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MTF Sex Reassignment Surgery in Bangkok, Thailand

Male to Female Sex Reassignment Surgery involves remodeling the male genitals into a form with the appearance of, and the function of female genitalia.

What is Male to Female Sex Reassignment Surgery?

Male to Female Sex Reassignment Surgery involves remodeling the male genitals into a form with the appearance of, and the function of female genitalia. Before any surgery, patients usually undergo hormone replacement therapy (HRT) and depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures.

Male to Female Surgery

Feminizing modification of the genitalia in males diagnosed with Gender Identity Disorder is possible upon submission of required supporting documents (see Special Requirements section).  The surgery aims to create a visually realistic and functional female genital anatomy complete with labia, clitoris, and vaginal canal.

The new clitoris is fashioned from a portion of the sensitive penile head (glans penis). It has its own nerve and blood supply, enabling sensitivity to sexual stimulation, arousal, and orgasm.

The neo-vagina is typically 5-7 inches deep and is made by Penile Skin Inversiontechnique if the length of the penis is adequate, or by Colon Vaginoplasty technique in cases of inadequate penile length.  As with biological females, this new vaginal canal is located between the urethra and the rectum.

Male to Female Surgery – Special Requirements

You need to be of legal age, in good health and must submit the following requirements before your pre-surgical assessment for SRS MTF

1. Letter of recommendation from two psychiatrists (one from a psychiatrist in the patient own locality and two from our psychiatrists) stating the following:

Diagnosis of a female with Gender Identity Disorder

Declaration of successful real-life experience as a male for at least 1 year

Certified psychiatrists issue this letter to individuals who meet the criteria of the Harry Benjamin International Gender Dysphoria Association

2. The medical certificate with details of male hormone therapy

Hormone intake must be prescribed and monitored by a licensed physician

Hormones have been taken for 1 year

What to Expect from Surgery?

The plastic surgery undertaken to reassign the patient’s sex from male to female involves the use of skin, tissues and sexual sensory nerves of the patient to transform the male sexual organ into a female sexual organ that is perfect in the following ways

1. Transform the sexual organ to that which is most similar to the female sexual organ.

2. The surgery will enable the patient to have as deep a vagina as her skin or the harvested colon graft would permit.

3. All sexual sensory nerves would remain intact in the female clitoris so as to have normal sexual sensations in this area.

4. Plastic surgery must be undertaken to hide the wound so that there is the least chance of it being visible.

Sex Reassignment Surgery Techniques:

1. General anesthesia is applied to the patient by an anesthesiologist.

2. A new vagina is formed between the anus and the urinary tract, approximately 5-7 inches deep.

3. The skin covering the penis is used to construct the inner labia, and a vaginal wall is consequently covered with either skin graft from scrotum or harvested sigmoid colon graft.

4. The core of the penis is removed, and the sexual sensory nerves are kept for use in creating the clitoris.

5. The testicles are removed to decrease male hormones.

6. The male urinary tract is shortened and shaped so that urine can flow out in the same manner as women. If the surgery has not been properly undertaken, urine may shoot up when urinating in sitting position.

7. The exterior parts such as the major labia, minor labia, urinary tract and clitoris are reconstructed to look beautiful and perfect as a female sexual organ which can still experience sexual sensations.

Sex Reassignment Procedures

Sex Reassignment Surgery methods available to construct new vagina and clitoris are as follow

1. General anesthesia is applied to the patient by an anesthesiologist.

2. A new vagina is formed between the anus and the urinary tract, approximately 5-7 inches deep.

3. The skin covering the penis is used to construct the inner labia, and a vaginal wall is consequently covered with either skin graft from scrotum or harvested sigmoid colon graft.

4. The core of the penis is removed, and the sexual sensory nerves are kept for use in creating the clitoris.

5. The testicles are removed to decrease male hormones.

6. The male urinary tract is shortened and shaped so that urine can flow out in the same manner as women. If the surgery has not been properly undertaken, urine may shoot up when urinating in sitting position.

7. The exterior parts such as the major labia, minor labia, urinary tract and clitoris are reconstructed to look beautiful and perfect as a female sexual organ which can still experience sexual sensations.

SRS-1 Vaginoplasty without vaginal depth:

The technique involves using penile skin and scrotum to construct the external genitalia such as inner and outer labia, neo clitoris and clitoral hood, and female urethra. Because penile skin is used to construct the inner labia and clitoral hood, the vaginal depth is very insufficient unless skin graft is covered intra vagina. This procedure is suitable for who those do not need vaginal penetration of sexual intercourse and unwanted vaginal dilation and vaginal douche for life.

