Last updated May 13, 2025 > [!important] Content Warning: > This article contains graphic medical images depicting post-operative care following nulloplasty surgery. These images include nudity and sensitive content related to genital reconstruction. Reader discretion is advised. The images are included for educational purposes to provide accurate information about the recovery process. If you are sensitive to such content, please proceed with caution. If you are not of legal age to view such content, please leave this page immediately. ![[IMG_0764.jpeg]] Hi! I’m `@borgpup`. I go by Axl. Not having a penis anymore is the best! Getting a nulloplasty was the most radical act of self-love and care I have ever taken. The month in San Francisco for its nulloplasty has come to a close and we have made it safely back home to Wisconsin. I tried to write this article in San Francisco, but things were still too much of a roller coaster on a day-to-day basis. Now that I’m home and have a little more recovery under my belt (day 31), it’s important to me to take the time to document an account of my surgical experience to the best of my ability while my memories are fresh. > [!important] [[Borgpup Pre-Op Nullo Q&A]] # _What was it really like to get surgery?_ Let me do my best to tell the story from the beginning. It was an incredible journey. Start to finish from making my decision to my August 9th surgery date, I got a nulloplasty in _nine weeks_. To date, every trans person I have interacted agreed that this is the fastest pace they have ever heard of. The [Crane Center](https://cranects.com) in San Francisco set me up with a video consult with my surgeon, Dr. Kenan Celtik, who took amazing care of me before, during, and after my surgery. My husband [@BayouGrizzly](https://www.x.com/bayougrizzly) took the entire month off work using FMLA to be my primary caregiver after surgery. 365 days ago, I still had no idea I would succeed at getting \#nullo surgery last year. From my earliest memories, I never felt comfortable having a penis. Even as a 4 year old in kindergarten, my stick figure drawings of myself had a dick; I was that self-conscious. I came out as gay at 17 and was a bottom's bottom from the beginning. Topping just didn't appeal; I never really enjoyed how that part of my body felt in the first place. In my mid-20s, I discovered that I loved being locked in chastity. Wearing a chastity cage was way better than nothing. Over the years, I probably went through two dozen different cages, of all different sizes, materials, and types. I always felt better locked, but none ever fit comfortably for long-term wear. I was always on the hunt for the "perfect" cage that fit better than the last. In summer 2023 l made a little pact with myself. I decided to finally invest in a custom cage from [Evotion Chastity](https://www.evotionchastity.com/). I chose the Orion with PA hook and catheter options. If this one didn’t work, I was going to look into getting bottom surgery. ![[IMG_3725.jpeg]] In May 2024, tragedy struck a family very close to me and reminded me that life is both short and finite. Getting bottom surgery always felt unattainable. The more I thought about it though, I realized that I have pretty good health insurance and that it would never get any easier. The most overwhelming part was figuring out where to start. Finding reliable information online was hard too. I learned the most from speaking with other nullos here on X. I was blessed with a supportive partner, [@bayougrizzly](www.x.com/bayougrizzly), and amazing guidance from people like [@versasspunk](www.x.com/versasspunk). ## So, just how does one navigate the US healthcare system to do this? Step 1: pick up the phone and call your health insurance company and ask “Does my plan cover gender affirming surgery procedures, provided that the normal WPATH criteria are met?” My insurance company said yes. Generally speaking, for US insurance