Megathread SRS and GRS surgeons and associated horrors - the medical community of experimental surgeons, the secret community of home butchers

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It's all about muh dysphoria right? Then why keep your vagina? It seems like they're just living their best frankenstein body life and if anyone asks they say it's muh dysphoria.

Insurance companies should have standards they have to follow to be covered. You are dysphoric? You need to be a man? No more vagina. But no one can question these people because that's twansphobic.

I really dislike the hypocrisy. I can't wait till this is all exposed for the cluster fuck it is.
 
Meet reddit user u/bonusdickboi and her "I want it all" vagina-preserving phalloplasty insanity. It's reminiscent of u/nonbinaryphallo (previously covered by @Falling Star and @Red Lobster HERE and HERE), but even more elaborate and bizarre.

The surgery specs:

View attachment 2589133

Translating mental patient to English -- by "T-dick" she means her overgrown clitoris.

Crime against nature committed by Dr. Mang Chen & the Buncke Clinic in California. This is apparently not even its final form, she mentions a "stage 3" surgery scheduled a few months down the road, but doesn't specify what it'll entail.


And for those of you who still have some shreds of sanity they want to get rid of, she shared a clip of the thing in motion:


She also posted a shot of the skin graft donor site (relatively healed over, just scarring). I have no idea how she was even walking around after this:


u/bonusdickboi's rating of Chen and the Buncke gang's Lovecraftian magnum opus:

View attachment 2589164

Edit -- Typo cleanup
Those warts look quite close to being genital.

I'm about ready to head back into the closet because this thing is considered part of the LGBT.
 
She captioned one of the pics similar to the first one you posted "So happy I kept my clit exposed because now I can keep my favorite little mouth soooo busy!" – what's that even supposed to mean?

I'm going to guess that she, too, sees the image below reflected in her clitball nightmare:

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<snip>

So she now has clit balls (more like axe wound if you ask me – yay, the differencest between FTMs and MTFs are narrowing down!), true and honest female genital mutilation (that is the gaping hole without clitoris close to the neoballs), and then asshole in the back that the sphincter is keeping shut. Or am I looking at it wrong? Please, tell me I am. Truly an honest faggot this woman is. Or is this one "straight"? It seems they just about always larp as a faggot.

Nope, sadly you're not wrong. And it seems to be bisexual, as far as I can tell. It constantly talks about penetrating its unnamed partner with its double-dick array (who always gets referred to as "they", so it's probably a natal female enby of some flavor), and flirts with at least one (presumably) female chaser in another thread, but her comment in another thread where someone else dreams about being in a cis gay male relationship makes me suspect she's got an inner fujo hiding in that coombrain too, because otherwise why would someone even click on that thread? So... I'm gonna conclude she went with "D. Have It All!" with more than just her junk and assume she's an omnicoomer.

Gross girl on girl flirting:

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Fujo hints?

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Who'd fuck any of this? I can imagine somebody trying at least once to fuck a MTF that has cut the only interesting thing chasers are after (his dick, the money maker), but this?

Chasers, and there seems to be a lot more of them for this particular... configuration... than I ever would've guessed before venturing down this cursed rabbit hole in search of tardmilk. (:_(

There's r/salmacian, which is a dedicated subreddit just for people who want to acquire multijunk in any and all configurations, and r/GrowYourClit is specifically for women who want a pseudopenis (some who are trying to grow big enough to actually penetrate with) but without the surgery or giving up their vajajays. That last one is absolutely crawling with chasers. There's also at least one porn subreddit, r/bigclit, run by the psycho coombeast u/theeuroslut who I covered in a post over in Tranny Sideshows that focused on the fucked-up custom androgyne subset of the Reddit troonosphere. Enjoy the roadmap to hell.

That donor site seems way too shallow, tho. Did she manage to get all the skin just from there? It's not pretty but 100% better than most of the degloving gore the arm crew usually get.

I thought I'd passed a reference to an arm donor site as well, somewhere in the mess, and u/bonusdickboi made my life easier by popping out a new post today that addresses that exact question. She doesn't mention the leg site here, but it clearly was for this -- I wonder if that skin was used inside the horror-tube for something? She'd referenced elsewhere this being a "tube within a tube job" somehow. Odd. She's definitely leaving some detail out.

