Hi! I just had a penile inversion vaginoplasty including tunica vaginalis with Dr Bella Avanessian yesterday (2/1/2022)!

Day 0

We got to the surgical center around 5:15 AM, which was 15 minutes early. We went in, were prompted by the security guy to sanitize our hands, then approached his desk. He asked for our ID's and my escort's (one of my partners) proof of vaccination. She showed him a picture of it on her phone, and that was accepted. She didn't have her ID but he said that having mine was enough for the two of us. He then directed us to the check-in desk, where I gave my name and we then sat waiting to be called on.

Eventually I was called up, and we followed a very nice lady to sit outside her cubicle. I provided my ID and insurance info and she asked a few questions, then had me sign an iPad with various consent forms. It was now 5:56, so she put on my bracelets, gave me a binder full of paperwork (and with a paper taped to it that said something to the effect of "Floor 2, OR")  and took me to a different waiting room to wait until called to go upstairs (the OR opens at 6). I took a selfie with the Mt Sinai waiting room 4 sign. A lady came to take us upstairs, but I really struggled to understand her. She spoke very loud and rapidly and I eventually realized that she was saying to go to the elevator, but patients only - this was where my partner and I had to part. We went into the hallway and hugged goodbye, then I got into the elevator with other patients. The security guard came over and took us up, got off with us (the elevator door stays open for him) and opened the door to the OR. I followed some other patients in, handed my binder to a staff member, and was directed to a little curtained off area.

Someone came in and instructed me to change into patient garb, and verified my name, dob, etc. The pants looked like they might be too small so she got me a larger pair. That pair was too large but 🤷‍♀️

I waited for a while, positioning was hard because I couldn't tuck anymore, so my dysphoria was worse. Eventually I found a good seating position and tucked that way. Another staff member (the head nurse, I think?) came in and verified my info, that I hadn't had anything to eat or drink, and let me know the anesthesiologist would be there around 7.

He showed up and told me about the anesthesia, confirmed I hadn't had anything to eat or drink, and let me know my surgeon would be along soon.

Then Bella (Dr. Avanessian) came in and was super sweet and nice, just like at the consult. I wish all of my doctors were like her, her bedside manner is so wonderful! She stated that her primary goal is to avoid any injuries, with areas of risk being my bladder, urethra, and rectum, especially my rectum (and knocked on the wall for luck). After that her goals are to retain sensation, have good depth, and make it look pretty and symmetrical. She said a rectal injury would be the biggest issue as that would increase the likelihood of a fistula developing and we'd have to take extra care in that unlikely scenario, and that if any injuries did occur they would make sure the proper doctors were brought in to handle it.

She had a consent form for me to sign about the procedure, and had noted that it was a vaginoplasty with potential use of the tunica vaginalis. This was what I was waiting for so I immediately said, "Yes! I definitely want to use the tunica vaginalis!" and she made a note about that. She repeated what she'd told me during the initial consult, that she hasn't really noticed any difference from using it - some patients will self-lubricate without it, and some will with it, and some just won't lubricate at all - but that it also does no harm so she's fine with including it.

She told me that the catheter might feel weird when I wake up, like I really need to pee, and to just let it happen, to not try to hold it because I couldn't anyway (I haven't had any issues, the catheter is wonderful lol).

She informed me that the packing in my vagina (MY vagina!!!! eeeee! ☺️) would collapse my rectum and might feel like a blockage or like I need to poop, but that most patients don't have a bowel movement until the packing is removed (which for me wild be in 8 days 😮) and to keep taking my still softener that whole time. It would be fine if I did poop, just unlikely.

She then told me I could tell my partner that if anything went wrong they'd hear about it before noon and if she hadn't heard by noon everything was going well, and she'd call when finished. She left after that, and shortly after another nurse came by to ask if I'd had anything to eat or drink and tell me Dr. Avanessian would be along shortly (I informed her that she already had been).

A little bit later someone came to take me to the OR. Walking there was torture due to being untucked, especially because I was wearing pants, but it was the final walk so I managed to push through it.

The OR staff all greeted me nicely and I took off the pants and laid down on the table. Someone came over and started my IV, she was really nice and calming. I had to stretch out my arm and make a fist, and she injected into a vein on top of my hand. It hurt so bad! Especially when she had to press down on it for some reason, and then when she drew a vial of blood. Then she hooked me up and told me they would start taking readings and then I'd be out.

They put little massage cuffs on my legs that alternate inflating and deflating to help with blood flow. I think there may have been a bit more, but that's about it, just some shattered glimpses of memories that aren't discernible, then I woke up in my hospital room!

Immediately I knew - everything felt right! I've been elated/euphoric ever since. I can't see what's down there, it's all sealed away right now, but it feels so right. ☺️😌☺️😌☺️😌

The hospital staff have been wonderful, everyone has been very sweet and attentive. My social worker visited not long after I woke up and I immediate gave her my room number at the hotel since I'd forgotten to call her to tell her but that so she could finish setting up the visiting nurse service. She was surprised that I was just waking up and already had that on my mind lol.

She also went and got me some more water without ice at my request ☺️

Dinner was tilapia, rice, and broccoli. It was tasty but I paced myself since I hadn't eaten since 2 nights prior, and also because the rice was a bit dry (exacerbated because my mouth was super dry). There was also some really yummy orange jello, and an apple (I still have the apple).

My partner came to visit 💕💕💕. Visiting hours are only 4-6pm right now, you can only have 1 visitor (not an issue since she's the only one here), and you have to show proof of full vaccination or a negative Covid test result from within the last 72 hours. We chatted for a while and it was really nice, although I don't remember much of what we said. She took pictures of the view from my room, it's really pretty although I can't see it from the bed.

I've alternated between alertness and lassitude, with some drowsiness in the mix as well. I slept on and off through the night, the weird thing is that I felt like I was asleep while I was still awake, which brings back memories of being in the hospital with my broken right femur in traction around age 11 - I dreamed I was playing soccer and kicked the ball with my right leg, and actually kicked my leg in real life. I've been a bit worried something like that would happen, but it hasn't. The leg massagers are amazing and I kinda want them for at home. The tight pressure feels so good and reassuring, and then they relax and I do too 😊

Day 1

The catheter has been great, I've just left everything down there in a state of release. Starting early in the morning I've had some gas, which is unpleasant and when it first made it's way out I thought I might have pooped as well; I had a nurse come check and I hadn't.

Breakfast this morning was pancakes, oatmeal, a banana, and orange juice.

Jonas, one of the PAs who was in surgery with me, came to check on the site. He told me that they got really good depth and I'm going to be very happy with the aesthetics! ☺️

I stood up around 10 am. Getting up was difficult since I had to avoid coming to a sitting position. I got light headed when I propped myself up, but it passed and I proceeded with standing. The nurse helped me up, then changed the sheets. She took my blood pressure when I was lying down and then twice when I was standing. While standing it felt kinda like I had a cramp in my left side, except down in my groin next to my hip. When I laid back down she put the top sheet on and part of it flipped down onto my groin. That was the first real pain I've experienced, but it wasn't much and was fleeting.