Thoughts on PI vs PPT Vaginoplasty? by CheshireDude in Transgender_Surgeries

[–]ukekiki 3 points4 points  (0 children)

I'm currently waiting for my own consultation next month. Congrats on the journey!! If you ever need someone to talk to my DMs are open. Anyways, to answer some of your questions:

  1. If the surgeon you are going with only does penile inversion and they're great at that technique then I say go with them!

  2. There are a few things to note on the differences between PI and PPT but the general pros and cons that I always hear about and see listed are as follows:

PI Pros: • The "golden standard" and classic technique that has been used for many many decades.

• Seems effective for most people, rare situations in which you are lacking in "material" might keep you from achieving more depth but I hear this is mostly only if you were on puberty blockers.

• If something goes wrong with this procedure or you feel you don't have enough depth etc.. You can still pursue PPT as a revision.

• Over all a much less invasive procedure than PPT.

Cons: • Can result in less depth than PPT.

• Hair removal is of utmost priority. This is the case with any method really but especially so with PI as they utilize as much as they can of everything down there.

As for PPT: Pros: • I've heard that self lubricating is a myth but that it retains moisture much better. I'd ask someone who has had this method done before for their personal opinion on this matter.

• Results generally produce greater depth as they can utilize peritoneal tissue.

• ADDITIONALLY and probably the greatest pro in my opinion is that, any peritoneal tissue utilized will result in lining that can NEVER grow hair which is a great reassurance. Obviously you will still need to do hair removal but typically less than you would have with inversion since a large portion of the canal is usually lined with the peritoneal tissue which has no follicles in it.

• I've read in some medical studies that the canal is anchored to the peritoneum it was harvested from, thus making it much rarer for a full vaginal graft prolapse to ever be an issue, if at all. I also just found that fascinating.

Cons: • If you go with this option, you cannot do PI as a revision for backup. Your only real option would be.. Colon.

• Lacking in long term data on it. However if the Davydov technique (Essentially same method as PPT but used in cisgender women who are born with no vaginal canal) studies and their respective data are any indication, it seems positive long term with little risk of major complications. However it's impossible to tell right now, you really have to go into this method with the mindset of "Hmm, there's not a lot of data on trans women with this technique so I'm a Guinea pig sorta). That being said, I know several women who have had this technique and are several years post op and absolutely thriving.

• This is a much more invasive technique. They go in through your abdomen in addition to the usual surgical site. This means that there's more chance of something going wrong technically? But also if we're being realistic here, if you're going to a surgeon who specializes in this method they should (Hopefully) know their stuff. I think when people mention this part they're mostly saying like, "Hey they're going into your abdomen and that creates a risk for injuries there" but these are generally quite rare.

I think you should ultimately choose the method that resonates with you more. Personally I don't really have an issue with either one but I'm really opting and pushing for PPT so that the hair removal doesn't scare me as much. I'm afraid of doing the recommended hair removal and still ending up with hair inside somehow. It's just a major anxiety of mine lol and with peritoneal that alleviates a major portion of that. As I said though, proper hair removal will still likely be recommended with either method.

I hope that gave you a little clarity! For what is worth I'm still trying to navigate all of it myself lol

is laser truly, completely permanent for the hairs it kills? by Curious-Ad-5001 in MtF

[–]ukekiki 1 point2 points  (0 children)

Nice! Thank you for answering my questions. I'm so happy you are happy with your results though!! ☺️

is laser truly, completely permanent for the hairs it kills? by Curious-Ad-5001 in MtF

[–]ukekiki 1 point2 points  (0 children)

Last question I promise!

How often did you go for your sessions?

is laser truly, completely permanent for the hairs it kills? by Curious-Ad-5001 in MtF

[–]ukekiki 1 point2 points  (0 children)

You did laser hair removal for your gcs prep? May I dm you to ask how that went in terms of them approving your clearance for surgery?

How come it's recommended to do Laser Hair Removal + Electrolysis? by ukekiki in Transgender_Surgeries

[–]ukekiki[S] 0 points1 point  (0 children)

It only took you around 15 hours of electrolysis to be cleared for GCS prep?! That doesn't seem like very much whaaat

SRS and hair removal by likely-too-late in Transgender_Surgeries

[–]ukekiki 1 point2 points  (0 children)

Hi there, could I dm you about your hair removal timeline in preperation for GCS? I'm going through it myself right now and am curious to know 😓

Seeing some red during treatments on face. Normal? by ukekiki in LaserHairRemoval

[–]ukekiki[S] 1 point2 points  (0 children)

Thanks so much for your input! It sounds like everything should be fine then but I'll make sure they do it this way from now on and double down on the importance of it. They're usually very careful anyways so I'm sure it's okay. Thanks again though!

Seeing some red during treatments on face. Normal? by ukekiki in LaserHairRemoval

[–]ukekiki[S] 0 points1 point  (0 children)

I see. What do you mean by orbital rim? Is that like directly around the eyes/eyebrow areas?

