anatomy talk:
I've seen a few neovages in medical settings now. fistulas are common, almost guaranteed. you can tell on dissection that the surgeons have chosen to align the opening and direction of the hole with the rectum. likely because this is the only open space in a male pelvis that isn't taken up by more important structures.
often, the dead end will be up against or near to the prostate. this seems useful if the hole is functional to its full depth, but most are not. they seem to be atrophied and lack perfusion; the deeper tissue is often black, grey or pale compared to surrounding structures.
they're unpleasant inside, but I'm not seeing the best results of course- I'm seeing emergencies and dead people. usually they're packed with feces, sebum, hair, urine. the ones done using the colon- they're a colon that isn't in proper use, and that's a really bad thing. the smell of a gi bleed is unforgettable, and these seem to tear and bleed frequently.
I've seen one phallo on the table. didn't look too bad as far as the health of the tissue- it appeared to have been done using a pedicle from the thigh, preserving blood flow. I don't know if this is common or not.
I'm not sure why they're removing all erectile tissue. women have a ton of it- that illustration posted far early in this thread shows it all. you could splay out a penis into a similar shape rather than just removing it all. it might help at least with their lack of sensation.
nothing will help with the filth and the fistulas, though.
there's an entire organization dedicated to assisting women in developing nations who have fistulas, to get them fixed. Google will show you the way. doctors without borders have been known to do this surgery also, if they're not in an actual war zone at the moment.
I think top surgeries are usually safe, mastectomies reduce cancer risks and implants are so common that there's no issue. but without shared science and actual medical clinical research, bottom surgery is a nightmare horror show for MTF. emergency surgery for a neovagina in an ER setting would involve closing the hole and using a drain and wound vac to encourage deep healing, leaving that person a nullo with a surfaced urethra. that is why they all sign out AMA and try to find hack surgeons for revision, even if they're septic.
with my limited experience I can't speak to ftm or how bad it can get, but it seems a much less dangerous and difficult procedure- in the best case it's the oldest plastic surgery on Earth, a pedicle that's then formed into an attached shape. surgeons were doing this during wwi, on people's faces.
that procedure done in that manner at least has some clinical research to back it up, some history.
I am deeply disturbed by MTF misogyny and aggression, especially towards women's necessary safe spaces, and towards lesbians. it's repulsive, more repulsive than any infected hole.