to cover it, (1) you have to have been on hormone replacement therapy (either testosterone or estrogens) for at least a year + (2) have letters of support from two different therapists and from your hormone provider. My PCP was my hormone provider. Therapy was easier than it sounds. I just used my insurance’s telehealth option to get randomly connected with any therapist. Before our first meeting, I sent her a thorough intro letter saying, basically, “I’m here for a bottom surgery letter. Is this going to work?” Living in Wisconsin, I was afraid it would be hard to find supportive providers; it wasn’t. Therapist #1 had no problem writing my letter after 1 session. She also referred me to therapist #2 who was also elated to write my second letter after one session. So, it only took me 48 HOURS to have both letters of support in-hand. Before I could blink, the part of the process I feared the most was already over. Step 3 is finding a surgeon. This can be daunting. My default move here was to ask my PCP for a referral from my insurance to an in-network provider. After multiple failed attempts to reach a particular Chicago provider, I learned they were booked out for just the consult until 7 months later. Howard Brown Health in Chicago connected me with a “navigator” who stonewalled and pissed me off. They said that bottom surgery was impossible to get done in anything less than 6-12 months. I already had all my letters. Hold my bong, I said. > [!important] Spoiler: they were wrong. It only took a few days for me to connect with the Crane Center in San Francisco. A week later I had a telehealth consult and the next day I booked my surgery date for August. 9, 2024. They worked hard to secure an out-of-network exception for health insurance coverage. Navigating the US health system from start to finish only took nine weeks. I had good employer-provided health insurance, but $0 in the bank for this to start. In two months my old X account went from 300 to 6000 followers and I successfully raised the funds needed. I had to pay the out of pocket maximum for insurance, a hotel in SF for 28 nights, living expenses, travel expenses, and missed wages for my husband who took all of August off work to be my primary caregiver. None of us knew if any of this would work or not, but it did! ## Dickless Men Roundtable We recorded this the night before we left for California in August 2024. It’s worth a watch if you haven’t seen it yet! Come learn about five of our journeys into new configurations. > [!important] [[Dickless Men Roundtable]] # Sat. 2024-08-03 03:00 CST (D0) The journey begins with our Uber from our apartment in Waukesha, WI to O’Hare International Airport outside Chicago, IL. 5 minutes later: “Fuck I forgot my Nintendo Switch! Well too late now I guess…” ## **3 Aug 06:27 CST** As you can see, we made our flight. ![[ohare-flight1.png]] ![[IMG_0534.jpeg]] Final Penis on a Plane selfie 🫡 ![[2156bfdc-1e20-4194-806c-b2748de729aa.png]] ![[departing-flight-path-to-sf.png]] ## **3 Aug 08:51 PST (time change!)** Oakland and San Francisco begin to greet my sleep-deprived eyes as we descended to SFO. ![[IMG_0545.jpeg]] ![[IMG_0547.jpeg]] ![[Welcome_to_San_Francisco.jpeg]] ## **3 Aug 11:04 PST** The first travel wrinkle was discovering we had arrived half a day too early to check into the hotel with our luggage. So, our first mission was to find someplace reasonable to stow it for the day. After that, @bayougrizzly and I spent the day exploring. ![[IMG_0552.jpeg]] ## **3 Aug 12:32** The Eagle SF has landed. ![[5BF2C207-2A1C-484B-8B17-CA7902D734F4_1_105_c.jpeg]] ## **3 Aug, 2024 12:37** After talking online every day for months, I finally got to meet my Nullo Dad [@versasspunk](www.x.com/versasspunk) IRL! ![[IMG_0561.jpg]] ## **3 Aug 13:53** First time visiting the [MSL](www.mr-s-leather.com) Flagship in person, since we were already in the neighborhood. ![[IMG_0558.jpeg]] ![[IMG_0559.jpeg]] ## **3 Aug 