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Yes, dear readers, it is time for a clinical discussion. Those who prefer to think deeply about other matters may wish to skip this post, but for many of us, vaginal depth is a question of deep importance. So let's get to it.
In the standard penile inversion method of vaginoplasty, vaginal depth corresponds directly to the amount of penile material available for inversion. The stories are legion of MtF transsexuals who wake after surgery to find that their vaginas are of less than desirable depth. Many surgeons have, therefore, developed their own variations on penile inversion to provide a depth closer to that of women whose vaginas have been with them since birth.
The method developed by Dr. Sanguan makes use of scrotal tissue as a graft to increase vaginal depth. From his pre-operative examination, Dr. Sanguan predicts I will have a depth in the 5-6 inch range. He will only know for certain tomorrow, however, when he stretches and inserts the penile and scrotal tissue to create the vaginal lining. It will likely be the first question I ask when I wake up after surgery. "How deep am I?"
For those who have been on hormonal replacement therapy (HRT) for an extended period, the amount of penile and scrotal tissue available is sometimes reduced through atrophy. In those cases, Dr. Sanguan makes use of an additional skin graft from a donor site, that site agreed upon in advance between doctor and patient in the interval between the first and second stages of gender confirmation surgery (GCS). Dr. Sanguan, OD, and I have all had that discussion, leaving its implementation in the hands of Dr. Sanguan if necessary. Anyone interested in the full details of Dr. Sanguan's method can find them at http://phuket-plasticsurgery.com/P-PS-grs-procedure.html.
So does anyone of my age, transitioning as I am later in life, really care about vaginal depth? Given that I feel myself as fifty-something going on twenty-something, I believe the answer is self evident. Insofar as medical science will allow, I want to be the woman I should have been born as in the first place.
Having delved deeply for a moment, I now resurface to report that OD is resting comfortably as we watch a French comedy dubbed into Russian. She is bound to the bed for the next three days or until the grafts have taken. I have walked the hallways as much as possible today in expectation of the same bed rest that awaits me starting tomorrow.
The most difficult part of recovery is beginning. My own surgery tomorrow will be the longest yet, as Dr. Rushapol will begin the facial feminization procedures we agreed on after lengthy discussion, photo sessions, and measurements today and yesterday. I also will learn the answer tomorrow as to how painful facial feminization surgery (FFS) really is. In months of advance research, I could not get a clear answer. Some who have been through FFS say it is far more painful than GCS. Others comment that there was virtually no pain at all. Still others say that FFS is painful only insofar as it involves soft connective tissue. More simply, "If it moves, it will hurt." Fortunately, we are not talking about much in the way of connective tissue, so I am hoping for the lower end of the pain spectrum. This is also what Dr. Rushapol predicts.
That is where we are on this, our seventh day at the Phuket International Hospital. OD is drifting in and out of sleep as we watch our French comedy. Last night I dreamed of being at her wedding. I have slept beautifully almost every night since we checked into our little room. Who knows the depth of the dreams that will visit us this night?
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