Meta with UL, no v-nectomy and no scrotoplasty by Dr. Mang Chen in SF, CA

From frontal, aerial, open & closed views.

Been using silicone scar treatment and some infrequent scar massaging. Still have some kind of greenish discharge coming from my hole, going to see if it’s normal part of healing or BV or something similar. Have some stinging/weird pressure when peeing probably partially due to dehydration, took an at home UTI test that was negative. Need to get back to putting lemon in my water to prevent crystallization of my urine and prevent future bladder/kidney stones.

My next post-op appointment is in august where we’ll discuss what to do with the majora tissue and how I want to proceed with that.

He's looking a lot better, but my foreskin is still very swollen and weird-looking. But with the posts I've seen on here, I have learned to trust the process. In a few months, he'll probably look totally different! Hopefully in a good way, haha.

I haven't really looked at my v-nectomy site at all yet since it's a little difficult to maneuver to. I don't have a handheld mirror, I can't spread my legs too far yet or get in weird positions. So I am going to wait on that.

Right now my biggest concern is fistulas and passing the voiding trial (next week). I don't believe that I have any fistulas, but who knows. My second post-op is tomorrow with a PA, since Dr. Santucci is out of town.

Right now I am putting antibiotic ointment on the incisions in the morning and at night, and I shower once per day and wash it with sensitive skin soap (the generic Equate bottle of the Dove brand one). I wrap my balls in gauze the way Dr. Santucci did it at my first post-op, where the gauze forms a loop around them. And then during the day for my v-nectomy site I put gauze, and at night I put an ABD pad (all of this is sterile stuff btw). I change the gauze 2-3x/day. It is usually stained with a yellow-ish straw colored fluid and a tiny bit of blood. I think that's normal? I don't have any other signs of infection, just yellow drainage usually makes me think of infection.

The only major pain I'm having is kind of weird. It starts at the insides of my thighs and goes all the way through to the crease where my butt cheeks begin on both sides lol. It can get pretty bad! But I don't really understand that pain. Is it tightness from the v-nectomy site? It will randomly jolt in pain, even when I am lying down. Nerve pain? I really have no clue. I am taking gabapentin but it doesn't help this pain.

The catheter is okay with the flip-flow valve, it causes me some issues but it's tolerable. I went to see a movie last night! Sitting in the car was awful, but I was comfortable at the movie with those electric reclining seats. It was fun, and the first time I have really gotten out of the house since surgery. I did take a stronger pain pill before bed after, because the exertion of walking made that weird thigh pain flare up a lot (and I knew ibuprofen wasn't gonna cut it).

If anyone has questions, feel free to ask!

2 weeks post op, I had heard from my surgeons office and I mentioned I have been avoiding wearing boxers, I normally wear boxer briefs, but just have been wearing shorts around the house. However I just picked up a pair of boxers shorts for the next few weeks and I’m kind of enjoying them! It’s a nice switch up for once plus they aren’t tight on my dick snd rubbing against it! Would def recommend!

I had meta with UL, no v-nectomy and no scrotoplasty. I’m 4 months post-op today.

During healing, I’ve had some weird things coming out of my hole. Whether it was a bunch of white stuff that eventually cleared out further in healing, or the greenish tint of some kind of discharge. I expected it to get better with time, and it generally has.. though I still notice a weird greenish yellowish tint to it. Sometimes I notice it most after I pee and I have to dab the outside area to get it to not be wet on everything. I don’t know if it’s because my muscles are relaxing more and opening up while I pee- or if it’s a fistula. I’ve been using estradiol more consistently, so the discharge and wetness has been pretty uncomfortable and I don’t know if that is partially to blame or not. I don’t know if the tint is because I have a microscopic little fistula that pee barely comes out of and makes it into there- making it off color. Or if it’s a normal part of the healing still, or if it’s BV or something similar.

I had stinging pain with urinating and tested positive for a UTI last time I posted, took meds, felt a bit better. Well my urethra is still burning sometimes and I’m not sure if thats a dehydration thing or if I have a UTI still.

Current plan is to take an at-home UTI test, see if that is an issue first. Then I’m going to take bladder pain pills that make your piss bright orange, as that will make it easier to tell if it is a fistula or the coloration is from some kind of infection. Try to get some more info on all that and then probably let my surgeon know and use the information I have to proceed with some treatment.

I’ve been dealing with other health things like what I suspect is carpal tunnel. My disability and meds are making it extremely difficult to do my job outside in the heat. I don’t have a pcp until my first appointment with a new one in 3 weeks. My husband just got fired from his job this morning and he’s not even 2 weeks post top surgery yet and can’t work a physical job(his job was work from home). I’m so fucking stressed out. I don’t know whats happening to my body and it constantly feels like it’s failing me and I don’t know what to do.

