- Joined
- Dec 19, 2019
It must come from the prostate, can't think of any other place.
Now I need a stiff.
Now I need a stiff.
Megathread SRS and GRS surgeons and associated horrors - the medical community of experimental surgeons, the secret community of home butchers
- Thread starter cuddle striker
- Start date
-
🐕 I am attempting to get the site runnning as fast as possible. If you are experiencing slow page load times, please report it.
- Joined
- Jun 17, 2018
10 years is optimistic, but give it 30 and if society hasn’t completely collapsed by then, it’s a near guarantee.
- Joined
- Apr 23, 2021
Why do the doctors docotrs always act like they are Moses parting the Red Sea of scrotal folds , why do they make them so far apart, is it that hard sew in the center instead of the sides. And even if it is better for healing, moist troid have "correction surgery" later, why wouldn't they ask to correct this simple but very evident mistake (I know I've seen one with the correction, HOW DOES THAT NOT BOTHER THEM, it's the one aesthetic improvement they are actually capable of achieving).We should post more “healed” pics frfr - think r/manmadepussy. Troons are always like “well of course any surgical site would look bad right after!” but what I’m saying is, do you wanna rub this mass of scar tissue?
The only measure of how good or bad a surgery went om Trangender surgeries is the amount of self-aware the victim still has left
I found the medical article Deschamps made about this case, nd thought we could have some fun "Expectations vs Reality" with those Competent Medical Professionals:
Pics the girl shared on facebook:
Instead of talking about both of these disastrous procedures, they are barely a footnote, talked about like they have been entirely sucessful and offered no complications, and Deschamps instead focuses only on showcasing this new procedure he made up on his own, clearly motivated only in finding new ways to make money out of insecure women (it's a fake Adam's Apple):
AUGMENTATION OF THE THYROID CARTILAGE
The operation was performed under general anesthesia. The face, neck, and chest were prepared. We began by injecting both the rib and the submental area with 1% lidocaine with 1:100,000 epinephrine solution. We marked a 3-cm transverse incision approximately 1 cm behind the submental crease (Fig. 1). Once the incision was made, we used sharp dissecting scissors to elevate the skin and fat off of the platysma and midline structures beyond the level of the thyroid cartilage. Lighted magnification is helpful for good visualization. A vertical incision was made between the strap muscles covering the cartilage until the cartilage was visualized. We then incised the perichondrium and dissected the anterior surface of the cartilage.
Fig. 1. Anatomical illustration of location of submental incision to access the thyroid cartilage.
We made an incision 6 cm long over the medial portion of the inframammary crease. Female-to-male transgender patients will often have undergone some form of mastectomy, and the same incision should be used. We then harvested cartilaginous rib using a standard technique with care taken not to violate the pleura. The harvested rib should be full thickness and 3 cm long to have a sufficient amount of cartilage for the graft.
A carving block and a no. 11 blade scalpel were used to shape the cartilage into an anatomically correct male thyroid cartilage (Fig. 2). The shape should be a narrow oblique pyramid with the base roughly three-fourths of the width of the existing thyroid cartilage. This dimension is mostly for stability of the cartilage, as it will be coapted to the native cartilage. We assessed the height of the cartilage by placing the framework of the cartilage over the existing thyroid cartilage and palpating and visualizing the result. It is best to create the initial cartilage framework slightly larger than anticipated, and to reduce the size incrementally until the optimal configuration is achieved.
Fig. 2. Intraoperative view of shaped rib cartilage.
(not shown in the article:
A picture of the "Painful tethered rib graft by Deschamps-Braly" as provided by our patient)
After the cartilage graft was satisfactorily shaped, we secured it to the existing cartilage using permanent suture (Figs. 3 and 4). Depending on the height of the patient’s native larynx, one may choose to either raise or lower the position of the graft to appear appropriate when viewed from profile. We then closed the platysma over the cartilage and performed the skin closure. It is not possible to attain perichondrial closure over the cartilage and no attempt was made to do so. We did not use a drain. A chest radiograph should always obtained to ensure there is no pneumothorax. On confirmation that there is no pleural leak, the patient is allowed to go home.
Fig. 3. Anatomical illustration of rib graft secured on top of existing thyroid cartilage with two sutures on each side.
Fig. 4. Intraoperative view of rib cartilage in place overlying thyroid cartilage.
Discussion
A prominent thyroid cartilage is one of the many stigmata that male-to-female transsexuals face. Although we have masculinized the faces of six cisgender men, we now describe a new technique applied to the first female-to-male transsexual to undergo masculinization. The starting point for surgical masculinization of the face is, in effect, the opposite of those procedures used to feminize a face.
The male thyroid cartilage is fairly variable. We note this from personal experience. It often protrudes 5 to 6 mm beyond the trachea. Augmentation of the thyroid cartilage to this size gives the patient a mobile, characteristically masculine Adam’s apple.
At 6-month follow-up, this patient maintained his result in terms of size and motion. There was no evidence of cartilage resorption or dislodgement. The cartilage was noted to be adherent to the underlying larynx and mobile with swallowing and speaking.
Conclusions
We present the first female-to-male facial masculinization surgery along with a new procedure for creation of a prominent thyroid cartilage. Our patient expressed satisfaction with the results of his facial masculinization, including thyroid cartilage augmentation (Figs. 5 through 7). In the hands of an experienced surgeon, this procedure is safe and effective in achieving the patient’s goals, and presents little downtime for patients seeking gender congruence of their facial features.
Fig. 5. (Left) Preoperative photograph of first female-to-male transsexual patient who underwent several facial masculinizing procedures, including thyroid cartilage augmentation. (Right) Postoperative photograph illustrating a now prominent tracheal cartilage on front view with neck in extension.
Fig. 6. Profile view, before rib cartilage augmentation of the thyroid cartilage.
Fig. 7. Profile view, after (3 months postoperatively) rib cartilage augmentation of the thyroid cartilage.
Patient's reported feelings on the surgery:
The operation was performed under general anesthesia. The face, neck, and chest were prepared. We began by injecting both the rib and the submental area with 1% lidocaine with 1:100,000 epinephrine solution. We marked a 3-cm transverse incision approximately 1 cm behind the submental crease (Fig. 1). Once the incision was made, we used sharp dissecting scissors to elevate the skin and fat off of the platysma and midline structures beyond the level of the thyroid cartilage. Lighted magnification is helpful for good visualization. A vertical incision was made between the strap muscles covering the cartilage until the cartilage was visualized. We then incised the perichondrium and dissected the anterior surface of the cartilage.
Fig. 1. Anatomical illustration of location of submental incision to access the thyroid cartilage.
We made an incision 6 cm long over the medial portion of the inframammary crease. Female-to-male transgender patients will often have undergone some form of mastectomy, and the same incision should be used. We then harvested cartilaginous rib using a standard technique with care taken not to violate the pleura. The harvested rib should be full thickness and 3 cm long to have a sufficient amount of cartilage for the graft.
A carving block and a no. 11 blade scalpel were used to shape the cartilage into an anatomically correct male thyroid cartilage (Fig. 2). The shape should be a narrow oblique pyramid with the base roughly three-fourths of the width of the existing thyroid cartilage. This dimension is mostly for stability of the cartilage, as it will be coapted to the native cartilage. We assessed the height of the cartilage by placing the framework of the cartilage over the existing thyroid cartilage and palpating and visualizing the result. It is best to create the initial cartilage framework slightly larger than anticipated, and to reduce the size incrementally until the optimal configuration is achieved.
Fig. 2. Intraoperative view of shaped rib cartilage.
(not shown in the article:
A picture of the "Painful tethered rib graft by Deschamps-Braly" as provided by our patient)
After the cartilage graft was satisfactorily shaped, we secured it to the existing cartilage using permanent suture (Figs. 3 and 4). Depending on the height of the patient’s native larynx, one may choose to either raise or lower the position of the graft to appear appropriate when viewed from profile. We then closed the platysma over the cartilage and performed the skin closure. It is not possible to attain perichondrial closure over the cartilage and no attempt was made to do so. We did not use a drain. A chest radiograph should always obtained to ensure there is no pneumothorax. On confirmation that there is no pleural leak, the patient is allowed to go home.
Fig. 3. Anatomical illustration of rib graft secured on top of existing thyroid cartilage with two sutures on each side.
