Since neither my wife or I will be going back to see Dr. Meltzer or Dr. Ley for surgery, and I have successfully purchased a new dick, I am going to end this blog here.
Since neither my wife or I will be going back to see Dr. Meltzer or Dr. Ley for surgery, and I have successfully purchased a new dick, I am going to end this blog here.
I honestly didn’t think I’d be doing an update on this blog because I am done with surgery.
However, my husband is actually my wife now. She is also transgender and was not out as of the time of my surgeries with Dr. Ley.
She recently had facial feminization surgery with Dr. Ley. She is the person I refer to as my husband during the rest of this blog because she wasn’t out of the closet at that time. I left the old posts intact because that was what she went by at the time, and she is cool with that.
However, since she had surgery with Dr. Ley, and there were office communication issues, I thought I’d add this quick and dirty round up for her on my blog. That’s two data points of interactions with Dr. Ley/Meltzer and their office staff.
Initially, we got a couple of consultations with different doctors for my wife. Dr. Ley does bone work, and used to do infant facial cranial surgery. She has the skill set one would want. Also, she just charges for time on the table. This meant that to go to Dr. Ley was $35,000 as opposed to $60,000ish we were quoted by others, without having the procedures my wife wanted which included brow, chine, hair line, cheek implants, and a lip lift/implant.
This meant we chose Dr. Ley. Of note, Dr. Ley was very warm and hugged both of us, and was fantastic during the consult. I was kind of surprised because she hadn’t been that warm with me in my own surgeries.
We got some information on what she could do for my wife. We liked what we heard and saw, and paid our money. (Thanks VISA!)
We got some information from the office on the different procedures, including the Malar Augmentation or cheek implants.
We asked Lindsay the nurse about my wife continuing facial hair removal via electrolysis afterwards, and over the phone Lindsy told my wife it was safe to continue 6 weeks post op. This is the same Lindsay I had so many problems with throughout my surgery process.
We recieved the PDF I’ve inserted below regarding care and aftercare for the cheek implants.
All was going well. I looked over the directions they gave for every surgical procedure, and it looked like my wife would on a liquid diet for 3 days, then a soft diet for 3 days, then back to normal on the 4th day. This was mostly due to the chin and cheeks, and their literature was very clear.
The problems began when we got the prescriptions. My wife was given exactly 20 oxycodone with directions of 1-2 every 4 to 6 hours post hospital. This was not going to even cover her, in case of issues, through her mandated hotel stay in Arizona.
If it went poorly, that’s 10 doses, Even at every 6 hours, the longest time span, that’s only 2 and a half days. In my experience as a nurse, these things fluctuate, and patients usually start out at 2 pills every four hours, and trail down as they heal. Some patients experience a lot of issues post op and this script didn’t have any wiggle room for any complications.
My wife and I asked about this, and were told by Lindsy that nobody ever should need more pain coverage. EVER!!!!! She was adamant and said it was office policy. I had flashbacks to her treating me like a dirty junky for asking to extend my pain script for a week.
Since we saw this issue coming, we worked with our GP who felt for having that much bone work in the face the pain management plan was inadequate. We had a script for a more appropriate pain management plan for my wife before we left Washington State.
When we did our pre-op visit the day before surgery there were two issues.
First, there were suddenly conflicting information on electrolysis after surgery. The office nurse, whose name I didn’t get, said they recommend 6 weeks. When Dr. Ley came in she recommended 6 months and to take 2 grams of amoxicillin every single time you get electrolysis. However, during the previous consult Dr. Ley had said 6 weeks to us.
I asked for a lot of clarification and when Dr. Ley left the room, I asked the nurse if this was about the reddit post some gal had made about her cheek implant issues with Dr. Ley. I was told that was the reason for the change. I pointed out that the poster was clearly suffering but also didn’t have a good grasp on the kinds of complications that can happen with these things, and the antibiotics was a helluva lot and seemed like overkill. She didn’t verbally agree, but was very sympathetic. It felt like a cover-your-ass move, not a patient care move.
I already had an antibiotic reaction because of the giant keflex dose Dr. Ley gave me in a cover-your-ass move, and this was just more of the same.
