I had penile inversion vaginoplasty with Dr. Marci Bowers in California in February 2025.
Going to her is honestly the worst mistake I’ve ever made and I'm struggling to convince myself that I haven't completely ruined my life.
Day 0: The morning of my surgery (Tuesday) went more or less fine. Bowers stopped by and I asked her some questions that I got simple answers to before she left. I was very hungry after fasting and bowel prep, but induction was without incident and I don't remember anything after that point.
Night 0: The first night I found out the hard way that I am one of the weirdos that is totally morphine intolerant. Because roughly 25% of people are some degree of morphine insensitive (
Riley et al. 2006), it is no longer preferentially used where I am from / have worked and if its use is planned during a procedure a pre-op challenge is generally conducted to avoid betting pain control on two coin flips not both being tails. I'd had no idea morphine was going to be used for pain control afterwards and no challenge was conducted, so
once the intraoperative fentanyl and propofol worked their way out of my system I was left with no pain control whatsoever for 2-3 hours with occasional screaming during muscle spasms. Hospital staff were unwilling to give me anything other than more morphine, which may as well have just been saline.
Eventually, after my spouse eventually managed to get through to Bowers on her personal cell phone number and with sufficient begging I was given a small amount of hydromorphone and my pain was brought back somewhat under control.
The remaining days in the hospital carried on with inadequate but not excruciating pain control.
Day 3: On the third day after bottom surgery (Friday) I was scheduled to be discharged from inpatient care and go back to the hotel where my wife was staying. My aftercare packet had made reference to a physical therapist that would assist me with walking before my discharge, but this never materialized. Regardless, I was able to walk with minimal difficulty and was picked up by my wife and driven back to our hotel room.
Night 3: Shortly after midnight
I woke up in the emergency department at the hospital where my surgery had been done with no memory of where I was or how I'd gotten there. My wife had found me in bed wrapped in blankets, clammy to the touch, and intermittently responsive complaining that I couldn't see. I had been taken by ambulance to the emergency department and it was discovered that I was bleeding internally. Some CBC values are included below for the sake of nerds like me.
Lab Value
RBC 2.4M/uL
Hemoglobin 8.1g/dL
Hematocrit 22%
I was sent back to the hotel with my spouse again shortly after regaining consciousness.
Day 7: By the time my post-operative appointment came around, Dr. Bowers had left the country so I was being seen by her physician's assistant instead.
I experienced a minor prolapse as the packing was removed, but was assured this would be fine as we were about to push it back in with the dilator. I was told that, during surgery, I had taken a SoulSource Orange #4 to 15cm of depth.
When Bowers' PA inserted the blue #2 dilator I was in severe pain and reached to my spouse for support in an attempt to avoid screaming again, but grabbed so hard I almost ripped their bicep off of the bone and they had to seek medical attention for the avulsion. My pain was disregarded by Bowers' PA and this was followed by being told to do Green #3 by myself. I mostly dissociated and followed orders for the first ~10cm or so; Bowers' PA pushed it in the rest of the depth for me when I couldn't manage it. I was sent back to the hotel room with dilators 2-4 with instructions to begin dilating the next day.
Day 10: Dilating had remained just as excruciating as the first day and by this point my lower left labia majora had become necrotic and was sloughing off. At one point while I was curled up sobbing while trying to dilate, my spouse had called Bowers' office and asked for me to be seen so I had another followup with her PA today. I had not been examined internally during my original postop, but
upon inspection this time it was remarked that I had significant wound dehiscence and large parts of my canal had no skin covering it at all, meaning I was sliding the dilator over muscle and fat. I was given a SoulSource purple #1 dilator to use instead of the blue #2 in hopes of putting less pressure on the exposed tissue. It helped mildly.
Day 13: Another followup with Bowers' PA. Dilation pain had not improved at all at this point.
My lower left labia majora had continued sloughing off of me. These problems were unaddressed. It was late February at this point and my complications were worsening continuously.
By this point I was in intense pain at all hours of the day. My closest point of reference for the pain was a gunshot wound I had experienced years prior.