Fig. 4. Intraoperative view of rib cartilage in place overlying thyroid cartilage.
Discussion
A prominent thyroid cartilage is one of the many stigmata that male-to-female transsexuals face. Although we have masculinized the faces of six cisgender men, we now describe a new technique applied to the first female-to-male transsexual to undergo masculinization. The starting point for surgical masculinization of the face is, in effect, the opposite of those procedures used to feminize a face.
The male thyroid cartilage is fairly variable. We note this from personal experience. It often protrudes 5 to 6 mm beyond the trachea. Augmentation of the thyroid cartilage to this size gives the patient a mobile, characteristically masculine Adam’s apple.
At 6-month follow-up, this patient maintained his result in terms of size and motion. There was no evidence of cartilage resorption or dislodgement. The cartilage was noted to be adherent to the underlying larynx and mobile with swallowing and speaking.
Conclusions
We present the first female-to-male facial masculinization surgery along with a new procedure for creation of a prominent thyroid cartilage. Our patient expressed satisfaction with the results of his facial masculinization, including thyroid cartilage augmentation (Figs. 5 through 7). In the hands of an experienced surgeon, this procedure is safe and effective in achieving the patient’s goals, and presents little downtime for patients seeking gender congruence of their facial features.
Fig. 5. (Left) Preoperative photograph of first female-to-male transsexual patient who underwent several facial masculinizing procedures, including thyroid cartilage augmentation. (Right) Postoperative photograph illustrating a now prominent tracheal cartilage on front view with neck in extension.
Fig. 6. Profile view, before rib cartilage augmentation of the thyroid cartilage.
Fig. 7. Profile view, after (3 months postoperatively) rib cartilage augmentation of the thyroid cartilage.
Patient's reported feelings on the surgery:
Now, the aftermath:
(keep that conclusion in mind as we go forward: "In the hands of an experienced surgeon, this procedure is safe and effective in achieving the patient’s goals, and presents little downtime for patients seeking gender congruence of their facial features.")
“You pay for my time, not my results.” -Dr. Deschamps-Braly
After my surgery with Dr. D., I suffered a deformed face after nearly a year and a half of infection, I'm in chronic, severe pain, I fear for the rest of my life, due to nerve damage, I fear I may have brain damage, and I nearly died before falling into a coma. At 24 years old, I fear that my life has been destroyed and that I will never recover.
I now have a medical diagnosis of facial deformity, nasal deformity and obstructed airway, I am left in extreme chronic pain due to severe nerve damage. My jaw and alveolar nerve have been damaged beyond repair, which has left me with severe, constant pain in the lower half of my face, including my lower lip, chin, jaw, and lower gums, which causes difficulty eating, smiling, laughing, talking, shaving, etc. He has now abandoned me despite my numerous attempts to mediate a solution and get basic continuance of care. I need to be on nerve medication 24/7 for severe nerve damage.
In late 2017 during my consultation, we discussed the material he planned to use in order to augment my face/jawline. He said that I would need to trust him entirely and so I did. Typical jaw augmentation should have a 1-2% complication risk. He assured me that this would yield the best results. I had no idea of the nightmare that was to follow under his care.
After the surgery I suffered from adrenal gland failure and was asphyxiating, luckily a family member was staying with me in the hospital at the time and she alerted the staff, saving my life. My adrenal glands were tested on 12/15/17 and function perfectly.
"Proof that adrenal glands functions fine."
I remained in a coma for 4 days after the onset of adrenal gland failure. The abnormal EEG recording "gives evidence for a very severe, diffuse, continuous disturbance of cerebral activity. No clear focal or epileptiform features are seen." I fear that this suggests brain damage occurred.
"The seizure."
Several surgeries were attempted to close the wound, but the wound in the mouth never healed and the implant later became so infected that it turned into an abscess that leaked out of the bottom of my chin and it needed to be removed. This left a large indent in my jaw and under my chin. He then put in hydroxyapatite directly after, even though in a letter from his assistant, Zhanna, she explains that, "Putting any extra material, including HA, will create more soft tissue tension and incision will fail to heal again."
"An email saying that HA added to the chin will cause further wound dehiscence."
"Dr. Deschamps-Braly placing the HA against his own recommendation to me, knowing it would stress the wound."
This also had to be removed. In the end, after what must've been at least 5 surgeries. I lost confidence in his ability to clear the infection. He planned to use external wires to hold my jaw in place and then try to clean the infection again.
I decided to seek care elsewhere. I felt that external wires would have left my face even more scarred and disfigured and I felt that any new material introduced to the area, including these wires, would have also become infected.
"Summery of what happened"
Nearly a year and half with the infection and on antibiotics daily, some of which required a PICCline, I developed chronic tachycardia. It was suggested by my cardiologist that the permanent tachycardia can be the result of a long and severe infection.
I called his assistant, Robin, explaining that I'm still in severe pain and suffered deformity and would like to see Dr. D, she responded by saying that Dr. D refused to see me and then hung up on me while I continued to cry from the pain. I was diagnosed with acquired facial deformity on 7/15/18 at UCSF.
In 2015 Dr. D also recommended a forehead implant which was confirmed by two other doctors to have needed removal since I became a migraine sufferer afterwards. There is a large, bald scar all across my hairline, even though Dr. D distinctly told me there would be no visible scar. I'm afraid that the muscle was injured and so now one of my eyes droops badly. I'm being seen at UCSF for the injury to the eye. I became a migraine sufferer after this procedure and I was not a migraine sufferer prior.
I will be needing additional surgery to remove the calcium lump that has formed in my forehead due to a reaction to the implant.
The rhinoplasty that Dr. D did warped my once-refined nose into a horrible, bulbous, crooked lump which looks nothing like a nose. I was diagnosed with acquired nasal deformity on 7/15/18 by UCSF and I also am diagnosed to have nasal collapse and airway obstruction. All of this caused by Dr D.
Dr. D refuses to help me get the referrals I need to nerve repair specialists so that my treatment may be covered. My surgeries with him and the resulting damages have cost upwards $100,000, which I offered to forgive if he donated $40,000, the initial sum I gave him for my 3rd surgery (a revision for two previous surgeries with him costing about $30,000 each), to a children's charity, but he refused. He remains the most noisome and grossly incompetent person I have ever met. I wish so much that I had never met him, I am so sad about the loss of my future due to him.
" I still have debilitating nerve pain years later and am now on Lyrica for it."
I was a violinist and now I fear I can never play again, due to the pain of the jaw on the chinrest. Goodbye, life!
-------
I would beware of this surgeon! Not only has he caused me to suffer from facial deformity and nerve damage, he has also shown to be litigious. Dear D. has threatened me and my family with a lawsuit for my reviews of him and for the requesting of my medical records from his office. I fear that he is doing this in an attempt to threaten my anonymity which would out me as transgender. I fear this could potentially put my life in danger in the future.
In the letter from his lawyer he is threatening to sue not only me, but my mother as well for "flagrantly condoning" my actions. Does he mean my ability to use the internet? I'm not entirely sure what he means, perhaps Dr. D does not know how to use the internet without his mother's help. This is worrisome coming from a surgeon. I'm surprised he didn't threaten to sue my late father and my dog as well. (Both are equally as guilty and should not be spared!)
He is also complaining that I am "threatening" him "vindictively" with my "demand" since I requested that, as an act of kindness, that he donate an equal amount of the damages that he has cost me to a children's charity instead of reimbursing me (which he hasn't done) so that he could write it off of his taxes. I suppose generosity is something he truly doesn't understand. I'm very tempted to send him that internet meme, "You keep using that word, 'demand'. I do not think it means what you think it means."
He also states that I am harassing him since I have been struggling since September to retrieve a complete copy of my medical records. Robin, the secretary, has not replied to my many emails requesting my medical records. She did one time reply asking me to take down my "untrue" review. When I asked her what parts she thought were untrue, she could offer no reply.
After nearly four months of calling and sending written requests, (Robin instructed me on the phone that my requests were to be written) what was sent to me was a document of over a thousand pages printed out and a CD which was badly damaged since it was shoved into a case with another CD and had slipped out.