15:00** We stayed at the Cathedral Hill Hotel in the Tenderloin for 28 nights. The amenities were sparse, as expected for the price. The staff went above and beyond to help take care of me after surgery. The hotel was located four blocks from St. Francis Memorial Hospital (surgery site), for immediate accessibility in the event of any post-surgery complications. An Airbnb would have made it easier to cook and take care of myself after surgery, but we happily made it work with the resources we had available. Everything we needed was within a few blocks. ![[IMG_0564.jpeg]] ## 3 Aug, 2024 17:47 Knowing the level of belligerently painful fuckery I was only 5.5 days away from surely starting, my next major mission was stocking up on San Francisco’s finest fresh produce for pain management. This was the absolute best choice I made on this trip, dear readers. Please note the THC in 20mg _tablet_ form. ![[IMG_0565.jpeg]] ![[IMG_0566.jpeg]] ![[LIGHTS_OUT.jpeg]] ## 3 Aug 21:07 After being awake for close to 48 hours, I crashed out hard. ![[IMG_0575.jpeg]] ![[IMG_0574.jpeg]] # **Sun. 2024-08-04 (D1, T-5 days)** GOOD MORNING BAY AREA WEATHER: ![[IMG_0578.png]] ## 4 Aug 11:27 Quiet day. Had a great ramen lunch with [@versasspunk](www.x.com/versasspunk)! ![[IMG_0585.jpeg]] ![[IMG_0588.jpeg]] ## **4 Aug 14:52** So tired moar sleepz plz. ![[IMG_0591.jpeg]] ![[F880D21E-5009-464B-BC20-957637D28C20.jpg]] # **Mon. 2024-08-05 - (D2, T-4 days)** @versasspunk and I cloned my willy for the first and also last time. Slept the entire rest of the day. I slept a LOT on this trip; I didn’t sleep much in July. Recurring theme! ![[telegram-video-5-5012694504830928001.mov]] ![[-3416243289199225080.mp4]] # **Tue 2024-08-06 (D3, T-3 days)** Big day! Pre-op appointment with the Crane Center in Greenbrae, CA, 30 min north of SF. Attempt #1 to record the Golden Gate Bridge was unsuccessful. All clear for surgery! <iframe src="https://drive.google.com/file/d/1NuxKP_FW7VsDRwMor3hf6YjmGF6uqGk-/preview" width="640" height="480" allow="autoplay"></iframe> # **Wed. 2024-08-07 (D4, T-2 days)** Slept in, followed by a gorgeous afternoon drone flight, followed by photo shoot 1/2 with @versasspunk by @photobydot2. I was happy but also ready for the waiting to be over. <iframe src="https://drive.google.com/file/d/1p79CfrsZzsszdmVmWITX_8Q_wtIFouya/preview" width="640" height="480" allow="autoplay"></iframe> ![[IMG_0631.jpeg]] ![[IMG_0633.jpeg]] # **Thu. 2024-08-08 (D5, T-1 day)** Last day before surgery! Bright and I met IRL for the first time for coffee! ![[IMG_0646.jpeg]] Spent the afternoon getting all of my surgery supplies in order. The best part the last night before surgery was getting the first round of photos back from Dot (www.photobydot.com)! This was the first of two photo shoots, so there’s more to come later! ![[www.PhotoByDot.com.jpg]] ![[www.PhotoByDot.com 1.jpg]] ![[www.PhotoByDot.com 2.jpg]] ![[www.PhotoByDot.com 3.jpg]] ![[www.PhotoByDot.com 4.jpg]] ![[www.PhotoByDot.com 5.jpg]] ![[www.PhotoByDot.com 6.jpg]] ![[www.PhotoByDot.com 7.jpg]] ![[www.PhotoByDot.com 8.jpg]] ![[www.PhotoByDot.com 9.jpg]] ## Surgery Day: Friday, 9 August, 2024 (Day 0) The night before surgery was pretty rough. I tried so hard to get at least a little bit of sleep, but that did _not_ happen. I never really told anyone about this part until very recently. In the hotel room that we shared a wall with, a dozen or so people decided to throw a rave until about 4 AM, so I got zero minutes of sleep before surgery. It got worse too. Having resigned myself to sleeplessness, I tried to take my pre-surgery shower. All I wanted to do was warm up and jerk off one last time. There was no hot water. The shower was ICE COLD. I completely lost my shit and had a full nervous breakdown in the fetal position on my tiny bathroom floor. So, that final wank never happened either. After my husband helped me recover and gather my essential belongings, we made our way over