Dr Andrew Ives
Location
Melbourne, Australia. Operates out of Masada Hospital.
Costs (2025)
- Initial consultation: $400 AUD
- Surgery: $22,000 AUD
- Anaesthetist fee: $4,500 AUD
- Rebate: $2,000 AUD
- Hospital stay: ~$3,500 AUD
- Revision cost:?
2021 - “Cost was $19700 including surgery, consults, anesthetic and post-operative care. Hospital stay was covered by insurance, Medicare paid back $2466.”
Method and surgical experience
Performs Labiaplasty and Penilve Inversion Vaginoplasty.
- Presumably has performed a large amount of surgeries. Likely high hundreds.
Online reports of the experience
Dr Andrew Ives website
https://transsurgeryaustralia.com.au/
Naomi M’s experience
Why Dr Ives?
From the get go I felt like I wanted my surgeon to be based in Australia, I felt like having insurance, Medicare and that if there were any problems I would have easier safer access to ongoing care as opposed to potentially being ghosted by overseas providers. I chose Ives specifically because there are not many options in Aus and I felt like Ives had more experience/less drastic negative accounts then Dr Hart. This was solidified for me when I had my consultation with Ives, I felt he was a caring, detailed man who wanted the best for me. I had my consultation a few months after he returned to practice and I found out he had been on break due to burnout from managing the country wide care of the volcano victims in 2022 while catching up on the waitlist of trans patients. This made me feel safer in his hands. His specialist nurses, especially Iffy, were also lovely people who helped with every question and I felt I would be in good hands with them.
Why PIV?
I currently identify as asexual, I don’t know if it will change post op, but I never really cared for sex penetrative or otherwise. I didn’t choose zero depth because I have the foresight to leave myself options should my sexuality change with the removal of dysphoria and fear of judgement. As such I felt PIV was the option with the least complications or harder recovery. I didn’t care if I need lube or anything, just wanted to have the least chance of long term complications I could. It is also the only option Ives offers I believe (other than zero depth).
What was the process of getting to surgery?
I was very quick to contact Ives team upon return to practise so I got my appointments very quickly. I had a roughly 6 month turn around between consultation and surgery. This wait was purely for my own hair removal still being in process. I could have booked whenever. I have had gender marker change and HRT since 2018 as well as a formal gender dysphoria diagnosis and endocrinology specialist. There were not many barriers to surgery as such, just lots of paperwork.
Pre-op requirements?
- I was on the BMI limit at 97kg, 189cm. I was told to bring my weight down if I could but if it went up it might be cancelled. I managed to bring my weight down 3-4kg and they were satisfied with this.
- I had to get a WPATH assessment done, so I saw Dr Georgina Cheng for a one off appointment. She had seen me in 2018 for my gender dysphoria diagnosis so I was able to get an appointment with her fairly easily.
Costs?
All up costs were around 30k, I have gold cover with HIF which included full hospital stay. Surgeons fees were 22k, anaesthetist 4.5k, including accommodation pharmacy and various unpredictable costs it ended up around 30k all up. Medicare gave me a 2k rebate.
What was your timeline?
6 months of hair removal, surgery, 1 week in hospital, 1 week at a hotel near hospital, currently 2 weeks recovering at home. I was able to walk around the ward after 4 days, I started sitting up after the first week. I was walking when I should not have while at the hotel. In hindsight I should have laid down more. For four weeks I am self sufficient at home, I walk to the shops, catch a bus into the city for some hobby nights. Sit at my PC during the day.
How was recovery?
The first week was really hard, I hated having the tubes in me. My IV drip was more painful than my wound site. The catheter was uncomfortable. I was terrified of needing a bed pan or soiling myself. Luckily after all the picoprep I had no bowel movements till day 3 when I was able to use the toilet. Being naked around the nurses while they helped me, especially with showering. It was weird but I was so tired and unwell I just wanted to be clean and it was kind of liberating just being in my body and not feeling the dysphoria of the genitals I used to have. I am very quickly getting fed up with dilating. It’s been very easy for me to dilate from a physical perspective but the time taken out of my day makes me feel like I can’t do anything else, I am just planning around the hour process of dilator and bath morning and night. Wound dehiscence at the entrance of my vagina scared the fuck out of me when it happened. It was my first and only breakdown cry, it looked so so bad and I thought I was going to have to go back in and get it all sorted. My team just said ‘nah it’s fine happens all the time’. And this did not help me. I still felt awful. I ended up doing a heap of research and reading about other people’s experiences with it, as well as reading other hospital guides about it happening and this helped me a lot. It’s still not healed at week 4 and I don’t like it but it has never really hurt.
Were you given any recovery information?