I asked for a digital medical record so that I could have this copied and sent to the surgeons I need in other countries to evaluate whether nerve repair to the extensive damage would even be feasible. When I told this to Robin she suggested that I photocopy each page back onto a CD. Aye, right. Catch yourself on.
Now his lawyer is threatening to sue me for filing a medical complaint against him for not sending me my records within nearly four months, and for contacting them through emails which they themselves had requested. He is also threatening to sue me over my review of him. In addition, let's not also forget the guilty crime which my mother has committed, the crime that is being my mother, apparently. I suggest that everyone stay away from this surgeon."
After my surgery with Dr. D., I suffered a deformed face after nearly a year and a half of infection, I'm in chronic, severe pain, I fear for the rest of my life, due to nerve damage, I fear I may have brain damage, and I nearly died before falling into a coma. At 24 years old, I fear that my life has been destroyed and that I will never recover.
I now have a medical diagnosis of facial deformity, nasal deformity and obstructed airway, I am left in extreme chronic pain due to severe nerve damage. My jaw and alveolar nerve have been damaged beyond repair, which has left me with severe, constant pain in the lower half of my face, including my lower lip, chin, jaw, and lower gums, which causes difficulty eating, smiling, laughing, talking, shaving, etc. He has now abandoned me despite my numerous attempts to mediate a solution and get basic continuance of care. I need to be on nerve medication 24/7 for severe nerve damage.
In late 2017 during my consultation, we discussed the material he planned to use in order to augment my face/jawline. He said that I would need to trust him entirely and so I did. Typical jaw augmentation should have a 1-2% complication risk. He assured me that this would yield the best results. I had no idea of the nightmare that was to follow under his care.
After the surgery I suffered from adrenal gland failure and was asphyxiating, luckily a family member was staying with me in the hospital at the time and she alerted the staff, saving my life. My adrenal glands were tested on 12/15/17 and function perfectly.
"Proof that adrenal glands functions fine."
I remained in a coma for 4 days after the onset of adrenal gland failure. The abnormal EEG recording "gives evidence for a very severe, diffuse, continuous disturbance of cerebral activity. No clear focal or epileptiform features are seen." I fear that this suggests brain damage occurred.
"The seizure."
Several surgeries were attempted to close the wound, but the wound in the mouth never healed and the implant later became so infected that it turned into an abscess that leaked out of the bottom of my chin and it needed to be removed. This left a large indent in my jaw and under my chin. He then put in hydroxyapatite directly after, even though in a letter from his assistant, Zhanna, she explains that, "Putting any extra material, including HA, will create more soft tissue tension and incision will fail to heal again."
"An email saying that HA added to the chin will cause further wound dehiscence."
"Dr. Deschamps-Braly placing the HA against his own recommendation to me, knowing it would stress the wound."
This also had to be removed. In the end, after what must've been at least 5 surgeries. I lost confidence in his ability to clear the infection. He planned to use external wires to hold my jaw in place and then try to clean the infection again.
I decided to seek care elsewhere. I felt that external wires would have left my face even more scarred and disfigured and I felt that any new material introduced to the area, including these wires, would have also become infected.
"Summery of what happened"
Nearly a year and half with the infection and on antibiotics daily, some of which required a PICCline, I developed chronic tachycardia. It was suggested by my cardiologist that the permanent tachycardia can be the result of a long and severe infection.
I called his assistant, Robin, explaining that I'm still in severe pain and suffered deformity and would like to see Dr. D, she responded by saying that Dr. D refused to see me and then hung up on me while I continued to cry from the pain. I was diagnosed with acquired facial deformity on 7/15/18 at UCSF.
In 2015 Dr. D also recommended a forehead implant which was confirmed by two other doctors to have needed removal since I became a migraine sufferer afterwards. There is a large, bald scar all across my hairline, even though Dr. D distinctly told me there would be no visible scar. I'm afraid that the muscle was injured and so now one of my eyes droops badly. I'm being seen at UCSF for the injury to the eye. I became a migraine sufferer after this procedure and I was not a migraine sufferer prior.
I will be needing additional surgery to remove the calcium lump that has formed in my forehead due to a reaction to the implant.
The rhinoplasty that Dr. D did warped my once-refined nose into a horrible, bulbous, crooked lump which looks nothing like a nose. I was diagnosed with acquired nasal deformity on 7/15/18 by UCSF and I also am diagnosed to have nasal collapse and airway obstruction. All of this caused by Dr D.
Dr. D refuses to help me get the referrals I need to nerve repair specialists so that my treatment may be covered. My surgeries with him and the resulting damages have cost upwards $100,000, which I offered to forgive if he donated $40,000, the initial sum I gave him for my 3rd surgery (a revision for two previous surgeries with him costing about $30,000 each), to a children's charity, but he refused. He remains the most noisome and grossly incompetent person I have ever met. I wish so much that I had never met him, I am so sad about the loss of my future due to him.
" I still have debilitating nerve pain years later and am now on Lyrica for it."
I was a violinist and now I fear I can never play again, due to the pain of the jaw on the chinrest. Goodbye, life!
-------
I would beware of this surgeon! Not only has he caused me to suffer from facial deformity and nerve damage, he has also shown to be litigious. Dear D. has threatened me and my family with a lawsuit for my reviews of him and for the requesting of my medical records from his office. I fear that he is doing this in an attempt to threaten my anonymity which would out me as transgender. I fear this could potentially put my life in danger in the future.
In the letter from his lawyer he is threatening to sue not only me, but my mother as well for "flagrantly condoning" my actions. Does he mean my ability to use the internet? I'm not entirely sure what he means, perhaps Dr. D does not know how to use the internet without his mother's help. This is worrisome coming from a surgeon. I'm surprised he didn't threaten to sue my late father and my dog as well. (Both are equally as guilty and should not be spared!)
He is also complaining that I am "threatening" him "vindictively" with my "demand" since I requested that, as an act of kindness, that he donate an equal amount of the damages that he has cost me to a children's charity instead of reimbursing me (which he hasn't done) so that he could write it off of his taxes. I suppose generosity is something he truly doesn't understand. I'm very tempted to send him that internet meme, "You keep using that word, 'demand'. I do not think it means what you think it means."
He also states that I am harassing him since I have been struggling since September to retrieve a complete copy of my medical records. Robin, the secretary, has not replied to my many emails requesting my medical records. She did one time reply asking me to take down my "untrue" review. When I asked her what parts she thought were untrue, she could offer no reply.
After nearly four months of calling and sending written requests, (Robin instructed me on the phone that my requests were to be written) what was sent to me was a document of over a thousand pages printed out and a CD which was badly damaged since it was shoved into a case with another CD and had slipped out.
I asked for a digital medical record so that I could have this copied and sent to the surgeons I need in other countries to evaluate whether nerve repair to the extensive damage would even be feasible. When I told this to Robin she suggested that I photocopy each page back onto a CD. Aye, right. Catch yourself on.
Now his lawyer is threatening to sue me for filing a medical complaint against him for not sending me my records within nearly four months, and for contacting them through emails which they themselves had requested. He is also threatening to sue me over my review of him. In addition, let's not also forget the guilty crime which my mother has committed, the crime that is being my mother, apparently. I suggest that everyone stay away from this surgeon."
Extra info from her comments:
My face was very feminine, I mainly wanted a stronger jawline and so I was seeking jaw augmentation. Dr. D pushed for me to also do brow augmentation, adams apple augmentation, and rhinoplasty, saying that it would yield the best results for facial harmony.
It felt like he wanted to destroy all of my own natural beauty and deform it into something that was HIS own. Looking back, I really still only wanted to change the jaw and I liked my nose, forehead, and never even thought of an adam's apple. I'm really sad that I no longer have my own face.Being so young, (my first surgery with him was when I was 22) I don't think it's fair for these surgeons to prey on insecure young people who don't know any better and will believe a surgeon who says more surgery= more improvement (or at least, I certainly didn't know any better, obviously.) Especially desperate trans people who many surgeons refuse to work with or simply don't understand.
After posting her story on trans related subs, she makes a post on suicidewatch:
She then visited the r/truedetrans sub (note: it's the "non-terfy one)":
We can see her despair after realizing the truth about transgender surgeries:
Finally, our story ends with this post on suicidewatch, her last post in the account:
LOL, Just kidding! Here is our boy Deschamps-braly talking about the surgeries again in 2019:
And later this heartfelt closing:
Let's remember, class: the medical articles written by these butchers are also biased, and you should take their "conclusions" of success with a heavy spoonful of salt!