to St. Francis Memorial Hospital. I showed up for surgery at 05:30. By 07:00 I was already under general anesthesia. As awful and not ideal as my night before was, my surgery still happened. Nowadays, my advice to people anxious going into bottom surgery is simple: “All you have to do is not eat, have clean bowels, and show up on time. If you can manage those three things, the rest is taken care of for you.” Sure enough, I showed up, they prepped me for surgery, put me under, and when I woke up it was finally over. ![[IMG_0680.jpeg]] My nullo crotch was born! ![[nullo-crotch-born.png]] Then I fell back asleep again, because drugs, except for the nurses waking my grumpy ass every two hours to check my vitals. Thank you nurses. ## Saturday, 10 August, 2024 (Nullo Day 1) My surgeon only kept me in the hospital overnight. The next morning, my Physician’s Assistant, Alex, stopped by to remove the wildly restrictive and uncomfortable compression bandage on my crotch, as shown above. I had him take this picture on my iPhone so that I could really see it. Me and all of Twitter got to see my new nullo crotch for the first time. I had a catheter for four days. I named my bag Wilson - yes, like in Cast Away. ![[first-postop-nullo-photo.png]] ![[catheter-bag.png]] ## Sunday, 11 August, 2024 (Nullo Day 2) The first shower after surgery felt fucking amazing after my ice cold horror show just before surgery. It helped loosen up some of the sticky surgical glue from the compression dressing. ![[2024-08-11-1.png]] I was incredibly sore from bruising caused by the compression dressing, more so than from the surgery itself, as you can clearly see here: ![[IMG_0695.jpeg]] ![[2024-08-11-2.png]] ## Monday, 12 August, 2024 (Nullo Day 3) ![[2024-08-12-1.png]] ## Tuesday, 13 August, 2024 (Nullo Day 4) First post-op appointment in Greenbrae. This time, I was all about trying to capture footage of the Golden Gate Bridge. ![[D1B232C4-A275-45D0-8390-28DB9D690B27.mov]] My catheter was finally out. It was convenient not needing to get out of bed to urinate, but the bladder spasms the last few days were extremely painful. I was delighted it was gone! ![[2024-08-13-1.png]] ![[2024-08-13-2.png]] ![[2024-08-13-3.png]] ## Wednesday, 14 August, 2024 (Nullo Day 5) ![[IMG_0794.jpeg]] ![[IMG_0791.jpeg]] ![[IMG_0813.jpeg]] [@Versasspunk](www.x.com/versasspunk) dropped in for a lovely little visit. ![[DD3D3725-A704-48F8-A58A-138A45319EF5_1_102_o.jpeg]] ![[IMG_0830.jpeg]] ![[IMG_0834.jpeg]] # **Thursday, 15 August, 2024 (Nullo Day 6)** I was starting to have some major nerve pain issues from my orchiectomy, on the right side specifically. Over the course of the day, it turned into a full blown 10/10 pain flare that ended up with me in the ER to get stabilized. It was a few inches to the right of my incision line, almost at the top of my right leg. It was a wretched few hours, but we got through it. ![[IMG_0878.jpeg]] ![[IMG_0873.jpeg]] # Friday, 16 August, 2024 (Nullo Day 7) Healing great, but very swollen. ![[2024-08-16-1.png]] # Saturday, 17 August, 2024 (Nullo Day 8) I felt much better than the day before. I spent a **LOT** of time in my hotel room without very much to do. ![[image 11.png]] ![[image 12.png]] ![[IMG_0909.jpeg]] # Sunday, 18 August, 2024 (Nullo Day 9) ![[image 13.png]] # Monday, 19 August, 2024 (Nullo Day 10) By Monday, I felt decent enough to actually go on a little adventure to the Mission with my husband. I was sore AF but still on the mend. ![[image 14.png]] ![[image 15.png]] ![[IMG_0931.jpeg]] ![[IMG_0933.jpeg]] ![[image 16.png]] ![[IMG_0937.jpeg]] ![[image 17.png]] ![[IMG_0934.jpeg]] # Tuesday, 20 August, 2024 (Nullo Day 11) Second follow-up appointment. Everything was fine. ![[image 18.png]] ![[IMG_1038.jpeg]] The [Crane Center](https://www.cranects.com) took better care of me than any other health provider in my entire