phalloplasty in australia

I was wondering if you have much say in size or if it's determined by your arm / anatomy?

Also did you organise a airbnb situation for the stays after each stage? I'm also living in NSW

Lastly, what level health insurance did you have, I have heard you need top hospital

Hey mate, apologies for the the delay in reply.

Generally you’re looking around 5ish in length for the average arm. You can request slightly smaller but not much. If you’ve got absurdly long arms, you might get a bit more.

I did after stage 1, but stayed with friends after all my other surgeries.

Hey mate, terribly sorry for the late reply - I’ve not logged into Tumblr in probably 9 months or so.

I couldn’t recommend him more highly, he is a brilliant surgeon with excellent bedside. Costs will likely be different by the time you have surgery, but I’d benchmark for at least 80k out of pocket.

In a change of events, I’m having stage 2 next week. Deflatedness at the base is a bit bothersome, but trying not to stress too much about it until after stage 3.

Graft looks pretty great, hand and wrist are fucked due to developing Complex Regional Pain Syndrome. I don’t have the energy to go into too much detail, but it’s pretty fucked shit.

Hey mate!

12 weeks.

Arm/hand update:

I’m pretty happy with how my arm is healing, aside from that red patch in the middle and the fact that the midseam is absolutely BEGGING to raise up. I’ve switched to silicone sheets as of two days ago and am still wearing tubigrip daily to keep the pressure on. I’m still experiencing swelling in my hand and wrist, which fluctuates, but it’s consistently staying less swollen. I still have reduced sensitivity/hypersensitivity in my thumb, part of the back of my hand, and the lower part of my palm. I’m probably around 90% in mobility. I’ve got some patches of hair growing in too.

Butt/leg/tummy:

Finally dressing free on all sites as of this week. Arm and leg incisions are healing well, sitting nice and flat. Still have some minor tenderness in my stomach if pushed on or strained significantly. My butt has pretty large patches of nimbleness on/around the incisions. I have very minor dog ears on the end of the incisions on the inner side of my legs, which aren’t the end of the world, but it’s a rather high traffic area for chafe, so I’ll likely ask for those to be revised if they aren’t and better by the time I have stage 2. Sitting is fine 90% of the time. Some positions and surfaces are a little tender still.

Dick:

Check up today with Gooseman at 8.5 weeks post-op RFF phalloplasty. He was super impressed with how my arm is healing. Everything else is healing well for the most part, besides a few little things. The scar on the underside of my penis has been pretty tight, particularly towards the base. I’ve been aware of this for weeks and have been massaging it with vitamin e and using silicone gel on it, which he wants me to continue doing. He said that the scar around the actual base of my penis is tight as well, which I truly hadn’t given much thought to and assumed it was normal, but that’s because I only have my only experience to base it off, where as he has everyone elses to compare to. He said that the tightness is causing it all to ‘sit a bit high’, which I assume was in reference to my junk that still sits below my penis, including my existing penis. This means that when he pulls my penis up and towards my abdomen, it pulls a lot on my existing penis. This is uncomfortable, BUT it works in my favour when it comes to wanking - I can basically tug gently on my penis and it’s enough to achieve orgasm. At present I will usually alternate between this and stimulating my existing dick, but I do believe I could achieve orgasm by tugging only on my dick, but I’ve still been a bit too anxious to do this, purely due to not wanting to compromise any of the healing process/long-term aesthetic outcome.

My primary concern has been about narrowing at the base, which has consumed a lot of my time the last few weeks. It’s certainly not overly noticeable or significant, but when you’ve forked out as much as I have on a penis, you’ll nitpick the tiniest things. Goossen thinks that the tightening of the incision could be contributing to this, but did acknowledge that I am “less full” and “a bit flatter” at the base, but he’s not concerned about it. Classic. He said that once everything is sitting properly (with implants), as well as when erect, it won’t be an issue. He also mentioned something about the tightness at the base contributing to this? But I don’t remember the specifics. 

He appeared very impressed with where my sensation is at. I had convinced myself that I read somewhere that left donor would result in more sensitivity on the right side, and vice versa. Then I was told that the hook up is done on the left and that I would likely experience more sensation on the left. I asked him about this today (whether the hook up was down on the left) and he didn’t confirm/deny this and explained how they try to hook as many nerves up, etc. and basically that there’s no rule of thumb for where you will or won’t experience certain sensations. He said that typically people will experience one side with more erotic than the other and more tactile on another side. 