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Also, she describes the process of healing from the arm graft. Anyone who does this is a complete idiot, it apparently does enough damage you need physical therapy to use your hand right again.

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Bonus Content:

I have an update on the unanswered question in the original post about what "Stage 3" would be -- it's going to be a pump up erection implant so she doesn't have to wear the bizarre metal harness for her frankencock any more.

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Also, the logistics of taking a piss with Rube Goldberg genitals, since she didn't reroute her urethra:

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Meet reddit user u/bonusdickboi and her "I want it all" vagina-preserving phalloplasty insanity. It's reminiscent of u/nonbinaryphallo (previously covered by @Falling Star and @Red Lobster HERE and HERE), but even more elaborate and bizarre.

The surgery specs:

View attachment 2589133

Translating mental patient to English -- by "T-dick" she means her overgrown clitoris.

Crime against nature committed by Dr. Mang Chen & the Buncke Clinic in California. This is apparently not even its final form, she mentions a "stage 3" surgery scheduled a few months down the road, but doesn't specify what it'll entail.


And for those of you who still have some shreds of sanity they want to get rid of, she shared a clip of the thing in motion:


She also posted a shot of the skin graft donor site (relatively healed over, just scarring). I have no idea how she was even walking around after this:


u/bonusdickboi's rating of Chen and the Buncke gang's Lovecraftian magnum opus:

View attachment 2589164

Edit -- Typo cleanup
It's pretty common for me to mutter "woah" or "oh my god holy shit" while looking at this thread. This was the first time that I actually screamed out loud. In terms of abominations, this is by far the worst one for me. The axe wounds and arm roll ups are bad enough. But this? Not even the nullos (AKA male infibulation) are this nightmare inducing.
Maybe this is a language barrier thing but I don’t think I would take advice from someone who doesn’t know the terminology for their surgery until Reddit tells them.
I don't know what RFF is called auf Deutsch, but my thoughts exactly. Then again, most of these idiots don't even know about basic anatomy (male or female) before getting their government funded mutilations.
Do some get stuck cathetering for life? It seems rewiring all that shit in these types of surgeries is gonna cause issues.
I watched some of that lady from a couple pages back's videos, and apparently yes. She posts many video and TikTok compilations of girls (almost all of these young women are barely adults/aren't old enough to drink) getting phallo and they absolutely cannot piss on their own anymore. She explained that the new "urethral lining" is essentially scar tissue and that the pores in the donor skin used does not help at all. At least one developed bladder stones so bad that she had to get them surgically removed.
It's all about muh dysphoria right? Then why keep your vagina? It seems like they're just living their best frankenstein body life and if anyone asks they say it's muh dysphoria.

Insurance companies should have standards they have to follow to be covered. You are dysphoric? You need to be a man? No more vagina. But no one can question these people because that's twansphobic.

I really dislike the hypocrisy. I can't wait till this is all exposed for the cluster fuck it is.
Hey, now. she's nonbinary! Big difference! /sneed
 
View attachment 2581963
Representative genital result no. 1. Patient 7 months after first-stage SRS. The large labia spread to demonstrate the small labia.
View attachment 2581966
Figure 13. Representative genital result no. 2. Patient 13 months after first-stage SRS and 6 months after second-stage SRS. Frontal view and view from above.
View attachment 2581970

I guess I do give these docs props for a better aesthetic result, but I find it hard to believe that it is any more functional than a standard rotpocket.
 
I watched some of that lady from a couple pages back's videos, and apparently yes. She posts many video and TikTok compilations of girls (almost all of these young women are barely adults/aren't old enough to drink) getting phallo and they absolutely cannot piss on their own anymore. She explained that the new "urethral lining" is essentially scar tissue and that the pores in the donor skin used does not help at all. At least one developed bladder stones so bad that she had to get them surgically removed.
I binged on her videos. It's some scary scary shit. The delusions are real with these women. I think the crazy thing, other than the body modifications, is the effects of testosterone on the female body. We know next to nothing about the high dose effects. The changes to the voice that are a warning about other body changes, especially to the heart.

Also some of these women wear catheters because of botched urethral lengthening. Either a hole in the line or a narrowing of it. If you can't urinate, you die.

I don't know much about estrogen in male bodies but couldn't MtF detransitioners just put on male clothes, cut their hair and get their fake boobs cut off and pass as a man again?