- Joined
- Oct 8, 2019
I'm done with this thread.
Nuance
kiwifarms.net
- Joined
- Feb 27, 2021
I have sincerely never seen something this disgusting before in my entire life. Even more horrified if it's working as intended.
- Joined
- Apr 23, 2021
Hey, most of the doctors in this thread are the same! You can still make it! <3
I saw someone already answered about other treatments besides phalloplasty but decided to add about the reconstruction. As we know, reality is a big terf, so there's this:
World's First Baby Born Through Natural Insemination by Father With Total Phalloplasty Reconstruction
"In this article, we present a case in which we used a sensate, pedicled ALT flap with sufficient bulk and stiffness such that a stiffener was not required, and which ultimately functioned well enough to allow the patient to naturally father a child. We believe this to be the first reported case in the literature of a penile reconstruction in a man leading to birth of a child."
I want to share the surgery pictures because it's also an ALT flap, a technique we know and love, and it allows for some stark contrast with the phallos we see here (even the modified flap design seems to be used mostly for men):
CASE
The patient presented to us at the age of 21 years with a partial phallus as a result of iatrogenic injury from an electrocautery burn sustained during routine circumcision. The patient was left with a residual penile stump of insufficient length to allow for penetrative intercourse (see Fig. 1). He did report retaining the ability to experience orgasm and ejaculate through the stump, although the ejaculate was expressed only as a dribble and not a formed stream. At an outside facility, the patient had undergone a previous attempt at phalloplasty with an RFFF from the left arm, which unfortunately failed for unclear reasons. A second attempt by the same facility using a right RFFF and saphenous vein grafting also failed. The patient had undergone severe psychological trauma as a result of the original injury as well as the subsequent free flap failures. At time of presentation to us, he was highly motivated to attempt a third reconstruction, but was firm in his belief that this would be his last if it failed. His goals were to have a reconstruction which would allow him to have sexual intercourse with his wife and improve his psychological well being. The patient was otherwise healthy with no allergies and did not use tobacco products or illicit drugs.
On examination, the patient's residual stump measured 3.1 cm. His bilateral forearms revealed stigmata of the attempted RFFF in the form of a healed split thickness skin grafts, which the patient had elected to camouflage with tattoos. He had a large scar on his right medial thigh from the saphenous vein graft harvest. Examination of ALTs on both sides showed good quality tissue, and pinch test revealed only a moderate amount of subcutaneous fat.
The patient was counseled extensively regarding options for reconstruction. Options were limited in light of his prior failed attempts at bilateral RFFFs. Based on our experience with the pedicled ALT flap, we chose to use this technique because it avoided the need for microsurgery, and because it allowed for the donor site scar to be placed on the thigh.
FIGURE 1. Preoperative remnant phallus.
OPERATIVE TECHNIQUE
In the preoperative area, perforators from branches of the lateral femoral circumflex artery were identified and marked in the central region of a line drawn from the anterior superior iliac spine to the superolateral border of the patella of the left leg. The flap was designed around these perforators in a longitudinal direction, to include regions for the neuorethra, body of the shaft, and glans, in a so-called mushroom pattern as previously described (see Fig. 2). After induction of general anesthesia, the area of the groin and lower thighs to the knees was prepped and draped. A suprapubic catheter was placed by the urology service.
FIGURE 2. Flap design.
The dissection was carried along the medial aspect of the thigh down through the skin and subcutaneous tissue to the muscular fascia and elevated along with the flap in a medial to lateral direction. The perforators penetrating the flap were identified and preserved. Care was also taken to identify the sensory nerves of the thigh; in this case, we were able to isolate both the lateral and medial femoral cutaneous nerves and to track them back for a distance of 6 cm for subsequent nerve coaptation. Dissection was then performed on the lateral aspect of the leg after ensuring the perforators were viable by Doppler examination and appropriately centered. The flap was elevated subfascially over the vastus lateralis, and the perforators were isolated from the muscle. The dissection was tracked proximally toward the origin of the lateral femoral circumflex vessels at the profunda femoris. During this dissection, the customary large perforator going superficially toward the rectus femoris was identified, ligated, and cut. The dissection closer to the origin of the vessel encountered further multiple branches that were also ligated and cut to ensure maximal pedicle length to permit tension-free tissue transposition.
A submuscular tunnel that accommodates 4 fingerbreadths was dissected under the rectus femoris and sartorius muscle. A second tunnel was created subcutaneously toward the perineum of the same caliber. During this dissection, the motor branches of the femoral nerve to the rectus femoris and the sartorius muscle were preserved. The flap was then passed underneath the rectus femoris and sartorius muscles and through the subcutaneous tunnel toward the groin area. The pedicle was critically evaluated to ensure minimal tension.
Reconstruction of the neophallus was then performed, beginning with deepithelialization of the edges of the demarcated region of neourethra. To ensure patency, the urethral portion of the flap was tubularized over a capped 16-French silastic Foley, and skin layers were approximated with deep dermal sutures followed by a running intracuticular stitch. The shaft was then formed by tubularizing the remaining tissue over the neourethral tube, and closed with deep dermal and intracuticular sutures. The remaining distal portion of the flap was rolled onto itself and trimmed it to recreate a circumcised neoglans. This was secured with half-buried mattress sutures.
The medial and lateral femoral cutaneous nerves harvested with the flap were coapted to the dorsal pudendal nerves at the penile shaft base. A urethroplasty was performed next by taking the urethral stump of the native urethra and the fish-mouthed neourethra. Triangular flaps were used to interdigitate the urethra to break up the circular scar and avoid constriction and closed in a simple interrupted fashion. The base of the neophallus was then secured circumferentially with interrupted deep dermal and intracuticular sutures (see Fig. 2).
A deep intramuscular 15-French drain was placed at the donor site. The ipsilateral thigh was covered with a split-thickness skin graft harvested from the contralateral thigh. Two 1/4-inch Penrose drains were placed around the penile construct. Nonstick gauze and cotton fluff rolls were used as padding around the penile base and shaft. A cylindrical protective silo was created from a normal saline plastic bottle and placed around the neophallus (Fig. 3).
FIGURE 3. Immediate postoperative result
OUTCOME
The patient had an uneventful recovery in the immediate postoperative period, with total flap survival and 100% skin graft take. However, on routine follow-up at about 6.5 weeks, a urethral fistula was identified on the ventral surface of the base of the penis (see Fig. 4). The patient was taken back to the operating room for layered closure of the fistula over a catheter. On continued follow-up, the repair remained successful. At 8 weeks from the original surgery, the suprapubic catheter was removed, a urethrogram demonstrated a patent urethra, and the patient was able to micturate through his neourethra while standing (see Fig. 5).
FIGURE 4. Development of urethral fistula resulting from catheter extrusion.
FIGURE 5. Final postoperative result with functional standing micturition.
Further follow-up examinations indicated the patient continued to be able to micturate from a standing position without formation of urethral stricture. On subsequent examinations, the patient had an advancing Tinel sign over the dorsum of his penis. Eight weeks after the closure of the urethral fistula, the patient was cleared for sexual intercourse. He and his wife reported that they were able to engage in regular sexual intercourse, and that the neophallus was sufficiently stiff to allow for penetration without a prosthesis. In addition to this, the patient reported significant improvement in his psychological state.
Seven years after his ALT surgery, the patient contacted the senior author of this article to report the news that he had fathered a baby boy with his wife. The patient denied any atrophy of the neophallus over time, and confirmed and that the child was conceived through penetrative sexual intercourse with physiologic orgasm and intravaginal ejaculation. One and a half years after the birth of his baby boy, the patient again contacted the senior author to report that he and his wife were now parents of a baby girl, also conceived through natural insemination. As of this writing, they do not plan to have any more children.
Our patient did develop a urethral fistula in the early postoperative period, which may be attributed to the rigid nature of the Foley catheter causing erosion and wound dehiscence. We were able to successfully repair this fistula with simple resuturing of the wound. When undertaking these types of cases, we highly recommend involvement of a urologic surgeon, not only for placement of a suprapubic catheter but also for helping to manage more complex urologic reconstructions of fistulae and strictures, which remain all-too-significant risks, and can be beyond the scope of the plastic surgeon.
