Sex Change Surgery Male to Female
Surgical Fee
Pre-surgery night and five nights recuperation in hosptial.
Doctor's fee
Clinical interview/surgery consultation
Psychologic 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 reassignment 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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Pre Operative Care
Patients must complete a health check up within three months prior to SRS. Patients must also be confirmed by a private physician to be free from serious medical diseases and must pass the following blood tests:
- CBC, HIV Electrolytes, FBS, Creatinine Urinalysis
- Alkaline Phosphatase, Chest X-ray
- SGOT LDH EKG
- Sex reassignment surgery with Dr. Saran Wannachamras bangkok, Thailand.
Patients must discontinue hormone treatment at least fourteen days prior to surgery. Hormones should be halted to reduce the risk of thrombosis (blood clots). Oral tablets should be halted two weeks prior to surgery and injectables should be halted four weeks prior to surgery. Oral antiandrogens can be halted three days before surgery (four weeks if injectables). Aspirin and smoking should be halted two weeks before surgery.
Letter of Recommendation
Two letters are required from foreign patients. One letter must be from either a medical doctor or a psychologist states that the person is a candidate for SRS. The other letter may be from any doctor, showing proof of having been on hormones for at least one year.
Passport and Visa
Please forward the copy of your passport to us before the arriving date.
US citizens can call San Francisco information (415) 744-4444 or you can search under "U.S. Government offices" in the white pages to find the phone number of your local passport office.
For most tourists, a stay of no more than 30 days does not require a VISA. For further information on Thailand's entry/exit requirements, please contact the Thai consulate in your country or your travel agent.
Citizens who wish to renew a passport under different gender should contact a clerk at the passport office and provide the following information:
- Female driver's license
- A court decree of name change
- Photographs
- A letter from your surgeon that states the date of surgery
Flight Arrangement
Our recommended airlines are Thai International, Northwest, Lufthansa, Singapore, and EVA which has wide seats.
Expenses
Sex reassignment surgery with Dr. Saran Wannachamras bangkok, Thailand.
Travel arrangements for 7 days will be at least around 100 USD per day
If you are HIV positive, then you are a risk to hospital personel. For this reason you need to pay an extra 30% of the original charge.
Airport Immigration and Customs
Please present the supporting documents confirming the scheduled operation upon request. Please do not carry any unnecessary drugs or dangerous objects in your luggage.
Appointment with Surgeon
The operation can be arranged once you have all the required papers ready. Just inform us of your earliest convenient date prior to arrival, either by clicking here to contact us via e-mail consultant@doctorsaran.com
Packing List
Pack only loose clothing.
If the patient arrives alone, it is essential to travel with light airport baggage/luggage (max. 20 kgs) to avoid risking injury during the 4-6 week recovery period.
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DAY 1
Arrive in Bangkok Airport. Meet with DoctorSaran staff and be escorted to the Hospital
Pre-surgery night (sex reassignment surgery) in the deluxe private suite in Hospital (www.piyavate.com)
DAY 2
Appointment with our doctor for clinical interview/consultation.
Check medical documents
Psychiatric tests (if necessary)
Admission to Hospital. You will be requested to sign hospital consent forms.
A nurse will come to clean and shave your genital area after you have showered. Afterwards, your perineum will be shaved before surgery. You will be given enema.
Craniofacial x-ray evaluation for facial feminisation surgery
Surgery (sex reassignment surgery) takes about three hours.
DAY 3-5
Upon waking up, you will be able to eat a regular meal. Feel free to move in bed. Do not be alarmed by the catheter for urine or the drainage tube which may contain blood. These objects will be removed within twenty-four hours. You might feel like you need to urinate, but this is irritation caused by the urine catheter. Pain is usually minimum only lasts for the first twenty-four hours. Afterwards, the pain will gradually subside.
A nurse will come and bath you twice a day and change your bedding as often as necessary
DAY 6
Our doctor will come and remove the dressing and bandages. Upon checking the results you may leave the hospital and check in to your chosen hotel. Otherwise you can continue your stay at the hospital untill departure.
DAY 6-10
These five days should be spent for resting.
DAY 11
Sightseeing or shopping.
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 post-operative 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. This certificate can be laminated at a photo finishing shop.
DAY 13
Transfer to Bangkok Airport for Departure.
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Useful Links
The number is +662 693-9391
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