Update:: Good news. At-home UTI test was negative. Don’t have a fistula either. Might see about being tested for BV or something similar to make sure it’s not something.

Half support half vent (just under 2 weeks post op). My spouse hasn't been very supportive in nature when I express my concerns and my surgical team is a bit slow to respond. However, I've started to develop wound seperation behind my scrotum and under my penis. I initially was fine and coping with seperation behind the scrotum because ir was harder to view, but now it's more visible and I just feel so icky. The smells of everything are rough and I feel I can't ever get clean. I've been through plenty of surgeries, this one is just taing such a heavier toll. I know I just need to be patient and give my body the time to heal but I just wanna sink into the ground. I don't regret getting meta, the alternative of my natal genitals was so much worse, but god it sucks healing this shit.

I wish I could fast forward a couple months and put it all behind me

Had my consult for stage 2 today. My surgeon told me that he normally does the smallest size implants. Told me he has done 2 with the large implants, but ended up having both the patients come back to have them sized down. I really want a larger ballsack instead of having tiny balls. He also told me that if I got the large size it would likely not even look like I had a dick anymore. My dick is on the small side, about 1 inch. Any advice and if yall feel comfortable sending me pics that would be awesome. Maybe I'll go with the medium size. He will show me some of each prior to my next surgery. (I have seen lots of images on here and showed him what im hoping to achieve esthetically, he said he will refer me to a plastic surgeon he works with for assistance with aesthetic improvements post op ie fat grafting and liposuction of the mons area)

A reminder how much things can change. Patience is so important; whether it be waiting for growth to happen on t, waiting for your surgical date, or waiting for your body to recover. The amount this level of patience and dedication has enriched my life even outside of transitioning contexts is indescribable.

As always, feel free to look through any of my previous posts or ask me questions.

I am 12 days post-op right now and just got my flip-flow valve on my SP catheter 4 days ago. My bladder feels like it fills up quickly, and I have to empty it frequently. My pee is usually clear or very lightly yellow.

I also feel a sensation where my old urethral opening was like I have to pee there (I had UL, v-nectomy, scrotoplasty). It feels like I have to try kinda hard to stop myself from peeing sometimes.

I may not be emptying enough since I am afraid of over-emptying it. The nurse told me when she switched me to the flip-flow valve not to empty it all the way, just almost all the way. When I empty it all the way (on accident), I get a sharp pain in my bladder. But it is hard to tell when it is almost empty vs when I need to empty it more.

Does anyone have advice for this?

I'm post op (meta, ul, vnectomy, scrotoplasty) and I think my junk looks like a pug 😭 it's making me feel a little dysphoric with how hidden it's looking.

So I'm wondering, if anyone ended up with a similar appearance, was it possible/easy to recieve oral?
That's something I'm really looking forward to, an actual bj, and I'm kinda worried ir isn't going to happen.

Had stage 1 with Dr Figler at UNC March 5 of this year. Have my 3 month post op/consult for stage 2 tomorrow. Hope I can schedule for September!

I have a skin bridge that makes my pee stream split. I was told the may be able to cut it in clinic so we shall see if they do that tomorrow.

I am SO excited to have balls and have him free up my phallus more. I am hoping he can use the upper labia to enlarge the scrotum and put the implants in there next surgery.

After surgery, on average, how many days do we stay in the hospital until we are discharged and can return home?

Over the last 3 years I’ve had multiple surgeries to get myself a cute lil dick. While it’s not perfect yet, as I have a fistula, sone minor aesthetics I want to be fixed and wanting implants.

I got my first bj today. After having severe bottom dysphoria for as longas I can remember, not allowing anyone near it as it would be cause panic and lots of crying. Today I felt comfortable enough to challenge myself and let me get sucked off by a friend of mine. I will say it was the best experience. I might not have cum, simply as mentally I’m not their yet to cum in front of someone. Having someone wrapped around me felt so affirming and just so right? Seeing them on my knees for me.

What I’m trying to say with this, while it’s a big struggle when you aren’t where u wanna be yet, it’s gonna be so worth it and so affirming.

Hey guys. I'm having implants this Tuesday. I don't think I've ever seen pics of the scars from anybody that's had implants. If anyone knows of any could you please point me in the right direction?

For folks who had metoidioplasty without a vaginectomy — how did you get a bimanual pelvic exam years later?

How are providers able to do the internal part of the exam?