The patient presented to us at the age of 21 years with a partial phallus as a result of iatrogenic injury from an electrocautery burn sustained during routine circumcision. The patient was left with a residual penile stump of insufficient length to allow for penetrative intercourse (see Fig. 1). He did report retaining the ability to experience orgasm and ejaculate through the stump, although the ejaculate was expressed only as a dribble and not a formed stream. At an outside facility, the patient had undergone a previous attempt at phalloplasty with an RFFF from the left arm, which unfortunately failed for unclear reasons. A second attempt by the same facility using a right RFFF and saphenous vein grafting also failed. The patient had undergone severe psychological trauma as a result of the original injury as well as the subsequent free flap failures. At time of presentation to us, he was highly motivated to attempt a third reconstruction, but was firm in his belief that this would be his last if it failed. His goals were to have a reconstruction which would allow him to have sexual intercourse with his wife and improve his psychological well being. The patient was otherwise healthy with no allergies and did not use tobacco products or illicit drugs.
On examination, the patient's residual stump measured 3.1 cm. His bilateral forearms revealed stigmata of the attempted RFFF in the form of a healed split thickness skin grafts, which the patient had elected to camouflage with tattoos. He had a large scar on his right medial thigh from the saphenous vein graft harvest. Examination of ALTs on both sides showed good quality tissue, and pinch test revealed only a moderate amount of subcutaneous fat.
The patient was counseled extensively regarding options for reconstruction. Options were limited in light of his prior failed attempts at bilateral RFFFs. Based on our experience with the pedicled ALT flap, we chose to use this technique because it avoided the need for microsurgery, and because it allowed for the donor site scar to be placed on the thigh.
FIGURE 1. Preoperative remnant phallus.
OPERATIVE TECHNIQUE
In the preoperative area, perforators from branches of the lateral femoral circumflex artery were identified and marked in the central region of a line drawn from the anterior superior iliac spine to the superolateral border of the patella of the left leg. The flap was designed around these perforators in a longitudinal direction, to include regions for the neuorethra, body of the shaft, and glans, in a so-called mushroom pattern as previously described (see Fig. 2). After induction of general anesthesia, the area of the groin and lower thighs to the knees was prepped and draped. A suprapubic catheter was placed by the urology service.
FIGURE 2. Flap design.
The dissection was carried along the medial aspect of the thigh down through the skin and subcutaneous tissue to the muscular fascia and elevated along with the flap in a medial to lateral direction. The perforators penetrating the flap were identified and preserved. Care was also taken to identify the sensory nerves of the thigh; in this case, we were able to isolate both the lateral and medial femoral cutaneous nerves and to track them back for a distance of 6 cm for subsequent nerve coaptation. Dissection was then performed on the lateral aspect of the leg after ensuring the perforators were viable by Doppler examination and appropriately centered. The flap was elevated subfascially over the vastus lateralis, and the perforators were isolated from the muscle. The dissection was tracked proximally toward the origin of the lateral femoral circumflex vessels at the profunda femoris. During this dissection, the customary large perforator going superficially toward the rectus femoris was identified, ligated, and cut. The dissection closer to the origin of the vessel encountered further multiple branches that were also ligated and cut to ensure maximal pedicle length to permit tension-free tissue transposition.
A submuscular tunnel that accommodates 4 fingerbreadths was dissected under the rectus femoris and sartorius muscle. A second tunnel was created subcutaneously toward the perineum of the same caliber. During this dissection, the motor branches of the femoral nerve to the rectus femoris and the sartorius muscle were preserved. The flap was then passed underneath the rectus femoris and sartorius muscles and through the subcutaneous tunnel toward the groin area. The pedicle was critically evaluated to ensure minimal tension.
Reconstruction of the neophallus was then performed, beginning with deepithelialization of the edges of the demarcated region of neourethra. To ensure patency, the urethral portion of the flap was tubularized over a capped 16-French silastic Foley, and skin layers were approximated with deep dermal sutures followed by a running intracuticular stitch. The shaft was then formed by tubularizing the remaining tissue over the neourethral tube, and closed with deep dermal and intracuticular sutures. The remaining distal portion of the flap was rolled onto itself and trimmed it to recreate a circumcised neoglans. This was secured with half-buried mattress sutures.
The medial and lateral femoral cutaneous nerves harvested with the flap were coapted to the dorsal pudendal nerves at the penile shaft base. A urethroplasty was performed next by taking the urethral stump of the native urethra and the fish-mouthed neourethra. Triangular flaps were used to interdigitate the urethra to break up the circular scar and avoid constriction and closed in a simple interrupted fashion. The base of the neophallus was then secured circumferentially with interrupted deep dermal and intracuticular sutures (see Fig. 2).
A deep intramuscular 15-French drain was placed at the donor site. The ipsilateral thigh was covered with a split-thickness skin graft harvested from the contralateral thigh. Two 1/4-inch Penrose drains were placed around the penile construct. Nonstick gauze and cotton fluff rolls were used as padding around the penile base and shaft. A cylindrical protective silo was created from a normal saline plastic bottle and placed around the neophallus (Fig. 3).
FIGURE 3. Immediate postoperative result
OUTCOME
The patient had an uneventful recovery in the immediate postoperative period, with total flap survival and 100% skin graft take. However, on routine follow-up at about 6.5 weeks, a urethral fistula was identified on the ventral surface of the base of the penis (see Fig. 4). The patient was taken back to the operating room for layered closure of the fistula over a catheter. On continued follow-up, the repair remained successful. At 8 weeks from the original surgery, the suprapubic catheter was removed, a urethrogram demonstrated a patent urethra, and the patient was able to micturate through his neourethra while standing (see Fig. 5).
FIGURE 4. Development of urethral fistula resulting from catheter extrusion.
FIGURE 5. Final postoperative result with functional standing micturition.
Further follow-up examinations indicated the patient continued to be able to micturate from a standing position without formation of urethral stricture. On subsequent examinations, the patient had an advancing Tinel sign over the dorsum of his penis. Eight weeks after the closure of the urethral fistula, the patient was cleared for sexual intercourse. He and his wife reported that they were able to engage in regular sexual intercourse, and that the neophallus was sufficiently stiff to allow for penetration without a prosthesis. In addition to this, the patient reported significant improvement in his psychological state.
Seven years after his ALT surgery, the patient contacted the senior author of this article to report the news that he had fathered a baby boy with his wife. The patient denied any atrophy of the neophallus over time, and confirmed and that the child was conceived through penetrative sexual intercourse with physiologic orgasm and intravaginal ejaculation. One and a half years after the birth of his baby boy, the patient again contacted the senior author to report that he and his wife were now parents of a baby girl, also conceived through natural insemination. As of this writing, they do not plan to have any more children.
Our patient did develop a urethral fistula in the early postoperative period, which may be attributed to the rigid nature of the Foley catheter causing erosion and wound dehiscence. We were able to successfully repair this fistula with simple resuturing of the wound. When undertaking these types of cases, we highly recommend involvement of a urologic surgeon, not only for placement of a suprapubic catheter but also for helping to manage more complex urologic reconstructions of fistulae and strictures, which remain all-too-significant risks, and can be beyond the scope of the plastic surgeon.
(would like to note tho, that those are surgeons for troons, so the chinese doctors later clarified they already knew of other sucessful impregnations via neophallus, note they point out they needed erectile devices, but maybe our man in the article was using one of the tried and true "wrapping" methods our aidens perfected)
Notice that even this guy failed 3 other times "for unknown reasons", and that it was all about intercourse with his wife, peeing standing was just a consequence, as with most men(I'm sure the ftms are getting their panties wet over that urinary flow tho)
My incognito boy supertucci on reddit is here to answer your pressing questions!
You joke but on the post I'm making I found a parallel not onlçy to the castration of sex offenders (first physical followed by chemical) but expecifically to when estrogen started being administered to those sex offenders and to troons. I feel like a crazy conspiracy theorist but it's all connected
Yeah, I look at the surgeries and gory accidents no problem but there's something about those weird fluids coming out of seemingly healed places that just hits different.