Nothing will ever be right for FtM again. How would they back out? At what point is it to late?
 
Thanks to the ongoing saga of Ripley Violet Tempest Storm, one of Kevin Gibes's orbiters over in Lolcows who wants the creepy "bigenital" futa/hermaphrodite surgery I posted an example of earlier, I got curious as to just how many butchers out there are offering this Frankenstinian nightmare for sale. I kept seeing the assertion that it was only about 3 surgeons in North America who would do it, but with all the mental cases I discovered in just one fishing trip through reddit, I was suspicious it was a lot more than that now -- there's apparently a disturbing amount of demand out there, and topics of discussion like u/nonbinaryphallo and u/bonusdickboi may not be so rare after all.

I was right. These are some names to keep an eye out for (I know a lot of them have popped up elsewhere in this thread in more "standard" surgical contexts, but I'm collecting them here too for completeness and ease of reference), and if they come up, whoever's scheduling surgery with them may be looking to do something... custom.

Directory of "Never Tell The Paypigs No" Butchers


Oregon Health & Science University (
OHSU) in Portland, Oregon

Daniel Dugi -- Discount butcher (literally, takes a lot of Medicaid) with a horrible track record, is getting grieved by 9 patients and even drew the ire of Jezebel, alongside Rumer. Seems to be the center of gravity for this Mengele stuff at OHSU.

Geolani Dy -- Joined in 2019 and works under Dugi. Spends part of her time practicing in another hospital in Alaska, of all places.

Jens Berli -- Reddit user u/nbsage had a "have it all" surgery with this particular butcher, and posted a thread to prove it.


Buncke Clinic in San Francisco, CA

Bauback Safa -- Don't have any particulars on this guy, beyond him and the other two having a history of doing these.
Rudolf Buntic -- Ditto.
Andrew Watt -- And again.


GU Recon in San Francisco, CA

Mang Chen -- This guy seems to be the new hotness on reddit and quite the customer-oriented salesman -- seems like he's using a friendly, always-available communication style and a willingness to do *anything* the client wants to rapidly build a clientele. He always turns up working in tandem with the Buncke gang above, and if it's something exceptionally bizarre like what u/bonusdickboi did, he's probably involved.


MoZaic Care in San Francisco, CA

Heidi Wittenberg -- Pretty sure she's been discussed a ton here, but a potentially-new detail is a post from u/MayGay64 (natal male) claiming he's in the process of negotiating a bigenital surgery where he'll have his factory-installed testicles preserved in some form so he can still coooooom.

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Megan McCaleb -- Don't have a specific post handy but seen passing mention on reddit of people claiming to have been this one's patient for these flavors of weird surgery.

Adam Bonnington -- reddit user u/Fit_Run_5532 claims to have had bigenital surgery from Bonnington specifically.


Align Surgical in San Francisco, CA

Thomas Satterwhite -- Infamous and already covered by others extensively I'm sure.

Crane Group in Austin, TX

Curtis Crane -- Everyone knows this guy and his buddies already. Easy to find his patients around, they're everywhere.
Richard Santucci -- Duh.
Michael Safir -- Also duh.


David Freet in Houston, TX

Only a few references to him around, discreet hints he may do bigenital stuff.


Loren Schechter in Chicago, IL

Claims around reddit he'll do multijunk. On an amusing note, he does NOT have a "no fat chicks" rule for his surgeries.

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Devin O'Brien-Coon in Boston, MA and Baltimore, Maryland

Apparently has a shitty attitude and is a crap communicator. Looks like he also practices in Baltimore, Maryland under the auspices of Johns-Hopkins. These butchers do get around, don't they? The surgeon who did enbytex (see bonus content below).


NYU Langone, NYC, New York

Rachel Bluebond-Langner -- Claims on reddit this doc will do it, but haven't seen anyone specifically come forward claiming to be a patient, so consider likely but unconfirmed.


Mt. Sinai, NYC, New York

Jess Ting -- Already well-known, not going to rehash this one here. Not 100% confirmed, but does the peritoneal, no dickflip required surgery, and I've noticed some of the surgeons like Crane are more discreet in how they advertise -- they won't openly state on their site that they do futa, but if they do peritoneal vaginoplasty for MTF, or non-urethral lengthening phalloplasty for FTM, there's a good chance they will do the (extra) weird stuff and let the victim keep their original equipment.

