#ftm phalloplasty education blog

[answersfromzestual]

This is another header I have been working on,

I thought the quote was great.

"the more I hold myself close, and fully embrace who I am. The more I thrive." -Elliot Page.

[answersfromzestual]

Do you mind me answering?

They do not do both surgeries at the same time because there are usually steps between chest surgery and the actual phalloplasty procedure. And it ups complications due to the time you are under anesthesia goes up. This can actually be harmful to you. The longer you are under anesthesia, the more likely you are to have side effects of it, and even can lead to death. It also affects your healing process because of the amount of stress your body would be under trying to heal both wounds at the same time. It may not produce the best results you could get.

My Phalloplasty Procedure alone was about 7 hours in the operating room.

Then, usually, after top surgery, they ask you to have a hysterectomy, which my clinic, for example, didn't do. Some clinics would rather you use an OBGYN for the hysterectomy. (This isn't to say another clinic would not perform the procedure).

But bottom line I feel is the time you would be under anesthesia and the stress on your body healing both injuries would be a lot on your body, too much to have the best results you could.

I don't want to be a sourpuss, I felt the same when I was where you are in transition.

And about using the extra tissue from your chest, it may not be as sensitive as your forearm, for example. Surgeons usually use tissue for your phallis that is extremely sensitive (like your forearm or lower back). This was just what my surgeon told me about which tissue he uses. For example, my surgeon only used forearm skin for the creation of the phallis.

I don't mean this to be rude, I just wasn't sure if you wanted an actual answer or not. If not, I apologize.

If you'd like to see some articles and more info on all the procedures, feel free to follow me.

Text to speech: Why don’t they offer top surgery and a phalloplasty at the same time where they use the breast tissue instead of limb tissue, {redacted}, hush,  and construct the penis out of that. Why not though?

[answersfromzestual]

question on phalloplasty: your FAQ post says it is possible, at least for you, to ejaculate post-surgery. I'm curious because I'd only seen people saying that it's not possible till seeing your post. how does it work?

There are two glands located on either side of the urethra (the tube where urine flows from the bladder to outside of your body). These glands are called the Skenes Gland.

When most of the surgeons I have looked up tend to [try to] save these glands, it does not necessarily mean everyone will ejaculate after their procedure. It depends on how active your Skenes Gland is in general.

It is a clear fluid, it is not the same as cis male ejaculate, it does not contain any sperm or semen.

An example of how active your gland is from what I understand how much fluid you excrete during times of intimacy. (Aka "wet").

I found a pretty decent article on the gland itself by the Cleveland Clinic here

I hope this helps answer your question.

If you have any more feel free to ask away!

Stay Golden Anon ✌️ 💙 💜

[gayhenrycreel]

i would like everyone to know that @answersfromtheshadows is a fantastic blog and you should follow him

ive been wanting to learn about ftm surgery and this is the perfect blog for it. the information is correctly sourced and backed up by science. the things people say about phalloplasty are pretty awful and this blog was everything i needed to know that it is actually a safe procedure and is not as bad as people think. in fact i think i might get phalloplasty myself now that i know how it works. answersfromtheshadows deserves more followers, and is an amazing education blog

[answersfromzestual]

Leaving this here because sometimes we need to hear nice things.

trans people i’m happy you’re alive!!!!!!!!!!!!!!! i’m so glad you’re here!!!!!!!!!!!!!!!!! keep doing your best!!!!!!!!!!!!!! i love you!!!!!!!!!!!!!!!!!!!

[gay-----pisces2]

Hello, I am a phalloplasty/ ftm transition education blog. I would be happy to share a gofund me if you were to make one for yourself. There are a lot of people who care and would want you to be happy.

I just wanted to let you know.

Stay Golden Friend ✌️💙💜

That sounds amazing! I'll probably not be able to create a GoFundMe currently, but if I'm ever able to, I'll message you :D.

[answersfromzestual]

Penile/ Phalloplasty Erectile Devices

There are two main types of penile implants:

Inflatable Devices

Semi-Rigid Rods Device

We will go over inflatable devices first. There are two mainly used types of inflatable penile implants used in phalloplasty, as well as cis men with health issues.

What are they?

Inflatable devices are the most common type of penile implant used, especially on phalloplasty procedures.

The two types are:

Three- Piece Penile Implant

Source

Three-piece inflatable implants use a fluid-filled reservoir implanted under the abdominal wall, a pump [in your main hand side] and a release valve placed inside the scrotum [and slightly located above the pumping mechanism], and two inflatable cylinders located on each side of the penis.