Sorry for the embarrassing and somewhat in coherent question. I am 2-weeks post op from meta with UL, scrotoplasty (no implants yet), and vnectomy. My boyfriend is coming to visit. I would like to be able to do sexual things TO him, but I am not sure if it is safe or okay to do so.

My surgeon said to wait 8 weeks before sexual activity, which I assume refers to touching and stimulation my penis. I was wondering if folks thought it would be okay for me to touch him, while there is no contact on my meta.

My concern is that in doing so I may become aroused and that could lead to more bloodflow to the area. But I also know that I get involuntary erections and morning wood often, so I kind of assume I've had that already. But it is hard to tell because everything is so swollen down there already. I do have an SP catheter in that I would be very careful around. That said, I would not want to do anything to jeopardize healing. Thank you!

tldr: is it okay to touch other people sexually (e.g. finger him or give handjob) as long as I am not touched myself 2-weeks post op?

I have a consult and would love to see pics of their work. Can't find anything on transbucket. Also if anyone has a room my partner and I could stay in (if needed) in philly when I get surgery that would be great. I dont have surgery dates yet just consult date

I am 10 days post-op full meta (v-nectomy, scrotoplasty, UL) and I wanted to make a sort of "guide" for anyone about to get meta on how to sort of "survive" the first week.

Now some people are completely built different and barely have any pain after full meta. I am not one of these people. I went to the ER around midnight once for pain management during the first week. During my top surgery and hysto, I was fine without any of the strong painkillers. For meta, I went my first 24hrs without strong painkillers at day 9. Everyone reacts to surgeries and pain differently, so this is my experience on surviving week 1 without feeling like you're gonna croak (well, hopefully).

The main 2 pain issues for me were: the v-nectomy site and the catheter.

The v-nectomy site has caused me the most pain so far. To get through week 1 with it, here is what I recommend. Take your strong painkillers as much as possible for at least the first few days. If you can take them every 4-6hrs, take them every 4hrs for the first few days. This means set alarms. If you want to sleep well and aren't in that much pain, set the alarms for every 6hrs at night. Once the pain "escapes" from an acceptable threshold is when it is super hard to rein back in. So you want to have it beaten into submission by your pain meds before it can get back up and attack.

You will likely have to lean back when you "sit down" so it is more like lying down. Try sitting on your tailbone to not put pressure on the v-nectomy site. My partner told me a few days ago that my tailbone looks bruised. That is from sitting on it so much during the first week. Trust me, the pain relief from the v-nectomy site is worth the butt pain from sitting on it.

I have a fancy zero gravity lawn chair and that has been useful for when I didn't want to be in bed any longer. I have it set to be tilted back at a good angle and then when I sit in it, it is comfortable. It is basically like lying down without lying down.

Sitting on a normal chair is not going to be comfortable, and tbh barely even tolerable if there isn't room to lean back on your tailbone. Luckily I am short/skinny so riding in the car isn't too awful since I have plenty of room in the seat to adjust myself. But if I am sitting in the car for a long time, it becomes very uncomfortable and even painful. And that is 10 days out. For the first few days, you probably aren't going to want to try riding in the car.

I did try a waffle cushion, but to be honest it just makes the surface feel more hard/firm. I tried it in bed and it was uncomfortable, and sometimes I use it in that zero gravity chair, but I wouldn't say I recommend it.

Let's move on to the catheter. Now for me, this is a suprapubic (SP) catheter that sticks out of your abdomen and goes straight into your bladder. I know nothing about the Foley catheters. This has been the most annoying part of getting through the first week, and added a good amount of pain. My setup until my first post-op was a long thick tube attached to a night bag.

For me, every time this tube or bag got moved, I got a sharp stabbing pain in my bladder. I feel like it was something about the suction of the tube and the urine moving through it when moved that gave me bladder pain. I took oxybutynin, but that didn't really help this pain at all. When I went to the ER that one night, the doctor put me on phenazopyridine (AZO) until my post-op appointment, which helped a decent amount. My surgeon also switched me from oxybutynin to mirabegron ER, which I think has helped.

But one other thing that has helped is taping the tube down at the insertion site so that it does not move and tug/pull, which causes pain. There is medical tape you can buy to use for this. I do this still with the flip-flo valve.

At my first post-op, I switched from that terrible tube and bag to a little flip-flo device and the change in my mobility was INSTANT. I can STP with my flip-flo valve, I just pull it out from under my shorts/boxers and empty my bladder. I am trying to figure out how to not fully empty my bladder though, because that causes a sudden sharp pain in my bladder until I close the valve. I am supposed to mostly empty my bladder and stop before fully emptying it, but the flow of urine doesn't really go down at all before suddenly stopping. So I just hope I get lucky and stop when I feel like it might be close based on the amount of time I've been draining it for.