Dr. Miroslav Djordjevic –- Belgrade, Serbia and now also practices at Mt .Sinai in NYC. Patients on reddit bitch like crazy about him being unpleasant to deal with.

Bonus Content:

I also found a remarkably extensive and horrifyingly-detailed blog called "Phallodiary" that I don't believe has been posted anywhere before. It belongs to some FTM vagina-preserving-phalloplasty evangelist by the username enbytex and in it she's posted dozens of entries all about her insane surgeries, recovery, and more, from a first person perspective.

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This blog is huge, both in terms of number of posts, and in terms of number of followers. Apparently a lot of people want to read about someones mutant junk.

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It gets relatively technical, so the medspergs on this thread might find it especially interesting to explore.


Random content samples:

Q: Without majora, does stuff get in your vagina? What if I skipped scrotoplasty?​

Q: Without majora, does stuff get in your vagina? What if I skipped scrotoplasty?​


Posted on March 30, 2019 by enbytex


A: I still have minora, and unless I’m spread eagle, they keep the opening fairly covered/closed. I don’t know what it would be like with no minora there, as far as protection of the mucosal zone, but maybe someone else can weigh in.
I don’t feel exposed, but my opening feels less cushioned and cuddled by that extra flesh. I notice this most around a thick jean seam or during penetration, although I don’t notice it as much as I used to. It’s def a different sensation without that cushion pulling back and forth at the opening.
It’s your choice if you keep minora or not. I have noticed legit personal dryness, since there’s no moisture barrier of the majora, and my underwear absorbs any minimal moisture. So, I have to apply a little lube or ointment now and then.
I had to go three months before scrotoplasty, and mechanically, I would recommend against it. The penis needs something to prop it up a little and while walking for comfort; it’s built to be at a 45 degree out and down angle in daily life. It felt bad to me to have it going straight down. It also felt very bad/awkward when it moved between my legs when walking and got pinched in my gait. It was so annoying I took to wearing prosthetic scrotum with my penis when I was waiting for his stage 2.
You could have the pump without a scrotum, but they’d have to put the bulb somewhere else if you didn’t have one. It could go in the belly or the thigh. The scrotum works well for a lot of people as the location. However, there is some discussion among surgeons of locating the pump elsewhere to avoid excess tubing bumps (since our scrota are closer hanging and therefore have extra tubing that can form a raised area). It would also allow for two similar material testicular prostheses.

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This one is worth saving, I think . It's long and the video audio quality isn't great, but this lady collected the tik-tok saga of FTM 'Alex Mack' who had hundreds of thousands of dollars in surgeries during the Covid pandemic, just to end up with .... health problems and a non-functioning flesh tube. I wonder how many surgeries were delayed because this sick girl needed validation.

Edit: Channel is TT Exulansic, she is also very active on tiktok apparently: @Exulansicbeta.

View attachment 2570027
That's great. Thanks for posting it.
 
I don't know much about estrogen in male bodies but couldn't MtF detransitioners just put on male clothes, cut their hair and get their fake boobs cut off and pass as a man again?
Essentially, yes. Detransitioned MTFs who have kept their genitalia intact can easily bounce back from HRT (which 99% of the time includes an anti-androgen like spironolactone, because estradiol alone is not enough), but any chest alterations (like gynecomastia and silicone implants) may be more tricky to deal with. If anything, the gynecomastia can be treated with medication or minor surgery while the implants can be removed and the chest re-sculpted back to its masculine form. I've heard whispers of detransitioned MTFs wearing chest binders like FTMs do after stopping HRT, but how true that is, I'm unsure. It would make sense, though, as before the trans fad blew up, chest binders were also recommended to closeted MTFs starting HRT to hide their medically-induced gynecomastia from others in their lives.
 
I can't get over the horrifying clit-"testicles". Fucking disturbing (even worse than cocks that have been split open by body modders). It's Frankenstein-esque madness -body parts are being flayed, mangled, molded into fake parts, stitched onto other parts where they don't belong etc.

Absolutely awful shit is being done in the name of trans insanity and the genital butchers are praised by their absolutely r.etarded victims.
 