To achieve an erection, you pump the fluid, which is salt water (saline fluid), from the reservoir into the cylinders. Afterward, you release the valve inside the scrotum to drain the fluid back into the reservoir. Usually, this is done by holding a small button on the release valve.

In both devices, the reservoir is filled with salt water (saline water) the day of surgery and remains in the device.

This particular system [three-piece] is how I get an erection/ deflate my erection.

Two - Piece Penile Implant

Source

The two-piece model works similar to the three- piece, but the fluid reservoir is part of the pump implanted in the scrotum. This device is not the most effective at maintaining total flaccidity (it may sometimes look slightly erect). This device has more limitations on types and styles of penetration/sex. Be sure to ask if there are limitations with the device and its particular model that was implanted.

In both devices, the reservoir is filled with salt water (saline water) the day of surgery and remains in the device.

The last commonly used erectile device is called:

Semi-Rigid Rod Penile Implant

Source

Semirigid rod devices styles are always firm. The penis can be bent away from the body for sexual activity and toward the body for concealment. There is no inflating or deflating.

A "positionable penile implant" is a semirigid device with a central series of segments that are held together with a spring on each end. It can maintain upward and downward positions better than other semirigid rods can.

What is best for you? Comparison Images:

Source

Most clinics have their own style of procedure that involves a certain type of erectile device. You may or may not have a choice with certain clinics, so make sure you research clinics and make sure they fit with your chosen device and procedure.

This article was written about just implantation of these devices in general, the different devices, and their functions. If you are interested in sexual intercourse, especially penetration, consider where you want to penetrate.

For example, some men are not able to perform anal sex with the two-piece option, while some men are able. Always ask your doctor before leaving the clinic about the sexual acts you can/ cannot perform. You can seriously injure yourself if you try something your device is not capable of.

I hope you enjoyed the article and know a little bit more about the selection of erectile devices for phalloplasty. I hope this helps you make an informed decision.

Stay Golden Everyone ✌️ 💙 💜

Source used 1

Source used 2

Source used 3

[answersfromzestual]

My Dear Followers,

Currently I am dealing with health issues and I may not be posting much or able to work on posts.

Please read through the blog directory, I will try to queue posts for the next bit, but I have to figure out how to queue for multiple days.

Thank you for your understanding,

Stay safe, stay true, stay strong.

-Zestual ✌🏽💙🩷

[answersfromzestual]

Hello there!

I run a ftm transition blog that mainly focuses on phalloplasty, but I do have several articles on other types of surgeries and procedures as well.

Please check out my blog directory, I also take questions, comments, and concerns.

i wish ppl didnt shit so hard on (transmasc) bottom surgery man. i feel like i wouldve looked into a metoidioplasty a lot sooner if i hadnt seen all of the negativity and stigma surrounding phallo and metoidioplasties. but as soon as i actually looked into it i realized it was something i want! extremely bad! and i feel like a lot of other transmascs would want bottom surgery if they actually knew more about different types and results

[answersfromzestual]

Graft Site Care for Forearm Free Flap Phalloplasty

Taking care of your grafting sites like your forearm, upper thigh (or other locations, surgeries vary) is a lot. Especially when you are in pain and feel just yucky.

I did not have a choice of where to take the graft to cover my arm's exposed tissue. My thigh was used over my lower back because of visibility.

The thigh was the easier part to take care of. All I had to do was put a thin layer of polysporine on it and wrap it up. It wasn't bad pain wise. It stung and ached at first, but the stinging and aching dissipates quickly as you heal. They only take a few layers of skin from your leg (or other graft site location), usually no fatty tissue or blood vessels, just skin. So that it will grow back and potentially not be any 'indentations' making it stand out against the rest of the thigh skin. Your first shower, it may be painful. I won't lie. it's something I wish that I was prepared for, honestly. I yelped (I have a very high pain tolerance) and swore like a sailor. I did this at the hospital, and a nurse was right outside the shower there to assist me. It was really kind of awkward, but at this point, my phallis was basically out all the time and was seen by every nurse in the building.

When it came to washing my arm, which I thought would be the painful bit of my shower, it never hurt. Personally, I have no sensation on my forearm graft site.

