GRS / SRS Surgery with Mr Phil Thomas at the Sussex Nuffield Hospital Surgeon: Mr Phil Thomas Contact Details: Mr P Thomas, The Sussex Nuffield Hospital, Warren Road, Woodingdean, Brighton, East Sussex, UK Procedure: Penile Inversion / Scrotal Graft Cost: £9,500 as of 1st April, 2004 Quick Overview ( go HERE for the full GRS diary ) Referral and Initial Consultation I was referred to Mr Thomas by my specialist for SRS surgery. Referral was on March 1st, 2004 and my appointment with Mr Thomas was arranged for April 1st, 2004. I had an initial consultation with Mr Thomas and an examination to assess me for my basic health and also to check what donor material would be available. I found Mr Thomas open and easy to talk to. He showed me some pictures of his results and spent time to explain the procedure, the possible complications and likley outcomes. Like any responsible surgeon he made neither promises nor guarantees. He did tell me he would do his level best as he undesrtood just how important this opeartion would be to someone like me. During my examinaton he had one of his gender nurses present who I found a great support during the phsyical examination. Liz was kind and caring and very sympathetic to how it feels for a TS female as in fact was Mr Thomas. After an interview of approximately one hour during which time I asked questions and felt I was given honest, straight forward answers and was given a range of possible dates for the procedure the consultation was over. Mr Thomas does request hair removal prior to surgery for portions of the pubic area. The surgery date was likely to be some time off as Mr Thomas told me he will not carry out SRS unless he is free for 10 days after the operation in case of any problems. SRS Operation I was admitted for my procedure on September 8th, 2004 with the operation scheduled for the following day at 08:30. The Sussex Nuffield is a small ( 30 bed ) private hospital with modern operating theatres and private rooms with en suite bathrooms which were well equipped and comfortable. The food ( once you are off your liquid diet is superb ) The staff at the hospital were very friendly and helpful and the gender nurse assigned to me was a great help. On my first day i had to have assorted basic health tests ( blood tests, blood pressure - all the usual things ) and found the staff friendly and efficient. They took time to introduce themselves to me so I would know who was who. The operation was carried out the following day by Mr Thomas and his team. I had a complete SRS with functional vagina and clitoris plus any cosmetic work to create a complete look. The operation was to all intents and purposes a complete success with no complications. The operation lasted approximately 4 hours and I woke up in the recovery room. The initial pain was pretty bad but less than I had expected. Nursing support during my stay was first class and Mr Thomas came to see me daily to check on progress. Like any doctor he was quite busy yet would always answer any questions or concerns I had in a straightforward manner and explain what was happening. The nurses were also very well familiar with SRS patients and were a great help and support while the two gender nurses retained by Mr Thomas were very helpful at teaching me all the stuff I would need to look after myself at home. I was in hospital for 9 days for the operation and post operative recovery before being discharged. Everything was included in the cost including my stents and take home medication including a douche bottle and the Betadine douching fluid plus pessaries, cream for the suture lines, pain relief and a good supply of KY to get me started. Post Operative Results At 6 weeks post operative I have had a few minor problems. Infections and similar - these are always a risk following SRS and are no refelection at all on the skill of either my surgeon or his staff. At 6 weeks I have a fully functional vagina. Its appearance is very realistic and the few females who have seen it were amazed at how good it looks. The operation secured me a depth of approximately 7" ( CAUTION - depth is a factor both of your donor material and the skill of the surgeon - Mr Thomas made no guarantees on depth for me but told me we should be ok for 6" ) The clitoris was sensate at 4 weeks post operative and indeed I experienced my first orgasm at that time. I have a small problem urinating, the stream tends to fire too far backwards - this is most likely due to the swelling of the labia following the operation and infection at 4 weeks post operative and is not a major problem for me. Mr Thomas did tell me the 'aim' can be off initially but that a minor correction would easy of needed. During my recuperation at home I have had to make a few calls to the hospital and found them helpful and supportive. Mr Thomas has called me back each time to get a first hand report of any problems and assured me that if there is any minor corrective work it can all be easily handled by him. Who else did I consider ? My original choice would most likley have been Dr Supborn in Thailand. In the event due to a pulmonary embolism in Januray 2004 I was advised that surgery and long haul flying may well prove dangerous for me and was advised to seek a UK surgeon. Initially I was unhappy at that partly because of the cost but also because most of my friends were done by Dr Supborn and I felt safe in that as a choice. On reflection I am glad I stayed in the UK. It seems most SRS ops require small corrective work after surgery and the fact that my surgeon is only 2 hours away is a big advantage. Also I am happier recuperating at home. I was always a little wary of going to