Or the most horrifying third option: Unemployed with a doormat spouse willing to become their servant
(posted the other post before catching up, so doing so here)
behindyourightnow
kiwifarms.net
- Joined
- May 17, 2021
I'm glad that story had a somewhat happy ending but seriously why the fuck are doctors still circumcising anyone? 'Routine circumcision' should not be a thing and this poor guy would have been fine from the beginning if doctors were not into burning skin off baby boys.
- Joined
- Mar 11, 2016
The "clit" in post op TiMs is the glans of the penis and the nerves in there are not modified during the chop. However, the urethra is separated from the rest of the penis so anything that would have come out of the dick before comes out of the rearranged urethra rather than the glans.
This brings us to an answer you'd rather not know, which is that he is masturbating and the fluid he is producing is cum. Sperm is only a small fraction of cum by volume so the dick chop will do little to the color or consistency.
Let's applaud this True and Honest woman everybody!
- Joined
- Apr 23, 2021
Yeah, second time hearing about circumcision with life-destroying consequences (the other being, of course, David Reimer). Such a simple procedure but shit can go wrong (and both cases were caused by electrocauterization destroying the genitals! Maybe use a different technique!
From Pubmed:
"Monopolar diathermy has a potential risk when applied to the penis or end artery structures because the current might reach the base of the penis and cause coagulation. The smaller the size of the penis, the more risk there is of energy traveling to the base of the penis.[29,30] There are several published case reports of severe complications due to the use of diathermy for circumcision, including penile ablation, penile necrosis, gangrene, and burns. All of those reported complications were due to the use of monopolar diathermy.[17,18,19,20,21,31]
Four children have been reported who had traumatic penile loss due to the use of monopolar diathermy for circumcision. All of them underwent feminizing genitoplasty.[19] Penile necrosis secondary to electrosurgery for circumcision in a 2-year-old boy has also been reported.[20] Only stumps of the erectile bodies and strictured urethral meatus remained. The child underwent a penile shaft reconstruction after the electrosurgical burn healed.[20] We believe that complications from using monopolar diathermy for circumcision are underreported."
"Gee et al. reported the postoperative complication rate as 0.2–0.6%, which ranges from bleeding, lymphedema, fistula formation, and iatrogenic hypospadias to the partial or complete amputation of the glans penis [14, 15]. El-Bahnasawy and El-Sherbiny [5] reported the largest series of pediatric penile injury. Sixty-four boys with penile injury were hospitalized over 20 years and among them 43 boys (67%) had penile injury caused by circumcision.
Although circumcision is regarded as a minor surgical procedure, it is not free of complications. Urologists have to pay more attention to reducing the complication by circumcision. Penile injury by circumcision also can have lifetime functional, psychological, and cosmetic sequel."
The amount of papers on serious penile injury after circumcision is kinda unnerving. Obviously cause it's performed so much, but reading those amputations stories for such an useless procedure I'd just opt not to do it (or at least research and make sure it's the safest possible method)
Edit: Look at the horrible info hiding in those reports!
TOTAL ABLATION OF THE PENIS AFTER CIRCUMCISION WITH ELECTROCAUTERY: A METHOD OF MANAGEMENT AND LONGTERM FOLLOWUP
"Four patients who had traumatic loss of the penis were managed after the initial injury with a feminizing genitoplasty. Patient reconstruction ranged from 6 months to 3 years. The technique of feminizing genitoplasty is described. There were no instances of flap necrosis, urinary tract infection or urinary incontinence. Immediate results were considered to be cosmetically satisfactory in all patients. Followup ranged from 8 months to 23 years, with a median of 10.5 years. The long-term results have been particularly gratifying in 2 individuals who have been observed for more than 18 years. Early feminizing genitoplasty offers an excellent method of reconstruction of the external genitalia in the child with traumatic loss of the penis who is assigned a female sex of rearing. (J. Ural., 142: 799-801, 1989)
CASE REPORTS
Case 1. The patient underwent elective circumcision just after birth via electrocautery. There was total and complete sloughing of the penis after circumcision, although 2 full weeks elapsed for the entire penis to demarcate and slough. Appropriate consultations and evaluations were obtained, and the female sex of rearing was elected. At 23 months after birth the patient underwent revision of the external genitalia, bilateral orchiectomy, urethral meatotomy and bilateral labioscrotal Y-V plasty. She did well and when she was 17 years old Mcindoe vaginoplasty was performed. The patient was placed on estrogens when she was 12 years old and has normal secondary sexual characteristics. She currently is sexually active and well adjusted.
Case 2. The patient underwent elective circumcision via electrocautery at 2 months after birth. There was complete and total loss of the penis, which gradually sloughed during a 6- week period after the injury. At 7 months bilateral orchiectomy and feminizing genitoplasty were done. At 16 months revision of the external urethral meatus was performed. In addition, at 32 months a second-stage labioscrotal Y-V plasty was performed. The patient was started on oral estrogens to induce puberty when she was 11 years old. Before vaginoplasty she required psychological counseling for this problem. When she was 16 years old Mcindoe vaginoplasty was performed with excellent results. She currently is a senior in high school and sexually active.
Case 3. A 2-day-old newborn underwent elective circumcision via electrocautery and a Gomco clamp. The glans sloughed at 24 hours postoperatively, the midshaft on postoperative day 2 and the base of the phallus by day 3. After consultation with various specialists a female sex of rearing was selected. When the patient was 6 months old bilateral gonadectomy and labioscrotal Y -V plasty were done. The child has done well and the cosmetic result is acceptable. She is scheduled to begin estrogen therapy when she is 11 years old and will undergo Mcindoe vaginoplasty when she is 15 to 16 years old.
Case 4. The patient underwent elective newborn circumcision with a Gomco clamp and electrocautery at 2 days after birth. There was extensive cautery damage to the glans and shaft. The wound was debrided but a majority of the phallus was lost (fig. 1). Multiple consultations were obtained and the female sex of rearing was chosen. Gonadectomy was performed when the patient was 6 months old. However, a significant amount of scrotal skin remained. When the patient was 3 years old feminizing genitoplasty with labioscrotal Y-V plasty, excision of redundant genital skin and perineal flap vaginoplasty were performed. Postoperatively, she has done well and the parents were pleased with the cosmetic result (fig. 2). A Mcindoe procedure is planned after puberty.
Our experience in patients with ambiguous genitalia and micropenis has led to a similar technique with minor modifications to be used in patients with traumatic loss of the phallus. Of our 4 patients 3 underwent early perinea! reconstruction to prevent subconscious rejection of the child, allow the parents to become accustomed to a new body image, and prevent uncomfortable questions from family and friends.
Central components of perineal reconstruction in infancy in these male infants with traumatic loss of the penis are recession of any remaining phallic tissue to provide sensation and hopefully a cosmetic clitoris, removal of the testes, labioscrotal Y-V plasty to provide labia lateral to the neovaginal orifice that will be constructed at a later date and repositioning of the urethra in a more normal position in the introitus. In these male patients vaginal reconstruction, such as a Mcindoe procedure, can be done at puberty.
In the child with traumatic loss of the phallus secondary to a cautery injury, the burn injury must be allowed to heal completely before genital reconstruction. This healing phase may include multiple debridements and a urethral meatotomy so that voiding will be unimpaired while the genital burn injury is healing. The initial surgical reconstruction begins with a circumferential incision around the base of the remaining phallic tissue (fig. 3, A), with a perineal flap also being outlined. The flap is dissected with care to ensure an adequate blood supply (fig. 3, B). The gonads are removed easily through this incision. After the flap and lateral tissue are dissected free, and since no vagina exists the urethra actually is opened for a vaginal introitus (fig. 3, C). The perinea! flap then is brought into the bulbous urethra to provide a feminine appearance to - the perineum (fig. 3, D). Next, any remaining dorsal skin of the phallus is mobilized and split in the midline (fig. 3, E and F). At this juncture a suture of 2-zero polyglycolic acid is placed to ligate the base of any remaining corporeal tissue to control bleeding when this tissue is excised (fig. 3, F).