Just be prepared also because for example I do, however, suffer from something called "phantom itching," which means that even though I can not feel any sensation on my skin, I get itchy, and scratching doesn't help because there are no nerves. It happens to me maybe once a week, but it the itch only lasts a minute or two. This happens in about 60% of people who lose a limb or any body part with nerves. I found to combat phantom pains, a study was done for limb pain for people who had amputations. The study was about showing the subject themselves in a mirror and seeing the limb is gone. In many cases this actually worked on subjects and they could reduce or even stop their pain. We are talking about people in severe pain where they no longer have the body part causing the pain. I did try this on myself and I told myself there is no way you can feel itchy in front of a mirror. It actually made the itch instantly go away a few times after I practiced.

My arm was in a cast when I woke up from the procedure and for two or three days afterward. It was to protect the arm and keep the new skin tight against the body.

When they remove the cast, it can look a little gnarly (these may be similar to the more unpleasant looking pictures before they heal). No worries, though. It will be all good. They wrapped my arm in a tensor wrap over my gauze bandaged arm. I had to always be covered and protect my forearm.

When I got home I was instructed to have compression sleeves already, I did (this is important). I made sure to buy two at once so I could rotate. They tend to get stretched out I feel like in the wash especially, so having multiple is always a good idea. It will help them last longer.

Caring for your arm can be a little intimidating at first. To keep the skin flat for the first week (healing times may vary on person to person), I had to once a day poke small boil like spots on my arm with a small, sterile needle (I could not feel this what so ever). Then would clean the area and bandage it as I was instructed. I had to use special wrap that keeps the gauze from sticking to the wound. I would put some polysporin on each wound, cut out a piece of the lubricated bandage to prevent the skin from sticking to the gauze bandage, gauze bandage my entire forearm, then I would have to wrap my arm up my arm in a tensor bandage. They should teach you how to do this before you leave the clinic. Their instructions should be followed even if they differ from mine. Surgerons know best.

I had to use tensor bandages at first to wrap my forearm because of the wounds and amount of bandages, but within two weeks of being home, I was already healed enough and wearing my compression sleeve. You can usually start wearing this once you have no more open wounds. Please follow your doctor's instructions, even if they do differ from mine.

Compression sleeves are worn 24/7. You only take them off to shower. You should always wear your compression sleeve for the best results. Keeping the skin taught (tight and close to your arm) is important to get that nice flat surface. The compression sleeves are actually not uncomfortable personally, the only parts of the sleeve I bought in particular (it went from my uppser bicep to my wrist, be sure to measure yourself to find the proper size for you). The very top of the sleeve was "sticky" and is to keep it from sliding down. When I was at work and would sweat the sticky band around my bicep, would slide and loosen (the sleeve itself was not really affected as long as it was still tight around my forearm. Before your surgery its a good idea to ask what they recommend you to get for a compression sleeve and how to measure yourself for one. I did not like how mine only went to my wrist. If it is possible for you to get one that maybe goes from bicep, past your wirst and around your thumb (for example) to keep it over your wrist. Around my wrist is a little wrinkly, I feel it was because of the band around my wrist would slide up once and a while and leave about 1/3 of an inch of a gap between the sleeve and my hand (basically where my wrist bends). The sleeve really flattened the indent between my fatty part of my forearm and the graft. I get compliments on how flat and nice my forearm skin laid. I had to wear the sleeve 24/7 (aside from showers and the drying time) for an entire year to the day, the clinic should tell you how long they want you to wear a sleeve, if not be sure to ask.

Compression sleeves are very important for keeping your arm skin flat and tight to your arm. Having multiple is a good idea. Being able to rotate is important. It helps keep longevity of the sleeves. It helps allow you to wash one and have one to wear as it washes and dries. They are usually recommended to be hand washed and air dried. Washing them in the washing machine can stretch and wear them out faster. Most compression wear is not suitable for the dryer.

And that is how to take care of your grafting sites according to my experience and the website from GRS Montréal.

If you ever feel like anything is wrong, you don't feel well, anything feels unusual to you, you are in an abnormal amount of pain, or maybe you do not perhaps remember all the exact after care instructions. Please contact your clinic ASAP. They most likely have nursing staff that answer phones and emails 24 hours a day to help you, especially if your surgeon/clinic isn't close by or easily accessible to you. It's better to email them and have nothing be abnormal rather than not mention anything and hurt yourself or harm your healing.

Source 1 - healing information (GRS Montréal)

Source 2 - case study on neuropathy

Source 3 - Myself, recipient of the procedure in 2014.