Thailand as I knew I would be solo. International travel is never easy in the best of circumstances and I was a little worried that being so far away in possibly bad shape may prove difficult to deal with with no friends to help me. I honestly dont feel any surgeon could have done a better job than Mr Thomas and on reflection I am very glad I stayed in the UK. Pictures at 10 weeks post operative Below are two pictures and text of the neo-vagina at 10 weeks post operative. Here's the vagina with my legs slightly open. You can see theres a certain puffiness to the right ( as you face it ) labia which was caused by the infection at 3 weeks post op. At this time there is a haemotoma under the labia which is slowly going. Here's the vagina opened up. The labia minora are under my fingers so you cant see them. They are quite small. The letters indicate location of clitoris, uertha and vaginal opening. Theres a small amount of redness at the base of the vagina where the skin hasnt fully recovered. The labia and clitoris are sensate and after dilating regularly and aggresively the vagina has a depth of almost 7" Bear in mind when looking at these pics that thaey were taken at only 10 weeks post operative and after a severe infection and haemotoma which at this stage had somewhat marred the cosmetic result. Mr Thomas told me that over time the result would be fine and girls should remember that SRS is really a 12 month long healing cycle. The vagina will take time to settle and of course much depends on your care of it and your determination to follow the dilation regime. Post Operative Check Up - 10 Weeks Mr Thomas includes a post operative check up in his price. I attended his outpatients clinic for this at 10 weeks. The post op check up revealed a small problem of bleeding near the urethra. Mr Thomas cauterised this with some kind of chemical agent. It was painless and has stopped any more sproradic bleeding. Apparantly it would stop in time anyway but Mr Thomas felt he would prefer to fix it now. The uretha has since settled down perfectly and the aim is now 'true' when I wee. I expressed a small concern that my outer labia seem quite baggy to me. Mr Thomas told me that they may take 6 months or so to settle down fully. If after that time I am unhappy then a small correcting op can be carried out under local anaesthetic although he would recommend leaving it at least 12 months. The check up revealed no major problems, the haemotoma is diminishing and Mr Thomas felt confident it would go in a few months completely. I found Mr Thomas friendly and easy to deal with as the post operative check, he was willing to answer all my questions in a frank and straight forward manner. 19 Weeks Later The haemotoma has disappeared completely as predicted. The vagina is now near perfect in cosmetic appearance and functionality. Dilation depth remains unchanged at approximately 7", the clitoris and labia have stayed very sensate and I am easily capable of acheiving orgasm. I have suffered a large amount of bladder infections and urinary tract infections. These seem to be par for the course for some girls and in that I suppose I have been unlucky. My GP has told me that some females are just prone to these and although they are irritating they are not serious. 9 Months Post Op After 9 months everything hs settled down. I cant say exeactly when things finally resolved with the bladder and urinary tract infections - they just seemed to get less and less until one day I noticed I hadnt had any problems for some time. I still get a periodic bout of cystitis which can be bad news. Part of the trick is to find a douche cycle that suits you. Enough to keep the vagina clean but not so much you destroy the natural bacteria which will help keep infections down. For me I found less douching was better and now I only douche out once a month with clean water - that seems to be the best solution for me personally, other girls will doubtless have other methods and cycles for managing this aspect of post op life. Depth has stayed almost constant at close on 7" and my dilation regime stays at once per day for 30 minutes ( thats 10 minutes beyond whats really needed but I dont mind spending a bit of time looking after myself. I dont get any pain from the vagina now but sometimes it can get sore if I over exert myself physically. Its a case of learning to listen to your body. 24 months Post Op I am completely happy with the results. Over the first 12 months there were occasional minor problems as I adjusted to the changes. None of these were due to surgical issues rather learning to 'manage' the neo-vagina. The outer labia are slightly larger than I would consider ideal but I am disinclined to consider more surgery as I have perfect function, sensate and orgasmic and no problems. As Mr Thomas suggested I have come to accept my body have learned to like the appearance and accept it as fully part of me. To go for further surgery with its attendant risks for the sake of very minor cosmetics doesnt seem worth the risk to me My own GP who has seen the result was frankly amazed at how natural it all looked and I am completely happy. CAUTION: I am concerned that some people have asked who I would suggest for surgery. I refuse to suggest surgeons to people and can only relate my own personal experiences in a truthful and honest manner as a guide to what this procedure is like in the spirit of providing experiences for use to the transsexual community.   Dilation Regime For girls who want to know about the post op issues regarding dilation following surgery with Mr Thomas - there is an article HERE   My Complete SRS Diary Back to Features and Articles Section