The remaining skin flaps from the dorsum then are brought inferiorly to create labia minora (fig. 3, G). The medial edges of these flaps are sewn into the lateral mucosa of the former urethra (fig. 3, H). If no dorsal phallic skin remains, the cephalad extent of the scrotum can be brought down medially to fill this space. At this juncture redundant scrotal skin then can be brought down into a Y-V plasty that will bring the scrotal skin posterior enough to reduce its rugated appearance (fig. 3, H). If, at a later date, this rugated appearance remains problematic the posterior Y-V plasty can be repeated. Formation of a true neovagina is deferred until adolescence.
FIG. 3. A, circumcision incision around remaining phallic tissue and outline of perinea! flap. B, dissection of perinea! flap. C, removal of gonads and initial urethral incision. D, apex of perinea! flap secured to floor of bulbous urethra. E, dissection of any remaining skin from remaining penile shaft. F, ligation of base of corporeal body and excision of any remaining erectile tissue. G, placement of sutures to reduce phallic remnant to anterior pubic area and use of any remaining phallic skin for labia minora. H, completed perinea! reconstruction with any remaining corporeal tissue recessed beneath mons pubis.
Central components of perineal reconstruction in infancy in these male infants with traumatic loss of the penis are recession of any remaining phallic tissue to provide sensation and hopefully a cosmetic clitoris, removal of the testes, labioscrotal Y-V plasty to provide labia lateral to the neovaginal orifice that will be constructed at a later date and repositioning of the urethra in a more normal position in the introitus. In these male patients vaginal reconstruction, such as a Mcindoe procedure, can be done at puberty.
In the child with traumatic loss of the phallus secondary to a cautery injury, the burn injury must be allowed to heal completely before genital reconstruction. This healing phase may include multiple debridements and a urethral meatotomy so that voiding will be unimpaired while the genital burn injury is healing. The initial surgical reconstruction begins with a circumferential incision around the base of the remaining phallic tissue (fig. 3, A), with a perineal flap also being outlined. The flap is dissected with care to ensure an adequate blood supply (fig. 3, B). The gonads are removed easily through this incision. After the flap and lateral tissue are dissected free, and since no vagina exists the urethra actually is opened for a vaginal introitus (fig. 3, C). The perinea! flap then is brought into the bulbous urethra to provide a feminine appearance to - the perineum (fig. 3, D). Next, any remaining dorsal skin of the phallus is mobilized and split in the midline (fig. 3, E and F). At this juncture a suture of 2-zero polyglycolic acid is placed to ligate the base of any remaining corporeal tissue to control bleeding when this tissue is excised (fig. 3, F).
The remaining skin flaps from the dorsum then are brought inferiorly to create labia minora (fig. 3, G). The medial edges of these flaps are sewn into the lateral mucosa of the former urethra (fig. 3, H). If no dorsal phallic skin remains, the cephalad extent of the scrotum can be brought down medially to fill this space. At this juncture redundant scrotal skin then can be brought down into a Y-V plasty that will bring the scrotal skin posterior enough to reduce its rugated appearance (fig. 3, H). If, at a later date, this rugated appearance remains problematic the posterior Y-V plasty can be repeated. Formation of a true neovagina is deferred until adolescence.
FIG. 3. A, circumcision incision around remaining phallic tissue and outline of perinea! flap. B, dissection of perinea! flap. C, removal of gonads and initial urethral incision. D, apex of perinea! flap secured to floor of bulbous urethra. E, dissection of any remaining skin from remaining penile shaft. F, ligation of base of corporeal body and excision of any remaining erectile tissue. G, placement of sutures to reduce phallic remnant to anterior pubic area and use of any remaining phallic skin for labia minora. H, completed perinea! reconstruction with any remaining corporeal tissue recessed beneath mons pubis.
Immediate cosmetic results in all patients have been satisfactory. Since all initially were male patients and scrotal tissue was present, satisfactory labia majora were constructed easily. Vaginal construction of necessity must be delayed until full growth of the patient has been attained. From a practical viewpoint this means the late teenage years or early adulthood. In our 2 earlier patients who have reached adulthood the Mcindoe procedure has proved to be adequate for satisfactory sexual relations. Psychosexually, both of the older children have developed a feminine gender identity and are active sexually on followup evaluation by medical sexologists.
In patients who have not sustained total loss of the phallus, debridement alone may result in an adequate phallus. However, if the majority of the phallus is lost the parents must understand the enormous undertaking necessary to try and reconstruct a functioning male phallus, and that gender reassignment is the best option. They also must be apprised of the success enjoyed with perineal feminizing genitoplasty if the female sex of rearing is chosen. With no evidence of flap necrosis, urinary incontinence or urinary tract infection, and with satisfactory cosmetic results our choice would be toward the female sex of rearing. The successful adaption and normal sex life of our 2 older patients are a tribute to early gender reassignment, the involvement of a complete team of specialists, including a medical sexology expert, and extensive familial counseling from the time of injury. This outcome certainly would be of help to aid parents in making this most difficult decision concerning altering the sex of rearing in infancy. Therefore, our results in this small select series indicate that a feminizing genitoplasty is a useful procedure in selected patients with traumatic loss of the phallus."
Now, when you guys want to ask "How did we get here?" WE HAVE BEEN HERE FOR YEARS, the troons just do it to themselves instead of having it done to them, but there have always been doctors willing to do this crazy shit.
Last edited:
- Joined
- Jul 22, 2020
@sanguis draconis
I'm curious what would happen to these kids 1989 wasn't that long before.... and I thought it's just a case of David Reimer.
And it's even more surprising that they're "psychologically fine and sexually active"... I can't help but press X to doubt... In which kind? How would they go about recieving medical services afterward because they'd be painfully aware that they're males and they're made into this. I'm also amazed that they managed to hide these kids so well that they were actually boys who had botched circumcision... Do they even know?
Working in academia, scientific papers are always not truthful and filled with false report to appease the publishers. These papers are filled with too many statement I doubt it is even true.
It's got too many 'why' to me. Fucked up medical experiments are not just sci-fi but reality.
I'm curious what would happen to these kids 1989 wasn't that long before.... and I thought it's just a case of David Reimer.
And it's even more surprising that they're "psychologically fine and sexually active"... I can't help but press X to doubt... In which kind? How would they go about recieving medical services afterward because they'd be painfully aware that they're males and they're made into this. I'm also amazed that they managed to hide these kids so well that they were actually boys who had botched circumcision... Do they even know?
Working in academia, scientific papers are always not truthful and filled with false report to appease the publishers. These papers are filled with too many statement I doubt it is even true.
It's got too many 'why' to me. Fucked up medical experiments are not just sci-fi but reality.
Last edited:
substream
kiwifarms.net
- Joined
- Jul 26, 2019
Somehow that's more horrifying than the rotting stinkditches with actual pus coming out. That's saying something, not sure what, but definitely something.
- Joined
- Aug 4, 2018
Because it started in america as a way to stop masturbation and no one dispelled this misinformation as well as (I assume) a bit of mom and dad wanting their kid's dick to look like "everyone elses'"
It's seminal fluid, with an inside out penis rotpocket, the "doctors" "reroute" the tube that carries semen into the inside of the disaster to "lubricate", so a fucked up man still ejaculates like one.
Jesus, imagine you're such a virgin you mistake a tranny for a real woman and then it does THAT.
I think I'd kill myself.
- Joined
- Nov 11, 2021
Can Dr.Mengle just fucking route the cumtube to my tear ducks so I can cum when I cry? Please and thank you!
- Joined
- Dec 17, 2019
RE: Stumpdick and it's thigh diagram
You can almost imagine the butcher addressing one or two of his surgical assistants. "Okay, see that card table over dere?" (points to a corner of the operating theater) "Okayyy, here's wat you doo: I gonna need you two sit over dere when we get da skin remove." (Hands over two sets of round tipped scissors and a bottle of Elmer's Glue) "Kayy, here you to go scissor when we hand overda skins. Glue for wen you mess up."
I had an odd thought. Looking at these recent complaints, I forgot that many of them have gone either to the ER, Immediate Care clinic, or their MD for medical complications and/or injury creating infection or septicemia.
Which (can't believe why I "forget" this) means that several sets of doctors, nurses, medical assistants, and LPN's see.
So... Why the hell aren't we reading or hearing about more whistleblowing or advocacy? I'm already aware a lot of them on are the corporate for-profit model meaning their jobs and licensure is at risk, hell-I've mentioned it myself numerous times. But this is happening far too frequently even after Plebbit banned neovaginadisasters.
