Dr. Kaushik gets approached by a big number of transgender women who confirm his view of why neither penile inversion, advanced penile inversion or full graft vaginoplasties are a good and acceptable choice for a transgender girl.

Most common issues these patients are facing are:

  • the vagina is too short
  • the vagina is not sensate or not sensate enough
  • the full-graft vagina is damaged by scars and numerous small openings in the graft, so that the patient actually dilates on raw flesh in these areas, making dilation very painful
  • the dilation regimen to keep the vagina from shrinking in diameter and depth doesn’t want to be kept up anymore because it is too time-consuming and/ or too painful
  • sexual intercourse is very painful due to inadequate width and depth of the vagina
  • the vaginal entrance is curved and points upwards instead of opening in a straight manner

Apart from those aforementioned issues Dr. Kaushik usually corrects any defects or issues that are present due to previous GCS/SRS surgeries, should that be possible.

Issues like those include:

  • creation of a proper size and properly shaped clitoris
  • creation of a clitoral hood
  • creation of defined labia majora and labia minora
  • repositioning of the urethra in correct anatomical position
  • correction of the urethral opening to prevent stenosis/ treat stenosis

Needless to say that all of these corrective procedures are oftentimes VERY time-consuming.

Take the removal of a penile inversion, advanced penile inversion or full-graft-vaginoplasty graft for example. This step has to be carried out first before a SIGMA-LEAD vagina can be successfully created.

This time-consuming process, that has to be carried out with utmost care has to leave all other important adjacent structures intact and unharmed – like the bladder, the urethra, or the rectum.

Also, the surgeon’s creative ability is put to the test numerous times when procedures for present issues demand off-the-book solutions to give cosmetically and sensately acceptable and helpful results to the patient seeking help.

Quite a number of GCS/ SRS surgeons around the world will not perform this kind of corrective surgery exactly for those reasons. It’s only the really dedicated GCS/SRS surgeons that will perform this corrective surgery because they know how desperate and in how much pain women like us are after we decided on a surgery, and the promises of other surgeons didn’t turn out to be true.

It’s also needless to say that the golden opportunity to get it all right and achieve the best cosmetic and sensate result is the first GCS/SRS that gets performed.

Dr. Kaushik will always give his best to achieve the best outcome for you in every aspect. However, an elaborate consultation before an OLMEC corrective SIGMA-LEAD GCS/SRS should be done, to make sure your expectations can be met and/ or that your expectations correlate with what Dr. Kaushik can do for you.

The procedure itself:

The OLMEC corrective SIGMA-LEAD GCS/SRS usually starts with the careful removal of whatever tissue lines your vagina up to this point. All penile inverted, penile inverted and scrotal-graft extended, or your full-length full-thickness scrotal graft vagina gets meticulously removed in a time-consuming process. The greatest care is being given to leave all surrounding tissues of the urethra, the bladder and the bowels intact. Also, a perineum incision might be needed to create a proper vaginal entrance point.

Dr. Kaushik will find a way to line the first 2-3 cm of your new vagina either with a penile skin graft or should that be necessary by another skin graft, which will be harvested at that point.

The incision for the SIGMA-LEAD graft will me made on your left groin. The appropriate rectosigmoid colon part with its blood and nerve supply will be identified and located.

The graft will be carefully mobilized and taken out. One end of the graft will be closed and the SIGMA-LEAD graft will then be put through an incision in the peritoneum into the vaginal cavity that got freed from the old graft just minutes before. The separated sigmoid colon pieces, where the graft was taken from, are sutured together again. The incision on your groin gets closed in a layerwise fashion to minimize scarring.

Close to the vaginal entrance the SIGMA-LEAD graft and the penile tissue – or the skin graft, should that have been used – get sutured together in a star-pattern way to prevent later constriction of this area.

Then Dr. Kaushik will address all other issues of sensate or cosmetic nature, to improve the cosmetic result you have had up to that point. Should it be necessary the vulva improvements will be performed at a later point depending on how much work is needed to fix your issues.

A list of feasible procedures would be endless because the possibilities for potential issues are too many to count.

After the surgery is completed you will have a vagina which:

  • is fully lubricating itself on sexual arousal
  • is fully sensate on all of the 16-22 cm’s of depth you have
  • will heal fast and feel like it’s always been a part of you
  • is looking forward to getting dilated or have sexual intercourse
  • which is normally fully capable of providing you with climaxes

On top of that, you will probably have quite a number of other issues of your vulva fixed, that weighed heavy on your mind before this corrective surgery.

Post-OP Time

After surgery, you will wake up with a dressing in your genital area and on your groin. Both of these dressings are painless. The groin dressing will be removed after 2-3 days.

For the next 4-5 days, you will be on IV (intravenous ) medications, which are antibiotics and pain killers. Also, you will have an epidural which reduced general anesthesia use during surgery and besided the pain killers the epidural is now highly effective for pain management.

After 2-3 days you will usually be allowed to take in liquids again, depending on when wind begins to pass through your anus.

The catheter will be removed after 6 to 7 days. Also after 6-7 days you will start walking again.

Dilation will be started 5-7 days after surgery. Dr. Kaushik will instruct you on how to do dilation properly and you will learn it fast.

You have to maintain local hygiene, which consists of washing your genitalia with a betadine mix (water and betadine solution) for about 3 weeks.

It will also be required that you wear a sanitary pad for the initial few weeks after surgery until discharge becomes less.

Sexual activity usually can be resumed after 1 ½ – 2 months.

The usual hospital stay for Indian clients is 7 to 10 days.

For overseas patients, a stay of three weeks is recommended to ensure complete recovery under Dr. Kaushik’s personal supervision before departure.

Any minor touch up procedure – should it be needed – will be done during this time period, so you can have a relaxed and worry-free departure.

You can find the Dilation Instructions after OLMEC SIGMA-LEAD GCS/SRS.

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