life. ![[CRANE_CENTER.jpeg]] ![[MDE.jpeg]] ![[GENDER_AFFIRMATION_ON_YOUR_TERMS!.jpeg]] ![[IMG_1194.jpeg]] ![[A5AFB61C-BF24-4CEF-8038-7F1175921485_1_102_o.jpeg]] ![[EA38655D-A3C5-4DA9-A200-526F41541648_1_102_o.jpeg]] <iframe src="https://drive.google.com/file/d/1gNUjelh4Mt6YOiN8RBugjb6nQzzVih4Y/preview" width="640" height="480" allow="autoplay"></iframe> ![[IMG_1064.jpeg]] # Wednesday, 21 August, 2024 (Nullo Day 12) ![[image 19.png]] ![[image 20.png]] ## Thursday, 22 August, 2024 (Nullo Day 13) ![[image 21.png]] # **Friday, 23 August, 2024 (Nullo Day 14) - Saturday, 24 August, 2024 (Nullo Day 15)** ![[IMG_1154.jpeg]] ![[IMG_1156.jpeg]] ![[IMG_1161.jpeg]] ## Sunday, 25 August, 2024 (Nullo Day 16) ![[image 22.png]] ![[IMG_1165.jpeg]] ## Post-op photo shoot!! ![[www.PhotoByDot.com 10.jpg]] ![[www.PhotoByDot.com 11.jpg]] ![[www.PhotoByDot.com 12.jpg]] ![[www.PhotoByDot.com 13.jpg]] ![[IMG_1213.jpg]] ![[www.PhotoByDot.com 14.jpg]] ![[www.PhotoByDot.com 15.jpg]] ![[www.PhotoByDot.com 16.jpg]] ![[www.PhotoByDot.com 17.jpg]] ## Monday, 26 August, 2024 (Nullo Day 17) Final (scheduled) post-op appointment! ![[IMG_1285.jpeg]] <iframe src="https://drive.google.com/file/d/1pktk32Ne0Ye21xAODw9-0hEhBwvVeLF9/preview" width="640" height="480" allow="autoplay"></iframe> ## Tuesday, 27 August, 2024 (Nullo Day 18) I thought that Monday was the last time I would see my friends at the Crane Center in person again. It was not. I took my morning selfie and noticed a stitch that was ready to come out. It came right out, but so did a bunch of other fluid too. After treating a UTI the day before, we then had to rush back to Greenbrae to treat a potential abscess/fluid pocket. I nailed my shot of the Golden Gate Bridge through the sunroof of our Uber on the way to the clinic this time. <iframe src="https://drive.google.com/file/d/1SphDSkuMG49m9ajjCcwtN33Zby4Fiz3M/preview" width="640" height="480" allow="autoplay"></iframe> ![[IMG_1307.jpeg]] ![[IMG_1306.jpeg]] ## Wednesday, 28 August, 2024 (Nullo Day 19) Adventure time! ![[image 23.png]] ![[IMG_1317.jpeg]] ![[IMG_1318.jpeg]] ![[IMG_1344.jpeg]] ## Thursday, 29 August, 2024 (Nullo Day 20) ![[image 24.png]] ![[image 25.png]] I was missing my baby boy so much. It was almost time to leave San Francisco. I didn’t want to go, but I also knew I would be more comfortable being in my own apartment instead of a hotel room in the Tenderloin. ![[IMG_1387.png]] ## Friday, 30 August, 2024 (Nullo Day 21) Versasspunk and I got to spend a little more time together before going home. <iframe src="https://drive.google.com/file/d/19VMgjyYU3f5fShML2o2qeTx6Kk163XQY/preview" width="640" height="480" allow="autoplay"></iframe> I was sad to leave, but was doing and healing so well. ![[image 26.png]] ![[image 27.png]] ![[image 28.png]] ![[IMG_1441.jpeg]] Thank you, San Francisco. <iframe src="https://drive.google.com/file/d/1QCVLIR6A1J0zAzc-ncZij426DfX3ixLY/preview" width="640" height="480" allow="autoplay"></iframe> ## Saturday, 31 August, 2024 (Nullo Day 22) Bye San Francisco. Until next time! ![[IMG_1463.jpeg]] ![[IMG_1464.jpeg]] Wheelchair service at the airport is the best! ![[IMG_1467.mov]] <iframe src="https://drive.google.com/file/d/1wVymUExyprz-Vlx570pOHEmmOPsK2DaV/preview" width="640" height="480" allow="autoplay"></iframe> ![[IMG_1469.jpeg]] ![[AE201A59-CED4-46B9-9450-1A00D8D3E722_1_102_o.jpeg]] ![[37A147D5-1E72-4508-A074-E7F61BB538D2_1_102_o.jpeg]] ![[55E858C1-5BDB-48BC-A6C9-F8BE7CF2FCD5_1_105_c.jpeg]] ## Home Sweet Chicago. <iframe src="https://drive.google.com/file/d/1SRv-zmKRAKo47pLpewMM5gKCiVVatGTY/preview" width="640" height="480" allow="autoplay"></iframe> <iframe src="https://drive.google.com/file/d/1G77oh91NQIopCHaShbktvgcjZBIE6Fdk/preview" width="640" height="480" allow="autoplay"></iframe> Another two hours of travel later, and we were finally home and reunited with Mr. Chase at last! ![[IMG_1506.mov]] <iframe src="https://drive.google.com/file/d/1fo6QuI1f3NjP2cu3OxVFMuJTpoTLml2b/preview" width="640" height="480" allow="autoplay"></iframe> ![[image 29.png]]