At present, I have extremely strong sensation on the right hand side, slightly less strong sensation down the left, about 1.5-2inches along the incision on the underside up from the base at a lesser intensity, and then fairly dull (by dull, I mean I need to apply significantly more pressure to feel the sensation and it’s not as intense) along the top of my penis until about half an inch of so from the tip, where I feel nothing. Along the right side, all I have to do is run my finger very lightly down the shaft to feel this. Along the left snd on the underside I have to apply slightly more pressure. On the top, I’ve experienced the sensation for a few weeks if I flick it, but within the last week I am starting to feel it more if I rub my finger rapidly on it with a little nit of pressure. This is all displaced sensation, which I feel in my existing penis. At present it’s not a pleasant, good, sexy time feeling, but will be once it settles. Currently it feels like someone is stabbing a pin into the head of my existing penis (which iis great if that’s your thing, but I find it unpleasant. However I always do it, as it’s nice being able to make that connection between my penis and my brain and feeling it as something that exists as a part of my body). At present, I have no tactile sensation. However due to the intensity of the sensation I do have, I am very aware if something hits my penis. 

At this stage, I’m booked for February 6th 2020 for stage 2. I had the option of November 21st, but with how close it is to Christmas and the closure period for Goossen and his staff, I chose to push it back. If I were to experience and issues with the hookup, I would go home with an SPC over Christmas until he returns. And as ridiculous as it might sound to some, I really wanna be able to swim over the summer. This also gives me some additional time to recover from stage 1 and for any issues with the scar tightness to settle as much as possible. As well as get back in shape after my stage 1 sedentary life and subsequent weight gain, and save a bit of extra money. As much as I want stage 2 as soon as possible, I think that this is the most sensible thing to do for numerous reasons. I figure that I’ve waited this long, I’m sure I can wait an extra 2 months. 

I’m back up to see him again at the end of September to check on everything again, and I presume I’ll head back up again early 2020 to check everything before we go ahead with stage 2. 

I am also allowed to run now, provided that everything is “packed firmly” and “well supported”.

I have a little ‘bobble’ sorta thing at the end of one of the incisions on my butt, which has been rather tender and painful. Goossen said it could be a stitch or scar tissue, and if it doesn’t resolve itself by the time I have stage 2, he will revise it. Butt is still tender when seated for long periods and/or bad seating. Still some tightness in the backs of my legs, but nothing that is too bothersome. 

My arm is hopefully on the homestretch. I’m still dressing it with MepitelOne, and will continue to do so until I’m fully healed and can switch to silicone sheets. The few little problem areas look like they have improved since Thursday when the dressings were last changed. Fingers crossed that when I go back to the hand therapist next week, I’ll either be healed enough to go dressing free, or very close to it. I try to touch it quite regularly over the top of the dressings (rubbing, patting, scratching, etc. to adjust to the sensation). 

As a bit of a related sidebar, I kinda wanted to touch on the arm and the scarring, etc. The significance of the arm graft was something that I had a really hard time swallowing when I first looked at RFF a good decade or so ago. Despite being a weird body part to like, my forearms are probably the only part of my body I do like, and the thought of altering one of them so drastically always terrified me. Because most of the information about RFF has typically been out of the states, I had no idea that the donor site would be replaced with a full thickness from the butt until my consult (why the states haven’t caught up yet is beyond me, truly). Despite already having made the decision to have RFF, this was a game changer for me. And honestly, if I didn’t have tattoos that were compromised when the flap was lifted that make it very obvious that my arm has undergone a major surgical procedure, I don’t think the end result would bother me much at all. It sits SO FLUSH that once my wrist swelling goes down, it will be totally seamless. I know that the conspicuous scarring is a huge deterrent for a lot of people, and I very much understand that, but I think it’s important that people understand that what you see online from guys in the states is NOT what your arm will look like if you have surgery with Goossen. I’m not here to shame or make comments about peoples choices to pursue ALT, abdominal, meta or any other alternative procedure, but I think it’s important that people aren’t scared off by misinformation. This is not to say that guys who have had RFF in the states have lesser or subpar results as due to the use of the split thickness.

Full thickness graft at 7 weeks post-op. Few little spots taking a bit longer to heal, but otherwise I’m very happy with it.

Okay, so, here’s a bit of a better run down. But still probably not super comprehensive.

Also, here’s a photo of my arm at 7 days. I don’t have any photos of the raw graft, as I didn’t see it.