My main guidelines are around dilating, 30 mins morning and evening, 15 minute salt bath each time. I started on a purple intimate rose dilator. I don’t particularly like it or hate it but after seeing some other dilators I have gotten worried it’s not as good as other options. I was instructed to try moving up to a green one at week 6 and no other dilators were provided so I assume I have to get my own if I want more depth. I was also given a strict regime of medication including lots of antibiotics (made me feel so sick), panadol, and diuretics. I was given a couple opioids, tapentadol and another stronger one. I have not used these at all as I haven’t had any pain like that. I was given wound care instructions which includes Ovestin (Estriol steroid cream) and Kenacomb for use on the dilator.
What was your doctor like to interact with?
Dr Andrew Ives has a peculiar personality. I can understand why some people struggle with him a lot. He is very awkward and a bit socially inept. Honestly nothing surprising to me for someone who has the career he is in. He can seem a bit uncaring and distant but I discovered through my nurses and some interactions just how much he cares about my wellbeing and recovery. In the lead up he asked me many times about depth and aesthetic goals, I always responded that I wanted a no complications surgery above all else and the rest was just pleasant extras. He didn’t seem to have a problem with this mindset, he was very happy with the depth results that we got. The nurses seemed happy with the visual result too but I don’t really know how to tell if it’s good or not lol. Nurse Iffy is a treat and I enjoyed interacting with her, sadly I believe she is retiring soon. I would find out through the nurses that Ives had been worried about my mental health and such, when I was emailing about my dehiscence and getting upset apparently he was checking in with them regularly to know how it was going. He gave me a hug when I had my last appointment before flying home and said some nice words. He never stopped being strange or awkward while I was there but I felt his kindness and care really came out through his actions. I did note at one point he commented “it’s the ones who listen to our care instructions that have the least complications” I am sure people have unavoidable issues all the time but for the most part my experience reflected those words. I listened, did as I was told and have had no issues so far.
How was the hospital?
I stayed at Masada hospital where Ives practices. The area is very interesting, St Kilda has the highest population of Jewish people in Australia and the street is full of good Jewish food, lots of bagel shops. The hospital was in the process of renovating the double rooms to single and as such I was in one end of a large mostly empty room that would have had two patients in it. They had not installed a privacy curtain or anything and at one point a kitchen staff missed the do not disturb sign and walked in to me getting my bum wiped by a nurse. Very awkward. The bathroom was spacious and nice, the shower was great. The beds were comfortable. The nursing team was a mixture of confused unhelpful nurses and some incredibly competent comforting nurses. My favourite nurse Anna truly made my time there much easier. She just knew what I needed and how to help me out. If you use the button to call someone and ask for anything you need it definitely helps. They had ABC on the ceiling TV which I enjoyed watching Guy Monts spelling bee on. The hospital food menu was expansive and looked great. I am vegan and they had a full, multiple option menu for me including plant based schnitzel. Unfortunately the antibiotics had me struggling to eat and the hospital food is still bland and unpleasant no matter how great the menu looks. I ended up having my mum bring me food from down the street quite a few times, lots of nice Indian food in the area. Getting zero sleep from the nurse checking on you all night was not fun. I did not meet the other girls in recovery there, I understand there were a few of us but there was no opportunity or place for socialising.
Did you have any complications?
The only complication so far is wound dehiscence at the posterior forchette. I was too active too quickly and pulled some stitches out and the area where my vaginal canal meets my perineum opened up a bit. It has only looked more open and worse since but between the nurses and researching online it’s just par for course and the only option is to wait it out. I was told to put a hanky corner over the spot to try protect it from the dilator a bit but I think it’s been more to protect my mental health, out of sight out of mind I guess. The clitoral hypersensitivity is the most annoying thing so far, the amount of discharge can feel concerning sometimes too.
Are there any resources that you found helpful?
- The womens college hospital site has a few PDFs about care and complications that I found informing in a way that worked better for me than my team saying don’t worry about it.
- Reddit trans surgery wiki of course.
Do you have any wisdom for the next person undergoing this process?
Work to reduce your expectations. If you are going into this procedure thinking about penetrative sex, feeling like a new person after, having your world changed. These things can happen, and might with time but you will feel like shit after this procedure. It sucks, recovery sucks, your life is completely disrupted, you can work towards goals but if you build your expectations around them you are going to have a much more distressing recovery. This process takes a long time to really show results. You will feel completely normal and unchanged physically while suffering the consequences of surgery and wonder why you even did it. The lack of dysphoria is great but it’s like appreciating not having a cold, as soon as the cold is gone you forget it even bothering you.
Regrets?
I regret not researching complications more. Wound dehiscence scared the shit out of me and I wish I’d been more prepared for it. I regret not resting more at the hotel and potentially avoiding wound dehiscence.