Thread by @MetallicRosa

@KatyMontgomerie This is gonna be a long thread of comments, it's 26 in total so bear with me. I had GRS 11 months ago with Suporn and know A LOT of patients. First off, go to reputable surgeon. It's better to wait or save up more than get a bad result. Impatience is the most dangerous thing.

@KatyMontgomerie Part of the reason revisions are common is because there are little things you can't do the first time, or minor tweaks the patient wants. For example, my surgery was with Suporn. Most of his patients I know went back for a revision. 2/?

@KatyMontgomerie This is because the initial surgery can’t create certain structures, like a posterior or anterior commissure. For some people (like me) that’s fine. My vagina isn’t perfect, but she’s mine, and I don’t want to travel that far, 3/?

@KatyMontgomerie lose that much time from work, etc, again, just to have a slightly narrower bit at the top and a slightly more anatomically accurate bit at the bottom of the introitus. 4/?

@KatyMontgomerie I would say most patients don’t “need” a revision. A revision is something people might want, and some might need one for dysphoria reasons or because of complications. But for the vast majority of patients from reputable, 5/?

@KatyMontgomerie skilled surgeons, revisions will be for tweaks and adjustments, NOT something essential. The most common revision for Suporn for example is urethral reduction. Because the urethra is often quite large compared to a natal vagina. 6/?

@KatyMontgomerie But most of the time, urethral reduction doesn’t actually work, and is only a small aesthetic change when it does. I think it’s better to go into GRS with the following mindset. It will hurt. It will not be “perfect” because NOBODY has 7/?

@KatyMontgomerie a “perfect” body that fits society’s bullshit. There will be things you don’t like about it, however minor. You may have complications. You might have impaired sensation or sexual function. You might not have as much depth as you would like, 8/?

@KatyMontgomerie and there’s no way to change that. DON'T have a target depth in mind. Revision can’t help with it. You’ve got a big first op, then the option of revision for smaller tweaks. It can happen, and it could happen to you. It’s a scary thought. But that’s ok, 9/?

@KatyMontgomerie and it’s better to handle that fear before surgery than during recovery. You can only control stuff that’s within your control, so do the best you can, and you’ll almost certainly be fine. Seriously! <3 10/?

@KatyMontgomerie It doesn’t have to be “perfect” to be better than it was pre-op. And you could have an amazing perfect recovery with no issues, who knows. What’s most likely is that you will be happy, but there will be one or two things you don’t like. 11/?

@KatyMontgomerie But if you go in wanting or expecting perfection then you WILL be hurt. no matter how good your result. You will not get that, doing so is setting yourself up to suffer. You will get what you get. 12/?

@KatyMontgomerie Like I said, you have to make that first shot count, and do everything you can. It’s an improvement in one area of your dysphoria and life, not a panacea. So take care of yourself during recovery, but do not slack off. 13/?

@KatyMontgomerie Don’t skip dilations, and if you have to skip dilations for travel then when you get to your destination you put down the sheet and you dilate no matter how tired you are, what time it is, or how hard the session is. 14/?

@KatyMontgomerie Even if it hurts, even if you bleed a little, the next one will be easier, just relax and let your body loosen up. If you wait longer it will be harder. If you grit your teeth and tense up it will be harder. 15/?

@KatyMontgomerie It sounds crazy, but relaxing dulls the pain. I had a major separation fixed under local anaesthetic, and it turned out that local doesn’t work for me. It provided almost no pain relief, and I just had to lie there perfectly still, 16/?

@KatyMontgomerie keeping my breathing steady and my body relaxed. It was apocalyptically painful, and if you asked me if I could withstand that pain I’d have said “no”. But I could, and I did, and once it was over things were much easier. I surprised myself. 17/?

@KatyMontgomerie My pain threshold is shit and I had stitches put through my inner labia. And I could do it. Human beings are fucking TOUGH, and you can handle much more than you think you can. I could handle it, you can too if it happens, which is unlikely anyway. 18/?

@KatyMontgomerie Fear is THE WORST thing you will deal with. The people I know who’ve had bad recoveries fall into two categories. First is people who just got really unlucky; multiple separations, lots of pain, 19/?

@KatyMontgomerie inability to orgasm, pain in arousal, bleeding, depth loss, and nothing they could do about it. I know one person who had this and she still feels that GRS was the right move, and she’s better off than before. And most of these lessen or improve with time. 20/?

@KatyMontgomerie The second category is people who fucked up by not dilating properly or regularly, tried to rush recovery and injured themselves, or worse relied on pain medication to the point of developing an addiction (then having to deal with withdrawal and recovery at once). 21/?

@KatyMontgomerie The second category is avoidable, and those tend to be the people who are really unhappy. But that’s really rare too. Most of the people I know are like me; happy, but not perfect. Many of them are having 22/?

@KatyMontgomerie revisions for those minor cosmetic things: urethra, commissures, asymmetry. I was told I didn’t need hair removal before GRS, but I shouldn’t have listened, because now I have to pluck hairs from the bottom of my introitus 23/?

@KatyMontgomerie and have to get hair removal soon, which is a pain on the NHS. If I could have a magic instant revision right now, yeah I’d get those commissures! But I only have 5” of depth and a revision would risk losing more. 24/?

@KatyMontgomerie My sensation is complete and perfect and I can orgasm, and I don’t want to risk losing that over a few hairs and some slight shapes. It’s not worth it for me, so I’m not doing it. And I’m ok! 25/?

@KatyMontgomerie The best advice I can give is to go in with realistic expectations, do everything you can within your control, and whatever happens is something that you can and will handle. Revision is something you can grapple with LONG after surgery, so keep your focus. 26/26

@KatyMontgomerie End note. The worst pain I experienced was not those stitches btw. It was that a trainee nurse messed up my IV and had to try several times to correctly stab a vein in the back of my hand. THAT was worse pain than anything else that happened. You'll be ok <3