Bookmark this post though, I guess. Because any day now an excited troon will post a TikTok about how they're getting a breakthrough procedure done involving having the inside of their face carved up and relocated.
Appropiate time to reply cause I just saw it's already happening! (article is from 2020)

Autologous Buccal Micro-Mucosa Free Graft combined with Posterior Scrotal Flap Transfer for Vaginoplasty in Male-To-Female Transsexuals: A Pilot Study
(+ sci-hub full article, including pics and detailed info)

It's a mix of the inverted peno-scrotal flap (which is "considered the state-of-the-art technique" according to the article) we are already familiar with and a buccal graft for the vaginal canal, basically.

Explanation of the logic of this new operation:

"The mutual substitution of the homologues may be a logical approach for MTFTS, since female and male genital organs arise from the same embryologic structures (for example, glans penis and clitoris are homologues). Therefore, based on the average size of the genital organs of both sexes and the principle of ‘‘planning in reverse’’ , we find in our preoperative design (Fig. 1) that the corresponding part of the penis is sufficient to reconstruct the clitoris, labia minora, and vestibule, and the scrotum which is about 10 cm in width is redundant for the construction of its homologue—labia majora (roughly 2.5 cm in width). Nevertheless, the vagina seems very difficult to be reconstructed by its homologous organ—prostatic utricle (Fig. 1). According to the principle of ‘‘Tissue Losses Should be Replaced in Kind’’ , we choose buccal mucosa to replace the mucosa loss of the vagina in our method.

Since 2003, buccal mucosa has been applied as a material for vaginoplasty in vaginal agenesis patients with promising results. However, it may take a long time for complete epithelization of the neovagina due to the limited availability of buccal mucosa. Our group attempted to use buccal micro-mucosa as lining material of the neovagina since 2006. According to our previous study in congenital vaginal agenesis, we found that the neovagina lining with buccal micro-mucosa is not only very similar in its macroscopic appearance (smooth, elastic, pink-colored mucosa with sufficient volume) and its microscopic structure (stratified nonkeratinized squamous mucosa) to the normal vagina, but also has an inherent secretory function along with good sexual function."

what goes where.1png.png

The corresponding parts between male and female reproductive systems.
what goes where1.png

The calculated procedure of mutual substitution of the homologues in the preoperative design of male-to-female genital reassignment surgery.

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Intra-operative view. The penis was disassembled: the neurovascular bundle and glans were used to reconstruct the clitoris, and the penile prepuce was for reconstructing the clitoral prepuce and labia minora; meanwhile, the male cavernous urethra mucosa was used to reconstruct the vaginal vestibule. The scrotum was dissected: the bilateral scrotal flap was used to reconstruct the bilateral labia majora, and the posterior scrotal flap (about 10 cm in length and 3 cm in width) was for the posterior wall of the vagina

They divide the surgery in 2 surgical teams, the "oral team" to get the graft and the "surgical team" to do their magic like we know and love. Surgical procedure of oral graft is described to be the same method from previous research like the article Outwith Quiddany cited that was used for vaginoplasty in natal women (and girls, since often those surgeries are used for congenital conditions).

Very mild gore pics of the graft, being taken and after healing, and a pic of the stuff they used to prep the graft to be used on the vag:

"The surgical procedure in the oral region is similar to our previous studies [Use of Autologous Micromucosa Graft for Vaginoplasty in Vaginal Agenesis, Long-Term Outcomes of Vaginoplasty With Autologous Buccal Micromucosa]. The parotid duct was identified to avoid unintentional damage (Fig. 2a) prior to submucosally injecting a combined solution of epinephrine and lidocaine for both local anesthesia and hemostasis. As many as possible full-thickness oral mucosa particles, about 7x5 mm² each, were harvested from both cheeks utilizing a round needle and surgical scissors. It was important that there should be adequate interstitial mucosa left for regeneration since no suture would be implemented (Figs. 2b, 3a) and bilateral cheeks would be tamped against by gauzes for hemostasis.

oralteam1.png

Fig. 2 Steps in buccal mucosa harvesting:
a The parotid duct was identified (blue marked).
b After local anesthesia, the mucosa was hooked up by a round needle and then cut off by surgical scissors.

oralteam2.png

Fig. 3 Views of the oral donor site:
a Immediate postoperative view: 30–40 full-thickness mucosal pieces (approximately 7x5 mm²) were harvested from both cheeks.
b Postoperative view at 7 days: complete wound healing.