The electrolysis recommendations are not realistic as electrolysis takes so many visits.
This was not reflected in the PDF I’ve linked above. Which does not mention electrolysis at all.
When we got to Arizona, it was the day before as they asked of us and we shopped for food fort he extended stay in the hotel. We shopped for the liquid and soft diet specifications. When we got into the consult with Dr. Ley, she told us it would be 5 days liquid diet and 4 days soft. She said that’s what they always suggest but that’s not on any of the literature we received.
Not a huge deal, but while my wife was in surgery, I had to go and buy several more days of food, despite having the hotel full of food. I wondered how folks without a friendly Visa card would deal with this if they were on their last penny trying to get this done.
Then when Dr. Ley saw my wife at Greenbaum’s while being discharged, she was told eat whatever she wanted. This would bypass the liquid and soft diet completely. We did not take that advice because it didn’t mirror the reality of where my wife was at in her healing.
Even the nursing staff at Greenbaum’s Surgical Center told my wife to ignore the sudden dietary freedom because it made no sense.
I was very happy we had the foresight to get another script for my wife, because my wife’s hotel recovery was rough as hell. Being off her hormones and being in pain did not work well together. She was miserable by day 4. She only needed a few extra pain pills but I cannot imagine her suffering in the hotel without them.
Neither of us like opioid pain medication and avoid it, but when you have all the bones in your face rearranged? That hurts. It’s what that medication is there for.
My wife did get a couple of check in’s but she felt the Lindsey wasn’t very interested, or informational with her questions. The advice given for some of her issues made little to no medical sense and my wife just went to our GP. My wife felt, much like I did, that the office was adversarial and non-responsive.
My wife then emailed asking about the electrolysis issue again. Lindsey said it was because it could introduce bacteria into the cheek implant area. This is crazy, because electrolysis follows the very shallow hair shaft and doesn’t even do anything deeper. You might as well be worried about a shaving cut.
My wife pointed this out because she’s going to Scottsdale to have a full day of electrolysis at a medical shop that numbs you up. This is the same shop that performs work for Dr. Ley. Lindsey then told her “the block” (meaning local anesthesia) would introduce a needle into the cheek implant area.
If they are numbing my wife’s face, and sticking syringes of analgesia into the cheek implant area then things have gone horrifically wrong, and you better start looking for cameras because you are in a SAW movie.
We actually confirmed with the electrolysis folks at Senza Pelo Med Spa in Scottsdale Arizona that they do not do local anesthetic like that at all. They do numbing, and all day beard removals all the time, and do it for transgender women with cheek implants. They’ve been doing it for over 30 years.
My wife pointed out to Lindsay that she was told 6 weeks was the wait time for electrolysis and Lindsey denied this and very argumentatively emailed and demanded to know names of who my wife talked to. My wife had talked to Lindsey, Dr. Ley at the initial consult months before surgery, and the office nurse. At this point, it was pointless to talk to Lindsey.
Lindsey was fairly nasty, and kept saying it was in the documentation they sent us that I’ve linked above. This is not true. I don’t even know what to say about this other than I literally have proof that it’s not true.
Prophylactic antibiotics for dental work is because of risks of endocarditis or it used to be related to prosthetic joint risks. The 2 grams of Amoxicillin is the recommendation for those with endocarditis risks.
My wife was super anxious because of all this, so we talked to our GP and she said she could think of no reason this would be necessary or even a risk. I asked on transgender surgery sites and nobody had ever heard of this. It seems the range of time post op to do further electrolysis is 6 weeks to 6 months depending on the surgeon. Only one surgeon recommended 6 months of the handful I was told about.
I used the prophylactic antibiotics for dental surgery in my research as that risk that is probably similar to what Dr. Ley was using and the dosage of antibiotics was the exact same.
Here is a paper from the American Association of Endocarditis discussing dosages. This is for endocarditis risks, not implants. Note it’s the same dosage.
Here is a page from the American Dental Association Website discussing how it’s not recommended for patients with prosthetic joints to receive prophylactic antibiotics any more. There is no real risk or evidence that it would help with infections.