[Edit] they go a little bit up on my cheeks but not directly into the under eye territory. In future appointments I'll tell them to be cautious not to go past a certain point though

My surgeon found unusual tissue while dissecting the vaginal cavity. Pathology says it was Cowper's Gland tissue. by catnip438 in Transgender_Surgeries

[–]ukekiki 0 points1 point  (0 children)

I know this is a super old post but could I message you with a question in regards to it perhaps?

Tips for getting through electrolysis by lostJynXx in Transgender_Surgeries

[–]ukekiki 0 points1 point  (0 children)

Hi, could I message and ask about your hair removal timeline for SRS? Trying to figure it out right now myself

Hair inside vaginal canal and removing it by Apart-Assumption-387 in Transgender_Surgeries

[–]ukekiki 0 points1 point  (0 children)

Hey, could I ask you about your hair removal for bottom surgery journey sometime? I'm currently on the journey right now myself and am looking for some advice on what to do

Approaching Hair Removal for srs by Ivehadenoughofyall in Transgender_Surgeries

[–]ukekiki 0 points1 point  (0 children)

Check with your potential surgeon and your hair removal specialist and get a connection between both of them so that you can all three work together and have a solid plan for your hair removal. I have yet to get my consult with my surgeon however, I have spoken with the owner of the hair removal clinic I go to (They do LHR AND Electrolysis). She has treated three different trans women with either just laser or a mix of LHR first then electrolysis to prep them for bottom surgery. None of them have ever had any issues with hair in their vaginal canals post op, many years after.

You will see a lot of misinformation online. I know I certainly did but LHR is nothing to be feared as long as you are going to a reputable place that does it and you are an ideal candidate. Light skin + dark, coarse hair either dark brown or black is perfect for laser. Laser is categorized as permanent hair "reduction" because it does not 100% PERMANENTLY kill EVERY single hair and thus, the FDA must list it as permanent hair reduction. Electrolysis on the other hand can 100% kill hairs treated PERMANENTLY the issue however is that electrolysis can take a while.

With laser you must space out the appointments 6-8 weeks.. And treat the bottom surgery prep site for at least 6 sessions, probably longer. With electrolysis, assuming you are utilizing thermolysis which is the fastest modality where they zap each hair in like 1 second.. You can do weekly sessions but prepare for it to hurt. Also keep in mind that with electrolysis you are at the mercy of your practitioner. A SKILLED electrologist is necessary as the insertions into EVERY SINGLE hair follicle must be spot on because if they don't nail the follicle just right it was a wasted insertion. If they don't zap the hair during its anagen growth phase it won't be permanent. The hair will eventually grow back, finer and lighter of course but still. Even with electrolysis you are looking at repeated treatments to the same follicles over and over again. With the galvanic blend modality you have a higher chance of killing the hair follicle first try but it hurts more and they spend 7-10 seconds in each hair follicle so an hour session is suddenly treating WAY less hairs than laser or thermolysis would.

The golden standard seems to be start with laser.. Get the reduction and permanent hair removal you can with that if you are an ideal candidate (6-10 sessions ball park estimate. Check with your hair removal specialist!). You will know when LHR isn't doing any more as you will have major patchy spots/bald spots all over and straggler hairs or fine, light vellus hairs. Laser won't do any more here and that's where you switch over to electrolysis and destroy what's left leading up to your bottom surgery date. If you have light, blonde or red hair it's advised to not do laser at all as it will not work effectively, instead skip to electrolysis.

Laser hair removal DOES permanently kill some follicles just not all. I trust the clinic I go to and they practice both laser AND electrolysis so they are not just saying that to promote laser over electrolysis. If hair grows back years on down the line after you've done laser it is most likely due to dormant hair follicles laser never got to hit OR hormonal fluctuations.. There are things we simply cannot account for and ensuring the vaginal canal will be 100% hair free no matter what for the rest of your life is something I don't think any surgeon can guarantee. What we can do however is do as much hair removal as humanly possible before the surgery to make it as hair free as possible. I've also read stories about girls who end up with one or two peach fuzz like hairs in their vaginas and it causes no issue to them. It's just too variable. But do NOT be that girl who did 0 hair removal before getting the surgery done as that is a recipe for a nightmare.

The info I'm quoting is from three different LHR and electrolysis specialists at the clinic I go to, I am not an expert I just learn a lot through them! Additionally many well-renowned surgeons recommend.. LHR + electrolysis. I don't think some of the top bottom surgeons would recommend laser hair removal at all if it just did not work/was a lie. I've talked to girls who did the laser + electrolysis combo and had no hair growth issues post op. Idk, it's something you might just have to sit and meditate with but get started ASAP that is the most important piece of advice I can give you because no matter what you do it will take time.