Preparing the stuff after harvesting: "The mucosal pieces were rinsed and minced into ‘‘micro-mucosa’’ about 1 mm² and then transferred into a sterile syringe (Fig. 4 center). Sterile Vaseline oil gauze was used to carefully wrap the soft silicone vaginal stent (Fig. 4 left), and then, the micromucosas were discreetly spread on the surface of the Vaseline gauze. The distributions of the micro-mucosas corresponded to the four aspects of the vaginal canal, including anterior, bilateral and apex, since the posterior wall of the vagina would be covered by the scrotal flap."

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Fig. 4 Preparation of buccal micro-mucosas and vaginal stent.
(center) The mucosal pieces were purified and then minced into particles approximately 1 mm in diameter using surgical scissors, which made them into ‘‘micro-mucosa.’’ The micro-mucosas were stored in a sterile syringe.
(left) The soft silicone vaginal stent was wrapped with sterile Vaseline oil gauze. Afterward, the micromucosas would be spread on the surface of the Vaseline gauze.

Now we get to where the magic happens, the surgery, including gory pics (I organized the text and pics for a more smooth reading):

"Orchiectomy and repositioning of the urethral meatus were conducted using the previously reported method [ Preecha's surgical technique]. Penile disassembly and clitorolabioplasty were conducted according to the preoperative design (Fig. 1). The posterior scrotal artery pedicled, inverted U scrotal flap (about 8–10 cm in length and 3–5 cm in width) was dissected in the scrotal skin (Figs. 1, 5).


cbt.png

Fig. 5 Steps of harvesting the posterior scrotal arteries pedicled, inverted U scrotal skin flap.

"A neovaginal cavity at a depth of 9–10 cm and diameter of 3–4 cm was bluntly dissected between the rectum and the prostate with the aid of a fiberoptic light retractor. During dissection, a Foley’s catheter was inserted into the urethra and a finger was inserted into the rectum to avoid unintentional injury. Complete hemostasis was achieved with electrocautery.

Next, the posterior scrotal artery pedicled scrotal flap was reversed into the canal and situated in the posterior wall of the neovagina (Fig. 6)."

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Fig. 6 The posterior scrotal flap (white arrow) was reversed into the canal and situated in the posterior wall of the vagina.

"Three parallel sutures with 3–0 Vicryl Plus were placed at the distal part of the musculus levator ani of the posterior neovagina which were then anchored to the inverted U scrotal flap to avoid prolapse. With the buccal micro-mucosal grafts facing the four neovaginal walls (anterior, bilateral and apex), the above-mentioned soft vaginal stent was meticulously inserted into the neovaginal cavity (Fig. 7) and was fixed to the skin around the neovagina introitus to maintain the stent in position."

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Fig. 7: The soft vaginal stent with the buccal micro-mucosal grafts facing the four neovaginal walls (anterior, bilateral and apex) was meticulously inserted into the neovaginal cavity.

"Iodoform gauzes were stuffed into the hollow stent to make the mucosal particles stick to the wound (Fig. 8). Finally, a soft gauze compressive dressing was placed for additional support."

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Fig. 8: The view after that iodoform gauzes were stuffed into the hollow stent and the stent was fixed to the skin around the neovagina introitus.

Post Operative care and Follow up:

"The gauzes in the oral cavity were removed on postoperative day 1. The first dressing change of the neovaginal cavity was on postoperative day 7. The gauzes inside the stent were removed, and the neovaginal cavity was douched using 0.02% chlorhexidine acetate. Meanwhile, the epithelial growth was examined and recorded. Then, new gauzes were reinserted to maintain the cavity of the pliable stent—this routine procedure was repeated every other 2 days for the first month. After that, a hard stent will be used instead of the soft one and it was asked to be kept in situ 24 h per day for 1–3 months postoperatively. Four months after surgery, patients were recommended to engage in regular penetrative coitus and the duration of stent wearing could be gradually reduced.