So... with at least one major warning/support group out there deplatformed, this still hasn't stopped, and in fact, seems to be accelerating and spreading. And we just happen to have this many professionals just standing around doing nothing? Not even a semblance of patient advocacy?
I already know all about the not wanting to be open to lawsuits or touching another doctor's "project," but Goddamn...what even is whistleblowing? What even is hiding your identity?
Even Tony Ortega and Marty Rathburn stick their necks out to whistleblow and get the truth out there. Why not any of these people?
You can almost imagine the butcher addressing one or two of his surgical assistants. "Okay, see that card table over dere?" (points to a corner of the operating theater) "Okayyy, here's wat you doo: I gonna need you two sit over dere when we get da skin remove." (Hands over two sets of round tipped scissors and a bottle of Elmer's Glue) "Kayy, here you to go scissor when we hand overda skins. Glue for wen you mess up."
I had an odd thought. Looking at these recent complaints, I forgot that many of them have gone either to the ER, Immediate Care clinic, or their MD for medical complications and/or injury creating infection or septicemia.
Which (can't believe why I "forget" this) means that several sets of doctors, nurses, medical assistants, and LPN's see.
So... Why the hell aren't we reading or hearing about more whistleblowing or advocacy? I'm already aware a lot of them on are the corporate for-profit model meaning their jobs and licensure is at risk, hell-I've mentioned it myself numerous times. But this is happening far too frequently even after Plebbit banned neovaginadisasters.
So... with at least one major warning/support group out there deplatformed, this still hasn't stopped, and in fact, seems to be accelerating and spreading. And we just happen to have this many professionals just standing around doing nothing? Not even a semblance of patient advocacy?
I already know all about the not wanting to be open to lawsuits or touching another doctor's "project," but Goddamn...what even is whistleblowing? What even is hiding your identity?
Even Tony Ortega and Marty Rathburn stick their necks out to whistleblow and get the truth out there. Why not any of these people?
Falling Star
kiwifarms.net
- Joined
- Feb 17, 2021
We've all heard the horror stories about phallodicks literally rotting off, but pictures are pretty hard to come by. I'm not sure if it's because it's rarer than the rumors make it out to be or if the victims are just too traumatized to come out about it. Well, anyway...
Rksmooth (a new reddit account) has bravely come forward. See the horror for yourself:
She unfortunately hasn't given any details on what went wrong or which butcher is responsible, but I'll keep an eye out for updates.
-------------------------------
To move on to something a little more light-hearted:
DotResponsible9245 (aka "Tentacle Dick") gave a small update a few days ago.
[Previous update here - big thanks to @Treasure Champs for documenting it, since Tentacle Dick deleted the pictures after her fellow troons joked about her tattoo.]
I'm sure you'll be shocked to learn that she's been dealing with serious urinary complications (and more)! Basically a tradition at this point.
Most recently, she underwent a urethral repair surgery. Let's see how she's doing 2 weeks post-op...
Sounds like there are even more surgeries lined up for her in the future (note the "my urethra is not connected through my penis yet"), and if scar tissue is a major cause of her current problems, I can't imagine that additional surgeries will help much... I guess we'll see!
Top comment:
Rksmooth (a new reddit account) has bravely come forward. See the horror for yourself:
She unfortunately hasn't given any details on what went wrong or which butcher is responsible, but I'll keep an eye out for updates.
-------------------------------
To move on to something a little more light-hearted:
DotResponsible9245 (aka "Tentacle Dick") gave a small update a few days ago.
[Previous update here - big thanks to @Treasure Champs for documenting it, since Tentacle Dick deleted the pictures after her fellow troons joked about her tattoo.]
I'm sure you'll be shocked to learn that she's been dealing with serious urinary complications (and more)! Basically a tradition at this point.
Most recently, she underwent a urethral repair surgery. Let's see how she's doing 2 weeks post-op...
https://www.reddit.com/r/phallo/comments/r59k24/2_weeks_post_urethral_repair_dr_ganor/
Yep, looks fixed to me!
Yep, looks fixed to me!
Sounds like there are even more surgeries lined up for her in the future (note the "my urethra is not connected through my penis yet"), and if scar tissue is a major cause of her current problems, I can't imagine that additional surgeries will help much... I guess we'll see!
Top comment:
- Joined
- Sep 17, 2021
Maybe she’s doing kegeals? Oh boy, I’m thinking maybe she’s flexing her asshole
behindyourightnow
kiwifarms.net
- Joined
- May 17, 2021
@sanguis draconis
"All of them underwent feminizing genitoplasty"
It seems like in the past everyone just thought that girls were just boys without a penis, and if you accidentally whoopsied a boy's penis away, you could just make him a girl. Then we grew out of that, briefly, and realized that women were their own sex… and now the troons are trying to pull us right back to where we were.
Just send the asteroid already.
"All of them underwent feminizing genitoplasty"
It seems like in the past everyone just thought that girls were just boys without a penis, and if you accidentally whoopsied a boy's penis away, you could just make him a girl. Then we grew out of that, briefly, and realized that women were their own sex… and now the troons are trying to pull us right back to where we were.
Just send the asteroid already.
Falling Star
kiwifarms.net
- Joined
- Feb 17, 2021
@sanguis draconis Thanks for the high-effort and very informative posts!I always knew about the intersex ( / ambiguous genitalia) babies being involuntarily trooned out, but I had no idea it was also happening to baby boys after botched circumcisions though, wow... That's really eye-opening and disturbing.
The story about the man with a damaged penis who went through multiple failed phalloplasties before getting one to stick (but still with complications...) was also very interesting. I feel bad for him (and his wife! geez, can you imagine?), but I guess it worked out in the end!
---------
About Dr. Deschamps-Braly and the poor girl he butchered:
Have you seen any recent activity on her Facebook? I don't have a FB account (and don't ever want to make one), so I can't check unfortunately. If she really killed herself, then that is just heartbreaking...
I did some searches on Reddit, and from what I can gather Deschamps-Braly is highly praised by MTFs for his facial feminization surgeries. The consensus seems to be that he's very expensive but consistently produces high-quality results. But notably... everything I'm reading about him is from MTFs getting FFS. That could explain why his attempt at facial masculinzation surgeries (experimental ones too!) on an FTM ended up being a total disaster.
Check out this recent and weird thread on Deschamps-Braly. Lots of praise again, but the commenters describe him somewhat strangely.
he's not like other surgeons / he's less clinical and more artistic / he has a bit of a cult following / he was smiling from ear to ear and was super stoked to work on me
Maybe I'm reading into this way too much, but I'm getting some vaguely creepy, narcissistic vibes. Like Deschamps-Braly thinks of himself as a genius sculptor of flesh & bone. It would explain his very high fees, his "artistic" approach to facial surgery, and why he pressured the FTM to undergo a bunch of additional procedures she didn't originally want. He saw her face as his own personal canvas, and he wanted to work on it as he pleased. Especially since he usually (entirely?) works on MTFs, he possibly saw this as a rare chance to experiment on something new and exciting. Of course, it was a disaster and he reacted terribly to her despair and accusations. Smells a bit like narc injury...?
That's my crazy headcanon, at least.
Falling Star
kiwifarms.net
- Joined
- Feb 17, 2021
Holy shit! 
- Joined
- Sep 10, 2021
just came across this re de-transitioners; very recent, dont recall it getting much notice.
Can only assume its up on their tally of BBC literal genocide.*
Detransitioning: Reversing a gender transition - BBC Newsnight
The number of people openly questioning their gender identity has increased over the last decade. Subscribe to our channel here: https://goo.gl/31Q53FDemand ...www.youtube.com
(round about 15.20 mins in is a good moment, particularly)
*They attack the BBC and the NHS. Where have we heard that before?
I've heard through the grapevine a big network is collecting detrans stories for a similar feature, not gonna reveal much since you know how troons will absolutely try to ruin it. And it's not a "right-wing" news outlet, so it will definitely generate a lot of seethe.
This is a very long but good and informative read, unable to paste it here since it exceeds the character limit
Castrating Children in the Service of Male Sexuality
Men's Fetishistic Practices Behind ‘Gender Dysphoria’
genevievegluck.substack.com