SRS-2 Vaginoplasty with skin graft

This technique involves using penile skin and scrotal skin to create both external genitalia, such as inner and outer labia, neo clitoris and clitoral hood, female urethra and the vagina.

   In case of scrotal skin deficiency, the vagina depth is still not satisfactory to the patient and then the plastic surgeon will consider using skin graft from other areas such as the groin or lower abdomen to further increase the depth of the vagina.

The operation time generally takes about 4-6 hours to complete.

Advantages:

This technique provides a one stage operation with full function and aesthetic. Most patients do not need more additional touch up procedure. The procedure enables them to possess the desired deep vagina as well.

Disadvantage

This technique is not suitable for those who have deficient skin. The patient might need hair removal at the penile shaft prior to surgery, to avoid intra vagina hair growth. In addition, skin graft might be added for the extra depth

SRS-3 The Sigmoid Colon Vaginoplasty:

This technique is used in the case where patients have short penises, or to assist patients whose vaginas have become stricture. This can also be used in patients who have never undergone sex reassignment surgery. The vagina which is made by a part of colon will have good lubricant and optimal depth.

Advantages:

1. This technique is beneficial for patients who have previously undergone sex reassignment surgery, whose vaginas have become stricture, and are unable to perform sexual intercourse.

2. It also helps patients with very short penises. In this regard, the surgeon will have already decided that the skin graft technique cannot be performed.

3. The vagina has a natural lubricant.

4. It is possible to determine the depth of the newly constructed vagina.

Disadvantages and limitations:

1. In open technique, a scar can be visible at the bikini line, just above the left side of the pubis.

2. The surgery is more complicated, with invasive procedures, such as cutting off parts of the colon, and the colon must be thoroughly cleansed (by an enema) one day prior to the surgery.

3. The patient may experience dyspepsia/indigestion symptoms 3-5 days after the surgery.

4. Both open and laparoscopic techniques are not suitable for those who are overweight or have fatty abdomens. The patient who requests for sigmoid colon SRS needs physical examination prior to make a final decision for surgery.

Post-Operative Care for non-colon SRS:

The patient must be hospitalized for 4-6 days depending on the technique. For the healing process to be complete and successful, patients are advised to:

1. During the first two days after surgery, patient must not take food that has fiber contents and beverages such as fruit juice, milk, and yogurt as these will trigger waste excretion. It may lead to contamination of the wound by the feces.

2. During the first 1-2 days after the surgery, patient should lie on her back, with hips raised and legs slightly apart as this will help reduce swelling.

3. On the third day after the surgery, patient may lie on her side.

4. On the third day after the surgery, surgeon will remove the draining tube, open and dress the wound. Patients who have undergone Sex Reassignment Surgery with Skin Graft or Sex Reassignment Surgery with Colon Graft, must remain in bed until day six when the urine catheter will be removed.

5. On the sixth day after surgery, patients of Sex Reassignment Surgery with Skin Graft surgery will have their urine catheter removed. The wound will then be dressed, and patient may be transferred to the serviced apartment for further recovery.

6. Patient needs dilation of the vagina using dilators. In order for the patient to maintain the width and depth of the vagina, patient should dilate the vagina at least twice a day for about half an hour each time. This process can be done at the serviced apartment.

7. The patient must clean the wound, as well as dilate the vagina at least twice a day until the external wound and that in the vagina are fully healed.

8. The patient must refrain from sexual intercourse for at least three months.

9. The patient must ensure that she keeps her appointment with the doctor once a week for a period of one month to maintain satisfactory results of the surgery.

 

PostOperative Care for SRS-Sigmoid colon:

1. During the first three days, patient cannot eat or drink until the intestinal function is recovered. In this period, the patients will have fluid via intra venous lines.

2. Patient needs to avoid bulk food in the first month.

3. Patient can do light activity after three weeks and resume normal daily activity at the third months.

4. Patient who has sex reassignment surgery with sigmoid colon graft must refrain from drinking water or taking any food until she can pass gases. Thereafter, patient may sip a small amount of water or take soft food. If the food is taken too quickly, indigestion or dyspepsia symptoms may occur. Therefore, the patient of this technique must strictly abide by the recommendations of the doctors and nurses.