[answersfromzestual]

how would you say your specific pain as well as what you may have heard from others and how much you felt you needed pain medicine, I am an addict and am trying to figure out if I can get phallo without narcotics

One day at a time ❤️

I understand your fears quite well. I did have an issue with substances during the first phase of phalloplasty even.

So let me be completely honest, you deserve that.

My specific pain was slightly different with each procedure. But the extreme pain usually did not last more than three to five days after being released from the clinic.

So during the first stage I remember the first just under a week being quite painful, more so after moving, walking to the bathroom, defecating (pooping), moving your lower abdomen can also cause you to feel sore after.

I needed to use the medication. But it was 4 or 5 days of extreme pain and discomfort. Even then, when you are lying still, it can be more of an ache and not pain.

The catheter is annoying because of the bladder spasms, but I didn't take anything more than regular extra strength tylenol for that.

I found that the actual pain did not last as long as I expected it to (as I said 5 days), it does depend how active you are as well as you are healing.

So I can't tell you for sure that they would let you have a more holistic approach.

You need to be able to take away the pain, without being able to be relaxed it will take your body longer to heal and can even cause complications that lead to a revision or infection.

The hospitals (at least here) tend to over medicate you. But you can ask for perhaps a lower risk medication.

After every surgery you will most likely require an injection(s) of medication to control your pain when you fully become awake and aware.

Usually you pay for medication as part of the cost of the procedure, most of these are soft tissue relaxers, antibiotics, maybe some stuff to help your constipation, things not at risk of abuse because they have no psychoactive (intoxicating) properties.

I don't know much about alternatives to these (pain) medications, if I find some out, I'll let you know. I would love to know as well.

I believe it would be helpful to have someone there for the first few days regardless to make sure you are able to get up for any reason you don't fall, to make sure you are okay, to help you make food, to help you move and lift things. After your procedures the first about three days for me I couldn't leave my bed (after the first procedure I still had to get up to go to the washroom, the second and third I had a catheter. This can be uncomfortable because of bladder spasms. That's kind of where that soft tissue relaxer comes into play.

I want to be honest there were many days I needed to take a stronger medication to help me relax so I could sleep. But it was tolerable after a few days each procedure, where as long as you keep your pain below what you would call a 7 level pain on a scale of 0 being no pain at all.

I think it would be helpful to talk to someone about this, such as a therapist or addictions councillor, even get yourself a good and responsible sponsor. Also it's okay to send a clinic you are considering an email about your concerns as well. If you want try using the term "I have adverse drug effects to *insert medication, or medication family here*". This is what for example you would tell the pharmacy if you had an adverse (bad) reaction to a medication (let's say you got a medication and it caused you to break out in hives, but not closing your throat). This could be risky, so this may be something to also talk to a trusted physician about, maybe a way to get around the harsher ones.

If you are planning this process soon, I would recommend like I said above working on your mental health and sobriety first.

From one recovering person to another your body may change, you may feel more comfortable in your skin, but the trauma will bubble up again and can cause issues. This happened to me. After surgery I fell off the rails for a bit because now my dysphoria wasnt occupying my thoughts, the other things had room to enter my life. What I want you to take from this is that changing your body will help for sure, but it will leave room for other issues that you've been struggling with be more forward in your mind. So having a good handle on your mental health will help you tremendously not just for the surgeries but with the other trauma you were running from. You have to love all of you because all of you is worth loving. I don't want to put a wrench in your plans, I just want you to be a healthy you.

But my recommendation mostly is emailing or calling a clinic you are considering and asking them about it. They will tell you what they can do, they may have an alternative to the heavy medications. You only know by asking. (If you want me to email them for you send me an ask/message P.Anon it won't bother me one bit. It can be hard)

If you want to actually have a conversation about this, feel free to start a conversation with me. I promise no one will no I am talking to you unless you let them know. I will never out anyone. It's just there is so much to your question and I'd love to give you as much help and support as you need.

So let me know if I missed anything, and feel free to contact me, we can talk about it more.

I hope I helped you at all,

With love, and support

-Zestual ✌🏽💙🩷

[answersfromzestual]

About the HRT and osteoporosis anon

Now, even if I were interested in testosterone, I am advised against taking it because I have hormone sensitivity issues (my natural hormone cycle SEVERELY affects my mental health) and we found that depo provera, a progesterone hormone birth control, stops any hormone influence on my mental health, and have basically concluded that sense I do not have interest in masculinizing my body, it is better not to risk trying testosterone because of any chance it may not take care of my hormone issues. I don't know if it would, but my doctor does not want to risk it, specifically because she knows I don't want T effects.

