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Sex Change

Sex reassignment surgery refers to the surgery to align the sexual appearance according to one's sexual identity. There are two kinds of surgery. Genital surgical sex reassignment: surgery to the genitalia and/or breasts performed for the purpose of altering the morphology to approximate the physical appearance of the other sex. Non genital surgical sex reassignment: any and all other surgical procedures of non-genitalia or non-breast, conducted for the purpose of effecting a more masculine appearance in a genetic female or for the purpose of effecting more feminine appearance in a genetic male.

Penile Skin Inverstion/Vaginal Plastry

Post Operative Care

All medicine supplies: SRS Kit, Donut pillow, two sizes of dilator, douche kit and one, medical grade lubricants. Post operative check-up at the Institute during SRS recuperation

GRS (or SRS) Certification

GRS/SRS Certification

Guaranteed Satisfaction

No doctor's fee if any correction are required. (Except medical supplies, medical treatments, anesthesia fee, operating room). All post-operative aftercare are provided without cost.

(Second stage SRS like colon transposition vaginoplasty is not considered correction, and will be separate fee).

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Fact about procedure

Dr. Preecha started SRS or GRS in 1978 about 30 years ago, all the SRS surgeons in Thailand were trained by him. Now he has done about 3,000 cases of Male to Female SRS, 130 cases of Female to Male, 350 cases of sigmoid- color vaginoplasty and many thousands of aesthetic surgery in Male Transexuals.

The technique used is Penile Skin Inversion, the sensational glans clitoris, labiaplasty and vaginoplasty in one stage with 3 different technique

Conclusion, only Penile Skin Inversion is US$6,500. With Penile Skin Inversion and Sigmoid Colon is US$8,400

Criteria of Approval

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.

Patients must have undergone at least one year of antiandrogens or/and female 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).

Surgery is performed by Dr. Preecha Tiewtranon M.D., Plastic and Reconstructive Surgeon, American Board Certified in 1973, Associate Professor of Plastic and Reconstructive Surgery in the King Chulalongkorn University, Faculty of Medicine in Bangkok, Thailand, also the former President of the Society of Plastic and Reconstructive Surgeons of Thailand and President of the Society of Aesthetic Surgeons of Thailand, Member of the International Society of Plastic and Reconstructive Surgery.

Surgical procedure

The M to F, SRS surgery is as followed

A portion of the glans (head of the penis), with its nerves and vessels, is converted into a clitoris. In so do, 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).

As of 2002, Dr Preecha has performed over 550 of successful colon transposition operations.

Technique

There are 3 main techniques

Results

The Male to Female SRS is done in one stage with result of:

Duration of Operation:

2.30 - 3.00 Hours

Possible Risks and Complications

The other complications which were mentioned in the literatures such as the urethra vaginal fistula, Pulmonary thromboembolism, extensive bleeding, serious infection have never occurred in his experience.

Side Effects

After Care

Before being discharged from the hospital to your hotel, the nurse will teach you how to take care of your vagina and prescribe some more medications. The stiches will be removed after 7- 10 days. And you will be able to return home.

Recovery Time

You need to stay recuperate totally in Bangkok for 10-14 days at least before safely flying home. You will also require 4-6 weeks recuperate at home before returning to work. (The neovagina can function within 6 weeks).

The cost of Penile Skin Inversion's already included 5 nights free of charged in hospital private room after surgery and medical treatments, post-op cares and etcs.

Hospital Admission

You will be requested to sign in hospital consent form. Then you need five nights admission to hospital for recuperation.

Anesthetic

General anesthesia(You are Asleep) or you can choose epidural or spiral anesthesia.

Post Operative Care

After release from hospital the patient will recover with the aid of liaison at the hotel. During recovery in the hotel, the patient must follow patient instructions, including:

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:

After one month of SRS operation you will be required to start applying Premarin cream to your neo-vagina. Apply two times a day to soften your neo-vagina. This would generally take around six months.

Patient can return to female hormones as before surgery after two months. 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.

Preparation

Dr. Preecha follows the HBIGDA criteria, you should have

Expense

Surgical fee is $ 6,500 (U.S.)

If you are HIV positive, then you are a risk to hospital personnel. For this reason you need to pay an extra 30% of the original charge. Prepare cash for your personnel to stay another 5 days after surgery.(If you would like to stay at hospital hotel room for additinal night after surgery is US$ 62 per night excluded meal) about $20-40 (U.S.) per day for food expense.

Airport Tax on departure is $15 (U.S.)

Touring arrangements will be around $100 (U.S.) per day (optional)

Appointment with Surgeon

The operation can be arranged once you have all the required papers ready. Just inform us of your convenient date at least one month in advance prior to arrival.

Patients are required to submit following documents before operation: (Int.' Patient only)

Personnel Belonging

Please carry only essential belonging. If the patient arrives alone, it is essential to travel with light luggage (max. 25 kgs) to avoid risking injury during the 4-6 week recovery period.

DAY 1

1. Arrive in Bangkok International Airport. Meet PAI staff and be escorted to the hospital.

2. Pre-surgery night in the private deluxe suite in Hospital

DAY 2

1. Meet with your appointment doctor for clinical interview / surgical consultation. All questions will be clarified personally and the surgery technique will be discussed and interview with Psychiatric tests (if necessary).

2. Check medical documents.

3. Admission to hospital. You will be requested to sign hospital consent forms.

4. The operation date and time will be arranged within twenty-four hours after Pre-operative consultation.

On the day:

1. The nurse will do complete enema to clean rectum.

2. Take shower.

3. Preoperative intravenous fluid and sedation.

4. In operating room under general anesthesia.

DAY 3-5

The day after: Upon waking up, able to have regular meal, and move freely in bed. Do not be alarmed by the catheter for urine and drainage tube full of blood, this is normal at first, it will stop in twenty-four hours. You may feel like you want to urinate, but it is not, due to the urine catheter irritation.

Pain is usually minimum only during the first twenty-four hours. Then subsided gradually, you can be ambulated with help daily. The dressing gauze and the catheter will be removed on the 4th- 5th days. You can urinate take a shower and to be discharged back to hotel on the 5th day. A nurse will come and bath you twice a day and change your bedding as often as necessary.

DAY 6

Your doctor will remove the dressing and bandages. Upon checking the results you may leave the hospital and check in to your chosen hotel.

DAY 6-10

These five days should be spent for resting.

DAY 11

You may go to Sightseeing or Shopping(Depend on doctor diagnosis).

DAY 12

If you were at your chosen hotel. Please return to the hospital where the doctor will remove sutures from the labia and do a final examination. You will receive a final postoperative recovery check up and some medications. You will also receive a medical certificate that authenticates the surgery and recommends that you receive a legal change of sex.

DAY 13

Transfer to Bangkok International Airport for Departure by PAI staff.

Optional: We will provide you a mobile phone. So your relatives and your friend's able call you directly and get more closely while your trip of surgery. Nevertheless, your private room also has a phone to call and our hospital operators will assist you. After you come to our office (PAI), please ask for more information. We will collect the mobile phone back one night before your departure from Bangkok. (International patient only)

Please note that this information should be used only as a guide to your treatment. All specifics will be discussed with your Surgeon during your initial consultation.