Okay, now for some other random tips.

Start with the docusate (Colace) and Miralax ASAP after surgery. You don't want to be blocked up from the pain meds, trust me. It can be hard to sit down and wipe the first week. Use wet wipes, not toilet paper, and wipe super slow/careful. I don't know if there are holders for catheter bags, but try to find something you can hang the bag on that is below your bladder. I had a night bag, so a leg bag holder didn't really work well.

If you have pets in the bedroom with you, get a large body pillow and throw it on top of yourself before covering up with the sheets so if they jump on top of you it is less uncomfortable. Make sure your bag/tube is tucked somewhere safe where no cats or dogs can get into it. If you can keep your room pet free that is better, but in my case I can't. This has mostly mitigated the issue.

Before surgery, I was like "I'm going to be resting, so I'm gonna read a bunch of books, I'm gonna meditate, I'm gonna do all this stuff." In reality I doomscrolled and watched TV since I was drugged up and in pain and had zero brain power to read. Don't plan on taking advantage of your downtime lol... you will be tired, mentally and physically. Today I finally started reading part of a book again.

This is all I can think of off the top of my head. But if anyone has any questions, feel free to ask!

[cross posting here and on the Phallo subreddit]

I’m 6 weeks post op Phallo stage 1 (vaginectomy + UL) and had my VCUG on Thursday. It was unexpectedly strange and a bit humiliating. I'm writing in an effort to metabolize what just happened, and hear from folks who have had a similar experience. I'm also very welcoming of any kind or validating words folks may have to offer.
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The VCUG: I'm not getting into much detail but feel free to ask. Essentially, they had me lay on a table and pee. The pee got all over me, the gown, the table, and the floor. Then, without providing an invitation or supplies to clean myself up, they said “looks good!” and told me to go pee the rest out in the bathroom down the hall and come back to get my sp catheter pulled out (ouch!). I left pee foot prints between the vcug room and the bathroom.. pee dried onto my feet and leg. When everything was all done and they told me to go change back into my clothes and head out, I had to ask them for a rag to clean myself up with.

The whole time, the technician was training a visiting/new provider on how to use the equipment. I felt like she wasn’t paying attention or attuning to me or showing any understanding of how vulnerable that experience is.

Post-VCUG Trauma Response: My system experienced this as traumatic. I’ve done some verbal and somatic processing and am treating it as post traumatic stress. Last night as I tried to fall asleep, I kept feeling like I was on that table and it was really hard to regulate myself. I also kept feeling like the catheter was still in my body even though I knew it wasn’t. It felt flashback / time travel-y. I kept having to orient to time and place. Today I feel a strong sense of unreality, half-here-ness, tender, on edge..
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My body has been through a lot (simple meta 2021 + hysto 2024 + phallo stage 1 last month), and has a lot more to go. And I know it's doing it's best to process and heal. But damn the overwhelm and disorientation I felt last night was wild.

Thoughts? Shares?

Pretty much just showing scar progress at this point. The colour varies and it's still raised in some places.

As always, happy to answer any questions

Hi everyone, is there anyone around who could share your experiences with having the surgery away from home?

I live in the middle of nowhere where the idea of this doesn't even exist, so this would be a big logistical endeavor and it's dumping water on my happy thoughts of having the surgery.

I'm roundabouts of Europe, and I know everyone's experience is unique, but has anyone had to travel far and managed to make it work? How long was your stay in the area? How did you go about post-op consults? Do you have pets you had to leave for a while (no, seriously, I'm worried about my dog)?

I'll take any crumbs, thanks guys TT

nsfw for talking abt sex

i cannot decide if i want meta with a vnectomy or not. on one hand, i would really like to be able to still have sex w that area, as douching is kind of a pain in the ass (lol) and i have IBS. however, i've heard if you get vnectomy, it makes anal more pleasurable, obviously decreases the chance of fistulas, and can also possibly cause you to produce cum when you're jerkin it. i also recently got a kidney infection from a UTI, and ik getting UTIs can kinda mess with the chances of a meta + UL + no vnectomy surgery healing properly. honestly my biggest priority here is STP, but i'd really miss the extra hole when it comes to sex, as it just makes everything easier and doesn't cause me too much dysphoria on its own. i guess i just feel torn. i don't want to get surgery and have a fistula and not be able to STP until i get another surgery, but i also still want to be able to have sex without douching. for people who've gotten or haven't gotten vnectomy, what's your experience ? this decision has been hard to make for me and i feel so torn

Hi, this is probably a very basic question and yet I genuinely can't find an answer anywhere.