My doctor has told me that with progesterone, my risk of osteoporosis is higher. HOWEVER, really all I need to do to combat this is what anyone else who is trying to avoid osteoporosis should do: eat a good amount of calcium and make sure I am doing weight bearing exercises. Please note, that there is such a thing as taking too much calcium. She said if you take too much calcium (i.e. take a supplement that you do not need to take) it can cause problems with your heart.

I have been taking progesterone since I was 16. She said usually they don't typically recommend depo provera long term because of the bone density loss risk, but because the reason I specifically need THAT birth control (in essence, that hormone concoction. I have tried other options to control my hormone issues, and depo is the only one that works the way I need it to) it is considered medically acceptable and medically necessary to let me take it at least until I would naturally no longer have a menstrual cycle and not need to worry about a hormone cycle causing issues with my mental health, if not the rest of my life.

So basically, if you are taking a hormone or medication that has a risk of bone loss, unless that risk is SEVERE, you are generally okay if you just eat more food with calcium and do weight bearing exercise (walking is an example of this)

This is what I was told as someone specifically taking a hormonal medication that has a black box warning of bone density loss.

Thank you Anon, this was a very informative addition!

I like that you told us about something I didn't even consider, progesterone.

I did see medications can cause bone density loss and osteoporosis, so for everyone else this is confirmed information in the medical community.

I really really like this, I don't think you understand Anon, this is a really well written answer and you brought up a VERY important point and useful information, especially for the younger generation(s).

Anon, if you'd like to contribute again, or more often feel free!

Thank you for this informative addition,

-Zestual

[answersfromzestual]

Also remember to try on things and not assume the size is right.

Also, you will need to know your leg length when buying things like jeans, (in inches).

You can get jeans from one place in one size then need two sizes bigger in another store.

Don't be afraid to dress in the style you want to.

Watch out for certain patterns of shirts and pants it can make you look bigger/smaller in problem areas.

Even cis men have love handles.

And depending on where you shop also matters.

I find clothes made by Asian clothing companies are good for smaller frames, this is really good for dress clothes.

You can always have pants hemmed if they are awesome, but too long.

I have a post about formal wear here if you'd like to see it. It lists companies for shoes and clothing specifically made for trans and non binary people.

FOR ANYONE WHO MIGHT NEED TO KNOW (cause I've told like 3 trans friends this week)

Your pants size in women's is the waist measurement of your men's pants size minus 20. 38x30 in men's becomes 18 in women's. some variation for cut and style but this is the baseline

Your shirt size in women's is one size up from your shirt size in men's. If you wear a men's small, you'll wear a women's medium

Your shoe size in women's is roughly two sizes up from your shoe size in men's. However, many men's shoes are slightly wider than women's shoes so you may have to get wide shoes in women's when you wear standard width in men's

hope this helps, and happy shape-shifting

[answersfromzestual]

Sorry, everyone, about the delay in posting about testosterone and hair loss...

There is a lot of information, and as many of you know, I am very ill at the moment. I am awaiting surgery. My brain is having a hard time focusing and being able to put the information together. I'm in a lot of pain.

I will be asking my wife to help me write out this post.

Again, she has no access and is not allowed to access this blog. This is confidential for my eyes only when it comes to asks and your replies, etc.

We will write it on a word program then post it here.

That way, she is not able to see the blog.

Your safety and confidentiality are my top priorities.

Thank you for your patience.

Stay Golden Everyone ✌️💙💜

[answersfromzestual]

I am working on a few posts, friends. I think you'll enjoy them.

I'm working on a few posts about phalloplasty postoperative care.

I have split the posts into two as of right now, the one I am closer to finishing is taking aftercare of your forearm and graft site. With this said much of the information was instructed to me by the clinic, but anything factual I of course will post sources of that.

Also I am working on a particular post about the actual phalloplasty operation itself. I have found some medical documents that outline the phalloplasty procedure and stages.

Stay Golden Everyone ✌️💙💜

[answersfromzestual]

Any requests for a particular topic of transition information?

I know I have covered many things very basically, so I am open to diving deeper into a topic that would be helpful to be either more thorough/ clarified, or a topic I haven't covered at all.

Also still open to asks, as always anonymous, is perfectly fine. Otherwise, unless specifically stated in the ask, I will copy and post the question with my answer, I will not post the ask itself and will not include your username.

Stay Golden Everyone ✌️ 💙 💜

You are all loved