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Sexual
Reassignment / SRS Plastic Surgery Thailand |
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Average cost - Us$ 5000 - 6500 |
Sexual Reassignment Surgery -
MTF - SRS Cost includes
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Surgical Fee
Pre-surgery night and five nights
recuperation in hosptial.
Doctor's fee
Clinical interview/surgery
consultation
Psychological and psychiatric tests
(if necessary Surgical & Doctors Fee)
Post Operative Care
Medicine supplies: SRS Kit, Donut
pillow, two sizes of dilator, douche kit and one dozen medical grade
lubricants.
Post operative check-up at the
hospital during SRS recuperation.
Medical or SRS Certification
Guaranteed Satisfaction
There is no extra cost if any
correction or additional checkups are required. (Second stage SRS
like colon transposition vaginoplasty is not considered correction,
and will be separate fee). All post-operative aftercare throughout
the patient's lives are provided without cost.
Travel Arrangements
Hotel booking and free
Transportation between airport and hospital.
Half day leisure tour with guide
(exclusive of meals and transportation).
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Criteria
Patient must be at least age 18 years of age. Patients will require
permission from parents if under 20 years old.
Patients must be diagnosed with at least one of the following disorders:
gender identity disorder, gender dysphoria, or associated conditions
(anxiety, depression).
Patients must have undergone at least one year of antiandrogens or/and
hormones.
Patients are required to have lived full-time in the cross-gender role for
at least 1 year (supported by Identification Documents).
Patients must have approval from a psychiatrist (MD), psychiatric social
worker (PhD), or clinical psychologist (PhD).
Surgical Procedure
Sex change surgery with Dr. Saran Wannachamras bangkok, Thailand.
This procedure is a combination of a penile skin inversion and an immediate
full thickness skin graft. The vaginal canal and opening is created beneath
the urethral opening and prostate gland. Vaginal depth is of concern to most
patients. The most important factor in creating this depth is the amount of
penile shaft skin. The technique that lengthens the depth of the vagina is
using the full thickness skin graft from the scrotal. Hair on the scrotum
must be removed so that the skin graft is placed at the distal end of the
penile skin flap. This technique can lengthen the depth at least 2 more
inches.
A portion of the glans (head of the penis), with its nerves and vessels, is
converted into a clitoris. In so doing, the clitoris will be functional in
sensation as well as in appearance.
The excess erectile tissue around the urethra should be removed in order to
avoid symptoms that stem from engorged erectile tissue during sexual
arousal, that may result in the narrowing of the vaginal opening.
Colon transposition is used for patients who need more depth (exceeding 8
inches).
Duration of Operation
Three hours
Risks and Complications
Infections; Infections are usually only minor and do not cause pulmonary or
systemic infections.
Short Vagina; Depth usually reaches six inches and will continue to extend
after 6-12 months due to the maturation of scar tissue. In case of very
short vagina, the second operation can be done after 6 months by using the
sigmoid colon procedure .
Rectovagina Fistula; A very serious complication of SRS, where a hole
develops between the colon and the vagina.There are 3 out of 1000 + cases
all were well taken care of.
Other complications such as urethra vaginal fistula, Pulmonary
thromboembolism, extensive bleeding.
Side Effects of sex reassignment
surgery
Wound disruptsions. There will be strong tension in the area around the
fourchet of the new vagina perineum. Wound care will be required, but will
heal within one month.
Unable to urinate. Urination difficulty sometimes occurs after the urine
catheter is removed, due to the swollen stump at the opening of the
shortened urethra. In such cases, the urine catheter should be retained for
several more days. Eventually urination will return to normal.
Bleeding. You may experience oozing blood around the gauze dressing after
the first day after surgery due to bleeding through the stump of the
urethral opening. This may require repacking or suturing.
After Care
Before being discharged from the hospital to the hotel, a nurse will teach
you how to take care of your vagina and prescribe more medications. The
stiches will be removed after seven to ten days. You will then be able to
return home.
Recovery
The neovagina can function within 6 weeks.
Results
After 6 weeks of sex reassignment surgery, the patient should be able to
engage in neovaginal intercourse. During sexual arousal, there is some
vaginal lubrication - though in most cases the patient should apply
lubricant jelly at the vaginal opening prior to intercourse (as with
dilation). Typically during arousal, mild swelling of the urethral meatus
from excess corpus spongiosum may occur which can be corrected for cosmetic
improvement without additional cost if the patient returns to Thailand.
During sex, sensation at the vaginal opening, inner labia, and neoclitoris
can be comparable, and certainly more sustained after climax, than
previously in the male sex. It is essential to avoid any strenuous activity
which can complicate recovery.
Hospital Admission
Five nights admission to hospital.
Anesthetic
General anesthesia (you are asleep)
Post Operative Sex reassignment
surgery Care
After release from Hospital patient must follow patient instructions,
including:
(1) Dilating is the most important thing you can do to ensure the success of
your surgery. If the patient does not dialate responsibly, this can result
in the shortening of depth and width of the newly made vagina because of the
scar contracture.
(2) Failure to dilate properly can result in serious injury. You will be
instructed to gently dilate into the right direction after the vaginal
packing is removed.
(3) Dilation can be painful for the first weeks, but is essential for
developing maximum depth and ensuring post operative functioning of the
neovagina.
During the recovery period, after each dilation session: The wound should be
washed gently with Hibiscrub (pink colour) in the shower followed by
douching while seated in the toilet:
(i) douche proportion = 5-10 ml (cc) of Betadine solution mixed with bottled
water until container is full;
(ii) insert the douche to full depth, squeeze, and hold tightly the
container;
(iii) while holding tightly the container, extract the douche;
(iv) keep the wound dry and apply Betadine solution with cotton balls; and
(v) apply Kemicitine ointment with a cotton applicator. If there is some
bleeding, press or apply pressure with a dry cotton ball to the site for 15
minutes. During the first weeks after surgery, feminine napkins (tampons)
should be changed several times per day due to normal vaginal bleeding
during recovery.
After one month of SRS operation you will be required to start applying
Premarin cream to your neovagina. Apply two times a day to soften your
neovagina. This would generally takes around six months.
Patient can return to female hormones as before surgery after two weeks. You
should consult your endocrinologist to re-adjust the dosage. A sudden change
in hormone levels, for some individuals, may result in the fluctuation of
emotion.
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| Average Cost of
the Procedure
- Us$ 5000 - 6500 |
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