So actually, you don’t need prophylactic antibiotics for dental work and since that is more invasive than electrolysis it would be ridiculous to take it.
We got the bone work that my wife wanted in this surgery. We both stand by the opinion that Dr. Ley is a gifted surgeon and does amazing work.
However, my wife is not pursuing the lip lift and lip implant from Dr. Ley because the issues with the office are just too difficult. The information given is spotty, inconsistent, and changes day to day. The phone triage nurse is adversarial and gives out terrible medical advice. It’s near impossible to get a hold of anyone in the office.
While my wife has great results, since we are paying out of pocket we will be pursuing the rest of her facial work and breast implants closer to home with a surgeon that has a better reputation for aftercare, and office staff.
I truly felt our experiences were good overall but that was because we have both worked in the medical field, have great general practitioner support, and I used to be a nurse. A lay person might have much more difficulties with this.
I have successfully mirrored this blog over on My New Dick Diary Word press called Rat Needs a Dick.
I did this because I have more control with WordPress, and Tumblr gets hinky with adult topics and buying a dick is definitely an adult topic.
As I put this in, I was thinking of going back and annotating the posts with a different font or something, with the wisdom and hindsight I have now. That might be beneficial to folks that are going into this.
(Future Note: I have done this. the transfer has some formatting issues, and I fixed everything I could, and added a few notes of insight as of 8/8/19.)
I don’t think there will be much in the way of new posts, but if I do, I will make sure it mirrors all posts on Tumblr as well. At most, I might do a surgery kit round up of the items I found most useful post surgery, and to have on hand. There was some things I wish I had thought of before going down, or had on hand when I got back. The hubbies emergency pillow purchase comes to mind.
Thank you for everyone that supported me through this, and gave me encouragement and kind words. I really do appreciate all of you.
I am pretty much done with this dick diary but I’d like to give a review of how I felt about the surgeons and their office. I waffled back and forth on doing this because it’s not all flattering, but in the end my loyalties are to other transgender people that want to use Dr. Meltzer and Dr. Ley’s office.
We are so very desperate to get our surgeries and it’s hard to find good information on what people experience with specific surgeons. Because of that, I am putting this up here.
I am very happy with my results. I felt both of them were very fantastic surgeons. I was Dr. Ley’s first metoidioplasty, alongside Dr. Meltzer. I felt it was well done and I like the look of it. When I went back to get the mons resection done, Dr. Ley did some revision work on my empty scrotoplasty. I feel she has a very good eye for anatomy and is an exceptional artist. I feel she really does good work.
I have fantastic results and I’d recommend them again and again based on surgical skills.
Nobody in this office will be on time for any reason. I went to a consult and two surgeries, with multiple visits. There was never a time I didn’t wait at least an hour. Take this into account with your own time management. I spent literally hours in the office waiting for my appointments, well past my appointment time. Hell, in my last surgery, Dr. Ley was hours late and the hospital staff was even annoyed. This effected my ability to even leave the hospital. I was ready to be discharged at 9am, but as everyone waited for Dr. Ley. I was finally informed at 5pm that I could leave because she wasn’t going to get to me until 11pm that night. I didn’t want to pay for another hospital night I didn’t need, so since I was fine and had no complications with the second surgery I went back to the hotel.
Getting actual answers from staff is difficult and felt adversarial. I worked with Lindsay as the nurse, and she was hard to get a hold of and even harder to wrangle actual answers out of. It took me multiple calls to get information about complication rates on scrotal implants, and really that should be an easy answer. She really only responded when I called the office and they made her.
I also had an issue where I asked billing how the payment worked. You have to pay upfront, whereas in most medical settings they bill insurance up front, and you pay the rest. I got an email back telling me if I didn’t pay on time they would take my appointment from me. All from just asking how they do business. I mean, damn!
I would also be careful about medical information. I was told a couple of outright garbage things from the nurse for surgery that were seriously false. For example:
Post-operative care sucked. Just straight up sucked. In my first surgery I had a metoidioplasty, hysterectomy, and a vaginectomy. I had extra bleeding, and some of the worst bladder spasms known to man. When I kept calling to ask what to do, I was treated like a pill seeking junky by Lindsay the nurse all over a request for 5 additional Percocet so I could take a half in the morning and a half at night to get me through my first work week with the painful spasms.