MTF sex assignment surgery

Breast Augmentation / Breast Implant Surgery in Bangkok, Thailand

            Breast augmentation is a common procedure performed by plastic surgeons, using breast implants that are placed sub-muscularly via an incision under the breast or around the areola. Although the technique is mostly the same as a mammoplasty augmentation in natural women, there are important anatomical differences between male and female chests in the case of male-to-female transsexual. Compare to natural women, breast envelope of the male-to-female transsexual is often undeveloped and tight so there may be less lipomatous tissue. Therefore, it greatly depends of the surgeon’s expertise and experiences to navigate through these limitations to achieve the best possible result for male-to-female transsexual.

            Male-to-female transsexual patients should be aware that the surgery cannot perfectly recreate natural breasts of natural grown-up women, especially if they already exhibit age-related bodily changes. In most cases of male-to-female transsexual, cleavage proves to be the very hard to create.

Incisions of Breast Augmentation  ​: 

1. Transaxillary
2. Peri-areola
3. Inframammary

Preparing for a Breast Augmentation in Thailand

Your surgeon, through our virtual consultation, will provide you with a list of instructions on what to do before your surgery. These will cover such areas as smoking, medications, what to bring with you to the hospital and when to have your last meal before surgery. It is of utmost importance that you follow these instructions, and the ones you will be given after your surgery. Your speedy recovery and health should be your number one priority. You will have to strictly follow these instructions before your breast enlargement surgery.

These are as follows

For smokers: STOP smoking two weeks before surgery. You will need another two weeks after surgery to start smoking. Smoking increases the risks of complications. Chemicals present in smoke act as free radicals which interferes with the healing process. Prolonged healing may result in the formation of large, hideous scars. If your surgeon finds out that you are still smoking, he will not perform the surgery. Stop drinking alcoholic beverages a week before your surgery. The day before your surgery, do not drink alcohol and make sure you do not eat or drink anything at least six hours before your operation. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding Know in advance that this procedure requires the absence of breast milk. Breast milk may contain bacteria which can contaminate the implant and trigger infection or capsular contracture. It is advisable to wait for three months. Your breast can also produce milk if you’re taking birth control pills or hormones. Stop taking these pills at least two weeks before surgery.

Preparing for a Breast Augmentation in Thailand

Your surgeon, through our virtual consultation, will provide you with a list of instructions on what to do before your surgery.

These will cover such areas as smoking, medications, what to bring with you to the hospital and when to have your last meal before surgery.

It is of utmost importance that you follow these instructions, and the ones you will be given after your surgery. Your speedy recovery and health should be your number one priority.

You will have to strictly follow these instructions before your breast enlargement surgery.

These are as follows:

For smokers: STOP smoking two weeks before surgery. You will need another two weeks after surgery to start smoking. Smoking increases the risks of complications. Chemicals present in smoke act as free radicals which interferes with the healing process. Prolonged healing may result in the formation of large, hideous scars. If your surgeon finds out that you are still smoking, he will not perform the surgery.

Stop drinking alcoholic beverages a week before your surgery.

The day before your surgery, do not drink alcohol and make sure you do not eat or drink anything at least six hours before your operation.

Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Know in advance that this procedure requires the absence of breast milk. Breast milk may contain bacteria which can contaminate the implant and trigger infection or capsular contracture. It is advisable to wait for three months. Your breast can also produce milk if you’re taking birth control pills or hormones. Stop taking these pills at least two weeks before surgery.

Breast Enlargement Surgery Risks
Risks of this procedure will include:

  • Bleeding and hematoma formation.
  • Fluid accumulation.
  • Infection.
  • Poor healing of incisions.
  • Keloid and hypertrophic scar formation.
  • Changes in nipple or breast sensation which may be temporary or permanent.
  • Breast asymmetry.
  • Capsular contracture.
  • Implant leakage or rupture.
  • Rippling (wrinkling of the skin over the implant).
  • Pain, which may persist.
  • Risks associated with anesthesia and possibility of revisional surgery.
  • Post-Operative Care for Breast Enlargement Surgery
  • Get enough rest; avoid alcohol and smoking for at least 1 month.
  • Start ambulating as soon as possible.
  • Avoid strenuous activities for 4 weeks.
  • Refrain from physical contact with breasts for 3-4 weeks.
  • May shower 48 hours after removal of drain tubes.
  • Only support bras without wire should be used after sutures are removed.
  • According to doctor’s instructions, bras may be worn about 1-2 weeks after surgery when most of the swelling has gone down. Support bras are recommended to maintain breast shape.
  • May wear bra with wire, 4-6 months after surgery.