Finally, we get some pics of the resulting monstrosities after healing, including a pic showing "Yellowish natural mucosal discharge, without an unpleasant odor" (why is it yellow? only God knows)

Over the past 5 years, nine MtF transsexual patients (six without previous surgeries and 3 who received penectomy and orchiectomy in other hospitals) received the reported method of vaginoplasty. The average age was 27.6 ± 6.6 years (range 21–39). The operations were performed successfully in all patients. All the patients were able to eat a liquid diet on day 1 and a soft diet on day 2 after the operation. The duration of healing for the oral mucosa donor site was 5.9 ± 0.8 days (range 5–7). There were neither visible scars nor mouth opening changes (Fig. 3b) at the donor site. The neovaginal canal was completely epithelized in 14.5 ± 1.3 days (range 13–17). The average clinical follow-up was 25.3 ± 4.9 months (range 16–31), and phone interview follow-up was 50.3 ± 18.8 months (range 30–81).

We observed that the posterior scrotal flap seemed also to be mucosalized in the moist mucosa micro-environment about 11 months after the operation. The neovagina was about 10 cm in length and 3 cm in width, lined with moist, elastic, hairless mucosa with a healthy red color (Figs. 9, 10). Yellowish natural mucosal discharge was also observed in the neovagina (Fig. 10), without an unpleasant odor. The mean time for the complete removal of the vaginal stent was 12.4 ± 3.1 months (range 9–17).

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Fig. 9: Typical male-to-female transgender case.
a The hard vaginal stent is 11 cm in length and 3 cm in diameter.
b Postoperative view at 11 months after our procedure: the neovagina was about 10 cm in length and 3 cm in width.
c Postoperative view in the same patient of a mucosal laminated vagina 11 months after construction.

1633293871088.png

Fig. 10 Postoperative view at 26 months: yellowish natural mucosal discharge was observed in the neovagina.

No rectal or urethral fistula or vaginal stenosis was encountered in this series. Eight patients experienced uneventful postoperative periods, while one patient suffered from scrotal flap prolapse. Twelve months after the primary surgery, we resected the prolapsing scrotal skin around the introitus, which is rectangular-like shaped, about 2.5 cm in length and 1.5 cm in width, and re-approximated the residual skin edge under general anesthesia. The second surgery would cause minimal vascular damage, because it was implemented 12 months after the primary one, at which time point, the vascular remodeling of the scrotal flap had already been completed. However, the innervation of the scrotal flap might be interrupted. Fortunately, patients reported satisfaction with both cosmetic and sexual function outcomes of neovagina after the refined surgery. According to the longtime follow-up, eight of the nine patients were satisfied with the appearance of the vulva and vagina; all of the nine patients were sexually active and reported sexual satisfaction, with good rates of sensitivity, no need of lubrication, and were able to achieve orgasm."

Conclusion: "The neovagina created by autologous buccal micro-mucosa free grafting in combination with a posterior scrotal flap shows sufficient volume in long-term follow-up, with mucosa texture that is moist, elastic, and has appropriate lubrication along with good sexual sensation. The reported method is easy and economical to perform and retains enough tissues for vulvoplasty to achieve a superior cosmetic appearance, with rare risk of complications and donor area malfunction. Also, it is feasible and advantageous to the patients who have insufficient peno-scrotal skin for neovaginal lining as well as those with an unfavorable previous vaginoplasty. For these reasons, we would like to present the new technique to both surgeons and patients as a possible viable option for MTFTS. A nine-patient pilot study with suboptimal follow-up may not be enough to confirm the long-term outcome of the new technique. Therefore, a large sample prospective cohort study with longer follow-up for outcome evaluation is required."

Hope you guys enjoy,might do a follow up with the Preecha surgical technique article they referenced cause I see it has some gory details and looking at how the sausage is (un?)made really puts stuff into perspective
 
I know we all love to talk about the poor gynos and frankly I hope most of them just take money from these exams, take a brief look, and tell them to go back to their surgeon because there's nothing they can do. Make up a 'Troon validation fee' for the time wasted because it's not a vagina and never will be so there's nothing they can do.

Can we take a moment to imagine being a urologist though? their study is the penis. You get a MTF come in whose 'life saving surgery' is literally what your worse case scenario is for 90% of your other patients. They can't really help either because their study is for an organ that is no longer there and has been essentially taxiderm-ed into a gaping hole in their groin.
Late, but a urologist doesn't only see men. If a woman has a bladder issue she'll also see one.
Though that doesn't necessarily mean they'd be equipped to deal with a neovagina, it's not like they weren't trained to work with real vags.
 
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