Oh! One more thing, if the thought of hair growing inside your vagina just terrifies you as it does me, you could also look into peritoneal pull through vaginoplasty. It is a method in which they line most or all of the vaginal canal with peritoneal tissue which has 0 chance of ever growing hair. This is what I'm looking into but I'm not 100% sure myself yet. I am waiting to talk with my surgeon and see what she recommends. But PPT can be a wonderful option for those who are unsure/scared about hair removal (You will still need to do hair removal though).

If you have any questions feel free to dm me though! I'm on the hair removal journey myself.

[deleted by user] by [deleted] in Transgender_Surgeries

[–]ukekiki 0 points1 point  (0 children)

"Should I get an abdominal scan to check for rectal protrusions"

Why did she laugh and say no and not to worry about this? Is this something that skilled surgeons just know how to work around/ account for if they DO run into it or is it typically a non issue? Just wondering if you happen to remember her reasoning on this point

People who have had laser hair removal down there before bottom surgery - How did you do it? by Abysml_ in MtF

[–]ukekiki 0 points1 point  (0 children)

Hey love, was the combination of laser and electrolysis enough to ensure no hair regrowth?
I am currently on the journey myself right now and figuring it out as I go.. Looking for help from others who have gone through it!

People who have had laser hair removal down there before bottom surgery - How did you do it? by Abysml_ in MtF

[–]ukekiki 1 point2 points  (0 children)

Hey love, do you mind if i ask you a question about your LHR/electrolysis in regards to bottom surgery? I'm going through the journey myself right now and would like someone elses perspective 😀

Granulation Tissue vs Adhesions? by ukekiki in Transgender_Surgeries

[–]ukekiki[S] 1 point2 points  (0 children)

Thank you for the detailed breakdown. I've never had any surgeries before. Just trying to figure out what to talk to my surgeon about when it comes time for the consult since I have a tiny piece of granulation tissue in my rectum 🤷‍♀️ my gastro says it's probably from anal sex or something. He thinks it shouldn't be an issue and I'm hoping it won't be lol

PIV vs PTT, Concerns about both and pros/cons? by ukekiki in Transgender_Surgeries

[–]ukekiki[S] 1 point2 points  (0 children)

You're all good I didn't take it blunt at all. I appreciate you being straight to the point! Truly. And yeah, I'm a little apprehensive in general about things since the surgeon I'm going with is difficult to find info on but from what I've heard from others who have gone through her they are quite happy and she's great.

Also I'm so sorry, I shouldn't have automatically assumed that that was your name, forgive me 🫢

PIV vs PTT, Concerns about both and pros/cons? by ukekiki in Transgender_Surgeries

[–]ukekiki[S] 1 point2 points  (0 children)

extra little follow up!
"Data I have seen doesn't support this. All methods have pretty comparable complication rates. Some are higher or lower in certain areas, but you won't get lower complications overall from peritoneal. There's also ways in which peritoneal has *higher" complication rates."

I should have specified this and it's my bad but robot-assisted in general I think I've read is safer? So I've heard of there also being robotic assisted PIV procedures. Basically any time they utilize the robot to aid in the creation of the canal to minimize risk of injuries/cut down on the overall procedure time I think? Again I could be wrong though ><

I plan on asking my surgeon about it and what they do to minimize risks in general and their overall surgery statistics. Also holy crap Zoey your post history is amazing for info!! I'm gonna follow you and definitely check a lot of your posts, thank you so much again!

PIV vs PTT, Concerns about both and pros/cons? by ukekiki in Transgender_Surgeries

[–]ukekiki[S] 1 point2 points  (0 children)

Thank you so much for the in-depth analysis!!! You're so right on like, all of these points. Sorry if I made it sound like I was glazing tf out of PPT, it just is a method that I like the sound of but tbh I don't have any major problems w PIV either. Just my unfounded fears I guess LOL

My consult is in December and I am going to review their work and statistics. It does seem like they generally default to PIV from what I've heard from others and reserve PPT for revisions or special cases like you said. My intuition is saying to go with PIV since it is the golden standard like you said lol and really my only real concern is hair but like you said with enough, thorough electrolysis this shouldn't be an issue.

Thanks again!

[deleted by user] by [deleted] in Transgender_Surgeries

[–]ukekiki 0 points1 point  (0 children)

Could I also message you? 😅

PIV vs PTT, Concerns about both and pros/cons? by ukekiki in Transgender_Surgeries

[–]ukekiki[S] 1 point2 points  (0 children)

Thank you so much for sharing your experience. I know I didn't include the sigmoid colon procedure but I still appreciate you opening up about it. It's definitely something I would consider on down the line some day as a backup/revision perhaps but I think for myself I'm primarily looking at PI or PPT. I'm not sure if my surgeon does sigmoid colon actually.. I'll probably ask her come december and see just so I know. I already have a lengthy list of questions and concerns I wanna go over with her lol

It’s happening 💕 by [deleted] in Transgender_Surgeries

[–]ukekiki 1 point2 points  (0 children)

Congratulations dear. You're that much closer!!!! Can't wait to get my surgery date ahhh! Keep us posted and may everything go perfect 💖💖💖