*The surgery will last for about 1-2 hours and is performed under general anesthesia.

Breast Massage

Proper breast massage is very important after breast augmentation in Thailand, in order to achieve a good breast shape and lower the risk of capsular contractures. During follow- up, the surgeon will instruct her on the proper way this is done. However, the occurrence of capsular contractures is also dependent on the body’s healing process after surgery and this condition can still occur even with proper massage.

Breast Massage Procedure

Position 1: Use both hands to gently push both breasts to bring them closer together.

Position 2: Push breasts away from each other.

Position 3: Push both breasts downwards.

Position 4: Push both breasts upwards.

Note: Massage gently to all 4 positions and repeat as many times as directed.

FTM sex reassingment surgery

FTM Reassignment Surgery (Phalloplasty)

Female to Male Sex Reassignment Surgery includes a range of surgical procedures that alter anatomical characters to provide physical traits more comfortable to the transgender male identity and functioning.

Female to Male Sex Reassignment Surgery

Surgical modification of the female primary and secondary sexual anatomy into masculine features is a series of procedures that can take about a year or more to complete.  Biological females diagnosed with Gender Identity Disorder may be eligible for this surgery upon submission of required supporting documents (see Special Requirements section).

There are three stages in the female to male sex change surgery separated by 3-6 months interval.

Female to Male Sex Reassignment Surgery includes a range of surgical procedures that alter anatomical characters to provide physical traits more comfortable to the transgender male identity and functioning.

Female to Male Sex Reassignment Surgery

Surgical modification of the female primary and secondary sexual anatomy into masculine features is a series of procedures that can take about a year or more to complete.  Biological females diagnosed with Gender Identity Disorder may be eligible for this surgery upon submission of required supporting documents (see Special Requirements section).

There are three stages in the female to male sex change surgery separated by 3-6 months interval.

FEMALE TO MALE SURGERY – STAGE 1
Mastectomy

A surgical procedure that removes breast tissue to achieve a masculine chest contour.  The surgical technique will depend on the volume of breast tissue and skin to be excised.

Total Abdominal Hysterectomy with Salpingo-Oophorectomy (TAHBSO)

A surgical procedure that removes the internal reproductive organs namely, uterus, fallopian tubes, and ovaries.

FEMALE TO MALE SURGERY – STAGE 2
Vaginectomy and Urethral Lengthening

Surgery that obliterates the vaginal cavity and lengthens the urethra in preparation for incorporation into the new penis in the third stage.  This gives the patient the ability to urinate effectively in the standing position.

Urethral prefabrication

Preparation of a new penile graft in the forearm with an embedded catheter which will serve as a functional intra-penile urethra after the third stage

FEMALE TO MALE SURGERY – STAGE 3
Total Phalloplasty

The forearm penile graft prepared during the second stage surgery is transferred to the genital area.  Nerves and blood vessels are conserved so the penis has sensation.  The new penis is expected to function as a male excretory organ for urine.  With the aid of an erectile prosthetic device, it can also achieve penetration during sexual intercourse.

During this procedure, the labia majora are converted into scrotal sacs.  The patient may opt to have prosthetic testes inserted in the scrotal sacs in a future surgery.

FEMALE TO MALE – SPECIAL REQUIREMENTS

You need to be of legal age, in good health and must submit the following requirements before your pre-surgical assessment for SRS-FTM

Letter of recommendation from two psychiatrists (one from a psychiatrist in the patient’s own locality and two from our psychiatrists) stating the following:

Diagnosis of a female with Gender Identity Disorder

Declaration of successful real-life experience as a male for at least 1 year

Certified psychiatrists issue this letter to individuals who meet the criteria of the Harry Benjamin International Gender Dysphoria Association

The medical certificate with details of male hormone therapy

Hormone intake must be prescribed and monitored by a licensed physician

Hormones have been taken for 1 year.

FTM sex reassingment surgery

FTM Sex Reassignment Surgery (Metoidplasty)

Female to Male Sex Reassignment Surgery includes a range of surgical procedures that alter anatomical characters to provide physical traits more comfortable to the transgender male identity and functioning.

Female to Male Sex Reassignment Surgery

Surgical modification of the female primary and secondary sexual anatomy into     masculine features is a series of procedures that can take about a year or more to complete.  Biological females diagnosed with Gender Identity Disorder may be eligible for this surgery upon submission of required supporting documents.

Medtoidplasty, There are two stages in the female to male sex change surgery separated by 3-6 months interval.