I was a nurse and did wound care and I felt these first surgery incisions were slow to heal (No fault to anyone. Sometimes that happens.), and I wanted to make sure someone assessed them because they were dicey. I was told to send in pictures, and when I did I never heard back. I had to keep emailing and calling and was told it was fine and not send in follow up pictures weeks later.
I had to go to my primary care physician to deal with all this. He was, as always, super supportive and quite horrified at how this went down.
With my second surgery I was told I’d have to remove my drain by myself. This can be done but since I was in Phoenix for so long, I asked for them to remove it. I had to really push to get them to do this. They couldn’t do it on the Thursday, Friday, Saturday, or Sunday before I flew out. Instead I had to go in Monday before my flight left. I was told the nurse would come in early to meet us and take it out so we wouldn’t miss our plane.
This was an unmitigated fiasco. First, we waited an hour past our appointment time so I guess the nurse coming in early thing never happened. Then two nurses took turns trying to yank the drain before Dr. Ley came in to yank hard on it. Between each attempt a half hour or so would pass. My husband kept asking about time, and a MA gal kept rolling her eyes literally at him. This was just so out of bounds and rude. I mean what the ever loving fuck was wrong with them?!
I passed out because the amount of pain that came with Dr. Ley yanking on the drain unsuccessfully. I have Graves Disease so this can happen with pain for me.
I had to be reopened up, drain removed, then stitched back closed in the procedure room. The MA gal that rolled her eyes at my husband was clearly not interested in even dealing with me and I found out that Dr. Ley didn’t even know I had passed out cold in the exam room ten minutes earlier. None of her staff had told her which seems pretty problematic.
We missed that flight home and it was more due to Delta and my husband’s diligence that we got home that night. If we didn’t travel for work and have a good working knowledge on how to work around this, we might have been stuck with the added time and expense of another night in Phoenix.
I felt this could have all been mitigated if the drain was 1) taken out four days earlier when it should have been or 2) if we had not been sitting in the office for literally hours past our appointment time.
I was healing fast and fine at home, but then developed a serious reaction to the extended gigantic Keflex prescription Dr. Ley gave me as a cover-your-ass move. From previous experience with the office, I dealt with it myself with my own primary care doc. When called for follow-up information I felt Lindsay was more worried about liability than how I was doing. I got a serious third degree about what else could have possibly caused the reaction. It was the Keflex. It was literally the only medication I was on at the time. Not even pain meds, which seemed to shock the hell out of her.
I basically just stopped talking to the office because I felt there was no point to it. I did get an email from one of the nurses asking if everything was good and if I could send pictures. I did and wrote a detailed listing of my progress including somethings about the long-lasting issues I was having with my bladder since the first surgery. (I have since asked my own doc and it’s to be expected. I’m a bit slow on recovery there.) I got back a
“Great!”. I doubt my email was even read. If you are doing triage through email this is not good. You are bad at it.
My overall opinion is that Dr. Meltzer and Dr. Ley do good work but the office could be a landmine of issues. If everything goes right, it’s golden. If you have any issues, then you will probably have to fight the office just to get through. I would do this again and am ecstatic with my results. However, I would have set up aftercare with my primary care
physician ahead of time and not even bothered to try and deal with that office for it at all.
I am sure they will know exactly who I am if someone there reads this. I am the only person that has ever had a drain stuck in their office. Who knows, though. Getting a drain stuck isn’t common but it’s not exactly uncommon if I recall back when I used to remove drains as a nurse. However, they said I was the first in office issue. However, since they ship everyone home with drains? Who the fuck knows what the real rate of issues are. It’s not like they communication with anyone.
This is why I waffled on posting this. It’s not all flattering, but it’s my experiences with the office. I hope by putting this out there that other people going to Dr. Meltzer and Dr. Ley can have the information in order to navigate their experiences with less frustration.
This will probably be the last post of real content here. I am considering mirroring this over on WordPress so I don’t have to worry about Tumblr’s weird issues. I plan to leave his dick diary up, so others can read it if they are considering the surgeries I had.