12 Weeks: At this point I finally was able to establish care with an OB/GYN near me and got my first silver nitrate treatment for the granulation tissue that had been growing inside of my canal.
I had lost ~5cm of depth by this point. I have been seeing this OB/GYN every 2 weeks since this appointment (with some exception) and to date have had 12 granulation tissue treatments (excision and silver nitrate) with her with minimal improvement.
I was still dilating 3x per day as prescribed and consistently losing around 20-40mL of fresh blood every session (60-120mL per day) as estimated by myself using the MAR method, leaving me in a state of constant exhaustion and fatigue.
Bowers' remained more or less entirely dismissive of my pain and complications and still had not examined me.
At this point I had begun reaching out to other surgeons' offices to beg for help, but was told uniformly that I wouldn't be seen before 1 year postop.
19 Weeks: After months of begging, I was finally given followup appointment and saw Dr. Bowers for the first time since leaving the hospital.
She excised a roughly fist-sized volume of granulation tissue from my canal and treated it with silver nitrate. She was entirely dismissive of my concerns around losing a third of my depth and the constant GSW-esque pain I was in.
25 Weeks: After 2 more granulation tissue treatments with my OBGYN, it was obvious that more effort was needed and Bowers eventually conceded a second followup appointment.
By this point I had lost another 2cm of depth despite constant dilation as prescribed as measured by my OBGYN using a uterine sound.
Bowers excised and cauterized more granulation tissue and was still completely dismissive of all other issues.
35 Weeks: By this point,
Bowers had decided I needed a revision to fix what was wrong. My canal width had contracted so much I could no longer fit the purple #1 dilator at all. I was still in severe pain that had forced me to withdraw from all athletic competitions I had intended to participate in that year. At this point,
Bowers pressured me into also doing a cosmetic revision labiaplasty. I didn't trust her at the time, but I was desperate for any kind of relief, none of the other surgeons I had reached out to were willing to see me, I was in so much pain I was certain I wasn't going to survive 2025 without help, and was scared she wouldn't help me if I didn't let her because aesthetics are her obsession to the degree that all she ever really talked about during previous appointments was how good my result looked cosmetically.
I went to the surgery center and my spouse and I were both very insistent that there be no morphine involved. Thankfully, there was no morphine involved.
Unfortunately, it turned out I had been right to not trust Bowers. Cosmetically, the result has been significantly worsened by her revision, but appearances are the least of my problems right now. While
the granulation tissue was destroyed and my pain was temporarily massive reduced, it has since regrown and I now also have significant nerve damage and no longer have anything beyond deep pressure sensation in most parts of my vaginal canal.
50 Weeks (Time Of Writing): At this point,
the scarring is so extensive I only have ~3cm of usable vaginal depth remaining before hitting a band of scar tissue that restricts any stretching. My OB/GYN can no longer use even the smallest speculum in her office without actively holding it in for the entire exam. I am still in debilitating pain every day and have had to drop out of all athletics. I can barely stand long enough to cook a basic meal and feed myself. Thankfully, my job is remote and I've been able to walk the ~20 feet from my bed to my desk most days and phone in something good enough to not get fired.
The granulation tissue (the only complication that's actually been addressed in almost a year since my initial surgery) has returned and I am still dealing with bleeding and constant discharge.
Now that I'm almost a year out from my initial surgery, I have been reaching back out to other surgeons' offices in hopes that somebody can save me from this living hell. Bottom surgery has been the worst thing to ever happen to me. I feel betrayed, violated,
deeply regretful, and totally hopeless that any of this will get better.
My friends are burnt out from watching my mental and physical health decline over the past year as I've been forced out of my athletics and into a sedentary lifestyle by seemingly inescapable pain and my relationship with my spouse is severely strained. My life at this point consists almost entirely of sleeping, eating, and dissociating to escape the pain. I spend most days laying on my couch/beanbag/bed/floor and staring up at my ceiling as hours disappear in what feels like seconds.
It feels like I already died and I'm just waiting for my body to get the memo. I don't know what to do anymore or how I'm going to survive this.