had surgery to correct the fistula a few days ago, so when that heals I'll probably write another update.

1
u/Adhler
Sat Nov 5 22:57:05 2022 UTC
(2 children)

Hello ! Contrat for this transition ! I Hope this path brought you peace ! I have a question. Do you keep fonctionnal testicules, with ejaculation and producing testosteron with this procédure ?

1
OP
Tue Dec 20 22:27:33 2022 UTC
(1 child)

Hey, just saw your comment! I did not keep my testes, but it was an option. Previously I was on spiro to block T production, so I was able to stop taking that. But if you want to keep producing T yourself that's possible.

I don't produce more than a drop or two of ejaculate anymore, although that would be different if you still produce T.

1
Wed Apr 24 10:03:43 2024 UTC
(0 children)

Just wanted to say you just re-inspired my hope that my ideal bottom surgery actually exists. I had just about given up too, so thank you, genuinely.

Also wanted to ask: Do you know if you can keep testes but cut off testosterone production? I would ideally like to keep mine for play purposes but not biological.