FEMALE TO MALE SURGERY – STAGE 1

Mastectomy

A surgical procedure that removes breast tissue to achieve a masculine chest contour.  The surgical technique will depend on the volume of breast tissue and skin to be excised.

Hysterectomy

A surgical procedure that removes the internal reproductive organs namely, uterus, fallopian tubes, and ovaries.

FEMALE TO MALE SURGERY – STAGE 2

Metoidplasty

In this operation, the surrounding skin of the clitoris is removed and released from the pubis to give the appearance of more length. The glans will appear circumcised in most patients. The final result is a normal appearing, but very small, penis.

The surgery usually yields very favorable result. Actual result will depend on various factors as described below. The outcome is largely dependent upon how much enlargement of the clitoris has occurred after using testosterone. Urethral lengthening can also be done at the same time, or later, to allow the patient to stand to urinate. Urethral lengthening requires complete removal of the vaginal mucosa. The best results from the metoidioplasty are in patients who are thin or near their ideal body weight. In most patients, removal of the skin and fat of the mons-pubis and pulling the skin upwards will improve the result. This will leave a curvilinear scar in the pubic hair and is usually done as a second stage when the expanders are replaced with a permanent testicular prosthesis.

         The principal advantage of the metoidioplasty is that it is less invasive, maintains the sensitivity of the clitoris, and does not create apparent surgical scars. Furthermore, it does not prevent future genital surgery from being done at a later time should one decide. The penis will not, however, appear adult in size, and it is
not large enough for vaginal intercourse. Formation of the scrotum (Scrotoplasty) can be done 1-2years after the metoidioplasty.

Recovery: Stay in hospital 3 days, require 14 days after surgery in Thailand.

 

Mastectomy (Top Surgery) in Bangkok, Thailand

The mastectomy (top surgery) procedure performed by the plastic surgeon, should achieve more than just a flat chest. Ideally, the subcutaneous mastectomy results in a chest which has an aesthetically pleasing male contour, is fully sensate and has minimal scarring. The procedure consists of removal of most of the breast tissue and removal of excess skin. Sparing of the nipple and areola is sufficient if the nipple-areolar complex is appropriately sized and shaped, but often the reduction and repositioning of the nipple-areolar complex is required to approximate male nipples.

Mastectomy (Top Surgery) Techniques

The choice of technique must be appropriately selected for the patient’s breast size and skin quality:

Keyhole approach for smaller breast

Figure 1: Keyhole approach for smaller breast

a) Small breasts with good skin elasticity may be removed with a minimum of incisions and subsequent scarring.

A Keyhole (or U-shape scar) approach is most often used in these instances.

Concentric incision approach

Figure 2: Concentric incision approach

b) Moderately sized breasts (B cup) with good skin elasticity can most often be removed with
a concentric incision which gathers skin and leaves a scar completely around the areola (or O-shape scar).

Mastectomy with grafting of free nipple

Figure 3: Mastectomy by free nipple graft

c) Large or pendulous breasts require a full mastectomy, which includes removal of the nipple,
with free grafting of the nipple to the appropriate new location. This technique will impact nipple
sensation significantly but may be the only option for large or inelastic breasts.

notice: Skin which is inelastic (often due to years of breast binding) can adversely affect the outcome and will influence (and limits) the surgeon’s choice of technique.

Risks and complications

– Bleeding is a risk of any operation, but the need for transfusion is very unlikely. However, specialized surgeons are well concerned and will always keep control to stop bleeding during surgery.

– Infections are very rare complications.

– Nipple necrosis. The blood supply of the nipple might be damaged with the more limited surgery and the nipple could die. If the nipples are used as grafts, then it is possible that they might not survive. These complications are exceedingly rare.

– The scars of the areola usually heal very well. The scars below the breast will take longer to fade out and will widen as mentioned above. However, a raised or excessively wide scar is possible and might need further treatment. It is possible that there may be residual tissue left, which appears as a contour deformity. This would need to be removed at a second stage.

Our Gallery

Surgery & Surgeons.

Sex change Surgery is an information of web properties that provide comprehensive patient education

THE DOCTOR

A surgeons or physician
is a professional who
specialize in beauty

MEDICAL NOTE

Any patient attending and exam/test completing history of a document for your disease.

CHECKUP

When your doctor gives you a physical exam, you can call it a checkup. During a checkup blood pressure taken.

Contact Us

Find Information

MTF/FTM Surgery & Surgeons.

Vision: ASEAN class people for undergoing surgery

The opportunity to change is for everyone.

 

Our community