I'm about 6 years post bottom surgery, and it's been good and bad.
I had issues with scarring for the first 12 months that made for a really difficult time dilating, and also meant that I wasn't able to have sexual interactions the way I was hoping to have them. I battled with that for a while, then covid came along, my mental health took a dive, and I stopped dilating.
Now, I'm effectively "zero depth".
And that all sounds bad right? But it's not. My dysphoria is gone. Clothes fit me the way they're meant to. I feel comfortable naked. I am comfortable in my skin in a way I couldn't be before bottom surgery. And sure, I can't have sex the way I want, but that was already true before I had bottom surgery, so even though I didn't get everything I hoped for, I am still way better off than I was before my bottom surgery.
Can you orgasm?
Yep!
Any unique hygiene issues?
Not really. Nothing comes to mind
What are some non-obvious post-surgery things that only become apparent when everything settles back into a routine?
Farts that roll up the front are a whole different experience :P
But more seriously, I don't really remember what "before" was like anymore. It's just normal life these days.