Dr. Davis has had a longstanding specialization in transgender procedures and has been performing gender procedures since the 1990s. He is a board-certified plastic surgeon whose particular surgical training at Stanford involved experience in this subspecialty under the tutelage of Dr. Donald Laub — a pioneer in the field. Since that time, he has worked with and trained other surgeons refining his expertise and broadening other surgeons’ exposure to this relatively under-represented area of surgical endeavors. He has operated both in the U.S. and internationally. Over the years, he has worked as part of a large multi-disciplinary team including therapists, fellow surgeons, and clinicians, as well as advocates in the transgender community to provide the highest level of care and the most advanced techniques to achieve his patient’s goals and desires. He is a member of WPATH (World Professional Association for Transgender Health), and has presented his work at multiple scientific and transgender-specific meetings.
Dr. Davis commonly performs a penile inversion vaginoplasty incorporating techniques and refinements from across the globe. The surgical goals are threefold, and patients can expect: 1) a sensitive and orgasmically functional clitoris and vaginal opening, 2) approximately 6 to 7 inches of vaginal depth, and 3) a natural and feminine appearance. While termed 'penile inversion', Dr. Davis's technique utilizes the penile skin just for the proximal portion and the opening of the vagina. The deeper portion of the vagina is formed using grafted scrotal skin. Using the time-honored plastic surgical principle of constructing analogous structures from like tissue, Dr. Davis creates the female counterparts from their male analogs. For example, the clitoris with it's accompanying sensory nerves and blood supply are derived from the sensitive glans penis tissue. The clitoral hood and inner labial lining and folds are derived from the prepuce or foreskin tissue. (Circumcised patients can still use the distal penile tissue to recreate these structures.) The labia majora are formed from the scrotal tissue, and so on. Embryologically many of these tissues can be considered analogous between the sexes. The urethra is shortened and placed in its correct anatomic position, residual surrounding urethral tissue is excised, and a fourchette is created at the inferior aspect of the vaginal orifice.
In preparation for any procedure. Dr. Davis and his staff will want to perform a complete history and physical and ensure you are in the best health possible to undergo a surgical procedure and anesthesia. It is vitally important to refrain from smoking or using any tobacco products for at least a month prior to your scheduled surgical date. In addition, we will require you to refrain from taking aspirin or any NSAID's (ibuprofen, and the like), all which can 'thin' the blood and lead to peri-operative bleeding. If you have other medical conditions of particular concern, these will be addressed in the weeks leading up to your surgery date also. We generally ask that you refrain for taking any herbal medicines, vitamin supplements, or iron or fiber containing products. In addition, the day prior to surgery, you will need to undergo a 'bowel prep' which essentially cleans out your intestinal system, and you will start a clear liquid diet that day also. Instructions can be found here:
Dr. Davis' prepFor those patients coming from out of town, there is additional information regarding local accomodations, directions, and the like in our FAQ section. Depending on your initial consultation via phone, FaceTime, Skype, or the like, you may be asked to obtain medical clearance or a History and Physical Examination by your regular hometown physician prior to arriving. That way, any required lab work is completed in advance of your arrival. In addition, it would be wise to plan at least a 10 - 14 day stay in the area, arriving a couple of days prior to your planned surgical date. Three weeks would be preferred, though, to allow early follow up and ensure that you are doing well with the post-operative dilations that are necessary. Obviously, these recommendations are highly variable and contigent on each patient's schedule and needs. In any eventuality, Dr. Davis is committed to stay in close touch, especially during the early post-operative period when healing well is essential, and during a time when patient's are getting acquainted with their new anatomy.
While, the surgical results are immediately apparent, it takes several weeks to months to heal completely. The groin will be quite swollen initially. Most patients can resume sexual activity in 2 to 3 months.
For the first several days post-operatively, patients remain in hospital with either light activity or bedrest. After approximately 5 days, Dr. Davis then removes the dressings and personally performs the first dilation with each patient, so that they are comfortable with the process. Patients can expect to begin dilating on a daily basis once the dressings are removed to maintain the vaginal size and depth. All healing in the body proceeds the same way, with collagen deposition and contraction. Without dilating, this process will result in the vagina closing down and shrinking. And, while some form of dilating is a life-long commitment post-operatively, the frequency can be greatly curtailed for most patients. However, for the first six months, it is very important to make time in your daily schedule for this critical activity.
Dr. Davis and his staff sees his patients frequently and regularly after their procedures. Healing properly and well is as important as the operative procedure toward achieving an excellent result. Dr. Davis is committed to excellent patient care and is always available for any future needs or questions that may arise.