Arrived at the hospital at 630AM, from there it was basically a whirlwind of paying my excess, getting triaged a nurse, taken through to pre-op, answering the same questions all over again with another nurse, getting my gown and compression socks on, then Dr Goossen came around. He ran through the procedure, asked me if I was 100% certain about going through with it, confirmed I was 150% certain, mum confirmed she was 200% certain. Goossen went through a little spiel about if there were any issues with nurses and if I felt I wasn’t being treated properly, to speak up about. He said that dysphoria can increase while in hospital and that there’s services available to me if I needed them. Note: in all the transition related procedures I’ve had done, never have I had a surgeon take the time to address these things.

Surgery took about 10.5 hours - I was under for an extra 2 or so, as he said that when they opened up my abdomen, they found extra nerves and blood vessels that they wanted to use (which I am absolutely okay with). I was verrryyyy out of it that evening, so I only have vague memories of the conversation I had with Dr Goossen when he came to see me.

I was only allowed a light diet the next day, as they didn’t want me to have to get up to use the bathroom.

The physio came around on Monday (surgery was Friday) to get me up for a walk. We didn’t even make it to the door before I was whisked back to bed as my blood pressure had dropped too low. Apparently I was grey, eyes fluttering and swaying. I managed to get up later in the evening and move over to the chair and have a bit of a wipe down. Got up for a brief walk on Tuesday with the physio, which was incredibly uncomfortable and difficult with the catheter, drain, IV and PCA in. By Wednesday I was getting myself in and out of bed without assistance.

They took the catheter out on Wednesday, which I was grateful for, however it meant having to urinate by myself. With all the dressings, etc, it meant that I was pissing all over myself. This made me feel like fucking garbage and I just didn’t have a good day on Wednesday. My dressings were falling apart, I stunk, I hadn’t taken a shit since Friday, feeling very dysphoric re: pissing everywhere. I basically stayed in bed and slept. Thursday was fairly similar. Dr Goossen came around Thursday evening and switched me to the donut from the initial dressings, which was so much better and improved my mood significantly.

Dressings on my arm came down on Friday. Goossen was super impressed with how it was looking and chose not to change the dressing that was on it, so rebandaged and the OT made my splint and gave me hand exercises to do.

I did think straight up that I had pressure sensation, which Goossen said he’s only had one other patient whose had it so soon, but then when he came back after a few days he made me second guess whether what I was feeling was sensation at the base. And now that it’s me touching it, I truly can’t decipher.

So far, I’ve experienced very minimal pain in the phallus/junk areas. My existing dick has been stitched to one side, as well as one labia minor being removed for the neourethra. That’s been more uncomfortable than painful.

Here in Australia, we use the same method as the UK, where the full thickness graft from the forearm is replaced with a full thickness from the buttocks, rather than a split thickness from the thigh. As such, the incisions on my butt have honestly been the most painful throughout everything.

The nurses said that I was one of the most mobile/independent that they’ve seen, so that’s pretty encouraging. The nursing staff were all incredibly competent and fantastic and I had no issues with them at all.

Today is Day 10.

My butt is noticeably less painful today than it was yesterday, but still the sorest spot. My abdomen incision is sore and my belly there is visibly larger than the other side. I’ve been doing my hand exercises and using my hand as much as I can (not lifting heavy things). I do worry that I might be overusing it, because that’s what I do, but I’m probably not. It’s not been painful, just tingly/stinging/ripping feelings (nerve sensations).

I still have numbness in my thumb, but it’s not as painful as it initially was. We initially thought this was possibly due to the carpal tunnel release I also had done while they were in the area, but it appears it’s phallo relate due to a nerve they usually have to cut through.

I think my biggest issue is with how unclean I feel, particularly in my, know, nether regions. Because I’m not allowed to shower, only song bath, in addition to the dressings on my butt feeling like my asshole is damn near taped together, as well as all the swelling and what not in that area, I feel like I haven’t been able to clean properly. I feel gross and smelly and putrid.

As of yesterday, I’m only take the oxy of an evening and cutting out the morning dose. I had a bit of pain yesterday by the evening, but didn’t notice much difference today.

The incision on the right side of my butt is very sore and I have persistent numbness in my thumb and lower part of my hand - this should likely sort itself out, but there’s the potential that it may not ever regain full sensation. My abdomen incision is still rather tender abd that side of my stomach is noticeably swollen. Arm has a stinging/tingly/burning sensation. All of this pain is manageable. I chose not to take the oxy this morning, as I’m not huge on pain killers, and I was pretty uncomfortable by about 8pm this evening. We’ll see how I go tomorrow.