(Future Note: I did mirror this over on WordPress, and I am glad I did because Tumblr’s anti-porn rules are destroyed a huge swath of transgender related blogs over there. )
I am pretty much done with the dick surgery experience. I still have a few stitches fighting their way to the surface but overall I am healed and fine.
I decided to create a general write up on my thoughts on what I consider key points if you are going to buy your own penis.
I’m not an expert. I’ve only bought one penis in my life. I can give you the benefit of
that one penis-buying experience though.
Then you have to decide on the extras. Dick surgery is kind of like going to the salad bar at Sizzler’s. One you decide on your entrée, you get to pick and choose the side items. Do you want testicles, implants or empty scrotoplasty? Implants have a risk of rejection and drift, where as an empty scrotoplasty might be absorbed back into your body over the years. You might not want balls at all, and it’s perfectly fine if you feel that way.
Do you want your urethra moved so that it runs through your penis like a cis gendered man? In Phalloplasty this is all but a guarantee of being able to stand to pee, in a metoidioplasty it’s up to how much enlarged clitoris you had to begin with. It’s not uncommon to have a catheter for an extended period, and possible revisions when getting urethral lengthening done, and there will have to be donor sites for creating this longer urethra.
You need to be aware of your own anatomy. In my case, I had a lot of fatty tissue in my pubic area, that necessitated a “cosmetic” surgery called a mons resection. It’s like a lower tummy tuck/dick lift all in one. Without it my metoidioplasty would have been buried and invisible. With it, I have a respectable penis. It was not covered by insurance, but the $4000 was worth it to me. Where insurance refused me, VISA stepped up.
Some folks do this without help, but it’s risky. My second surgery, the mons resection, went so well I actually went out and did things afterwards. I had no problems at all. I just packed up my drain and taped it to my stomach so it stayed out of the way. My first surgery? I was a mess. I had complications and I could barely walk or pee. I needed all the help I could get. The thing with surgery is you might be fine, but that extra person will really be crucial if you are not.
Plus, when I used to nurse, I always told people to bring a loved one with them
to the hospital. You never know. Sometimes things just don’t go down right, and
as transgender person, having someone there to advocate for you might be
necessary when you are half out of it post-surgery.
I will be putting out a review of my experiences specifically with Dr. Meltzer and Dr. Ley’s office in the next few days. I have mixed feelings on that but I think as a community I want to lay it all out on what I experienced.
Okay. I got a response from Dr. Meltzer/Dr. Ley’s Office. I was asked a series of questions in email and I wrote in depth answers to them. Some of my answers should have been red flags about things like bladder spasms, and reduced urine flow. I got a “Thanks for the update.”
I swear. This office, man. Not that I was going to handle those red flags with them, because 1. it’s half the country away, and 2. I think I’d get better followup care elsewhere.
Great surgeons, but followup care needs an overhaul or something. They have communication issues.
I heard back from Sara via email about the pictures I sent to Dr. Ley. Apparently they look good?
I guess it took a month to look?
In other update news, things are going well. I’ve been working out great, at least until I re-disolocated my left collar bone. So despite feeling great I have to take it slow for other unrelated reasons. At least I can walk a lot, and do small things.
I am fighting with the dissolvable stitches in the long abdomen incision still. I can clearly feel the knotted sutures under the skin. I just hit 3 months, and if I recall, it took me closer to 5 months last time to completely sort out.
I have not used any scar treatments and the incisions look exactly like my top surgery scars where I did use scar treatment. They retreat a bit every week and look better and better. Scar creams, tapes, and whatnot are probably a complete waste of my money and time. Beware surgery offices that sell products is the moral to that.
I plan to get a fighting rooster tattooed on my lower abdomen anyways so that will obscure it more. I’m not showing people my actual dick when they inevitably ask because I’m trans, but I will show them my “cock” when I get it tattooed on my lower belly. My tattoo guy thinks it’s hilarious.
I haven’t got a lot to report other than I have a nice small penis and it works. In this case no news is good news.
I think in a couple months I will write up a nice essay on my takeaways from this process and what someone should do to prepare if they want to go have surgery with these surgeons.