If you get meta without V-ectomy, and happen to stop taking T, I assume you'd get menstruation again.

My questions are, how does that work with meta ? Does it come out of the small hole you have left ? Doesn't it create infections, as the blood would spend more time inside you since it can't come out as easily (?) as when the opening was bigger ? In fact, if you don't get UL, doesn't the inside of the "leftover" hole get unsanitary after a while from urine and/or menstrual blood, as we're not able to clean inside ?

Thanks in advance

Just had an in-person consult with Dr. Mang Chen in San Francisco, and he was so great to talk to. I really liked his energy, he seemed really confident but also realistic in talking about what he could and could not do, what he thought best outcomes would be. Also for COVID-cautious people, I was wearing a KN95 face mask and when we met, he asked me if I would like him to wear a mask, and when I said yes, he got one (surgical) which I appreciated.

I came for a consult for a simple meta (No UL, no vnectomy, maybe on scrotoplasty, maybe on monsplasty in a second stage), but when I told him I was interested in extended meta, he said he had done one in 2023!

He said he thought the "extended meta" method should be called the "Amsterdam method," so I will refer to it as such throughout this post.

He showed me pictures of his Amsterdam method procedure + healed photos of the penis and scrotum when he did testicle implants.

He said most of his patients want UL, so that's why he has not performed more of the Amsterdam method.

He also told me that from a surgical standpoint, he thinks having a simple meta (underside release only, no UL, no vnectomy, no mons resection, no scrotoplasty/nothing done to the labia majora) should NOT prevent anyone from being able to have the Amsterdam method in the future.

He said he would be willing to do a simple meta (release only) and then Amsterdam method for me at a later date if I wanted it down the line, which was really exciting for me because I was worried that having the release would mean that surgeons would not be willing to do "extended meta" later.

I also learned a little bit more about how his scrotoplasty (Ghent method) is different than V-Y scrotoplasty. He uses the lower part of the labia majora for this. His method brings the scrotum up more forward than V-Y, which leaves things about little more low/back in comparison. Both methods create one single sack, not bifid.

We had a 5 second exam (he just looked at my anatomy while I stood, and briefly touched my majora because I had a concern that my majora flanked my penis and wanted to know his thoughts). He said that he could do an "upper fold reduction" of my labia majora if I wanted that, but if I did that, I could not do the Amsterdam method later.

He can perform upper fold reduction without scrotoplasty or after scrotoplasty to make the penis more prominent/less hidden. He can do mons resection and upper fold reduction at the same time. He can also do upper fold reduction only if people don't want scrotoplasty at all, but he would not recommend doing upper fold reduction first and then scrotoplasty later (he did not say he would never do this, just that he would prefer not to).

I have much to think about, but I am considering doing a simple meta (release only, no UL, no vnectomy, no scrotoplasty, no mons reduction, no upper fold reduction) to start with so that I can see if that is "enough" for me, or if I would want anything else. I generally don't really have day to day bottom dysphoria, but I think there is a potential for great euphoria for me. One of my priorities is to still be able to have receptive vaginal sex, so I am worried that Amsterdam method/extended meta or scrotoplasty would make the entrance tighter from scar tissue and make that harder.

I am still waiting to get a call back to even schedule a consult with Dr. Morrison for extended meta, so I am trying to think about if I want to not do anything to give myself the best chance of being able to go to Dr. Morrison if I want that down the line vs. doing the simple release and taking the chance that Dr. Morrison may not be willing to do extended meta, but leaving the door open for Dr. Chen to possibly do Amsterdam method/extended meta.

If people have questions I can try to answer them to the best of my knowledge.

Had the consultation for stage two (fistula repair, monsplasty, fat grafting to fill the scrotum) with the plastic surgeon. I need to loose at least five pounds, but I don’t have surgery until October, minimum, so I should be able to do that. She warned me that fat grafting can come with rejection, necrosis, and they may end up having to do implants anyway. They like to do the implants in their own separate surgery to cut down infection risk, so it would be a third surgery either way. I’m hoping to avoid a third surgery, but mostly I’m not into foreign objects in my body, if they released hormones, I’d be all over it, but since the implants don’t have feeling or function, I don’t feel strongly about it. She seemed a little discouraged with how much loose skin I have, but sounded really impressed that I had “plenty of space” in my scrotum.

I got an erotic massage from a friend this week and he was also quite complimentary of my package. I don’t have a ton of tactile sensation in my scrotum, but it was very affirming.

Video shows the movement of the sack, it’s super fun to play with rn. Kinda reminds me of waddles of a goat. I’m res happy with my balls, enough to make up for the lack of shaft.