Transgender Surgery

srs surgery thailand

Gender Affirming Surgery, often known as Sex Reassignment Surgery, is a critical intervention intended for individuals facing gender dysphoria or a sense of discomfort due to a mismatch between their appearance and their true gender.

Gender reassignment surgery (GRS)
Gender reassignment surgery (GRS)
What you need to know about GCS/GRS?

Surgery time  : 4-6 hours
Period of stay in Thailand : at least 20 days
Anesthetic : General anesthesia
Hospital stay : 5 nights
Time off work : 6 weeks
Start walking slowly : 3 days
Sexual intercourse : 3-6 months
Exercise : 6 months
Full recovery : 6-12 months

Read more

Gender Affirming Surgery, often known as Sex Reassignment Surgery, is a critical intervention intended for individuals facing gender dysphoria or a sense of discomfort due to a mismatch between their appearance and their true gender. This surgery is aimed at significantly improving the quality of life for these individuals, allowing them to live comfortably in a gender that truly represents their inner identity.

Vaginoplasty, a comprehensive surgical procedure performed in a single step, involves creating a vaginal cavity, orchidectomy, Clitoroplasty, urethroplasty, and labiaplasty. The primary objectives of this surgery are to construct a natural-looking and fully functional vagina, enabling sexual satisfaction, including the potential for orgasm, and ensuring sufficient size for sexual activities.

TechniquesSkin Graft Technique (Penile Skin Inversion/Scrotal Skin Graft/Abdominal Skin Graft):

Procedure: Utilizes penile and scrotal skin to line the vaginal cavity. Abdominal skin graft is an option if there’s insufficient genital skin for adequate depth.

Recovery: Known for quicker recovery and no diet restrictions.

Stability: Considered a standard and stable technique with over 30 years of use, offering predictable long-term results.

Limitations: Does not create a self-lubricating vagina, necessitating the use of lubricating gel for dilation and sexual intercourse.

Sigmoid Colon Graft Technique:

Procedure: Involves using a section of the sigmoid colon to create increased depth and a self-lubricating vagina.

Recovery: Longer recovery time and requires diet restrictions before and after surgery.

Risk: More complex procedure with increased risks of post operative complications, not recommended for patients with certain health conditions.

Criteria: Recommended for patients with very short genitals or those experiencing vaginal stenosis post-primary sex reassignment surgery. The patient’s BMI must be less than 23.

Approval Criteria for Sex Reassignment Surgery

The eligibility criteria for sex reassignment surgery are as follows:

  • Age Requirement: Patients must be a minimum of 18 years old. For patients under 20, parental consent in person is mandatory.

  • Diagnosis: Patients must have a diagnosis of Gender Identity Disorder, Gender Dysphoria, or associated conditions, and must obtain approval from a licensed psychiatrist (MD), psychiatric social worker (PhD), or clinical psychologist (PhD).

  • Hormone Therapy: Patients are required to have undergone at least one year of hormone therapy as part of their transition.

  • Real-Life Experience: Patients must have lived full-time in the cross-gender role for a minimum of one year before being considered for surgery.

Risks and possible post-op complications and how to prevent/resolve

  • Adverse reactions to anesthesia

  • Blood clots

  • Fistula

  • Bleeding

  • Urine obstruction

  • Wound separation 

  • Infection

  • Hematoma

  • Necrosis

What to expect as a result?

Immediately after surgery: what to expect?

  • Swelling and bruising

  • Minor bleeding

  • Asymmetry due to swelling

  • Unpleasant odor/ secretion

Long term

  • Natural look vagina

  • Adequate depth for sexual intercourse

  • Sexual sensation with possibility to have orgasm

  • scar

FAQs

Is genital hair removal necessary before GRS?

Hair removal around the perineum area is recommended if you're concerned about hair growth near the entrance of your vaginal cavity. For more details, please refer to this blog.

Can I come to Thailand alone for surgeries?

Approximately 30% of my clients come here alone. After hospital discharge, you'll be self-sufficient, but be mindful of potential loneliness. Bringing a friend or family member is a good idea.

Is a diagnosis of Gender Dysphoria required for GRS eligibility?

While Thai law mandates approval from two Thai psychiatrists, they readily provide letters if you have a diagnosis from your country or a gender change on your passport.

How long is dilation required after GRS?

All GRS techniques necessitate dilation to maintain vaginal cavity width and depth. During the first post-op year, dilation is required twice daily. After one year, you can gradually reduce dilation frequency until finding a suitable routine.

Transgender Breast Augmentation
Transgender Breast Augmentation
What you need to know about Breast augmentation?

Surgery time  : 1-1.5 hours 
Period of stay in Thailand : at least 10 days
Anesthetic : General anesthesia
Hospital stay : 1 night
Time off work : 2-6 weeks
Exercise : 3 months
Full recovery : 3 months

Read more

Estrogen can have a notable impact on breast size and shape for some MtFs. While breast growth commences shortly after starting estrogen, it’s a gradual process, typically taking two or more years to reach maximum size. If hormonal, waiting at least 12 months is recommended for optimal development, aiding nipple growth and chest skin stretching for a more natural implant appearance.

Surgery can be a standalone procedure or follow other SRS types. In some SRS programs, MtF breast augmentation and genital surgery can be performed simultaneously to minimize anesthesia exposure.

Augmentation incisions, including periareolar, inframammary, and transaxillary, offer various options. 

During consultations, candidates discussimplant types, silicone shell texture, breast shapes, placement(subglandular/submuscular), and sizes (100 cc. - 800 cc.).

Risks and complications:

  • Anesthesia reactions

  • Blood clots

  • Infection

  • Hematoma

  • Temporary numbness

  • Scarring issues

  • Capsular contracture

  • Lopsided results

  • Nipple placement discrepancies

  • Skin wrinkling

  • Implant problems

  • Changes in nipple/breast skin sensation.

Following the surgery, gauze dressings are initially applied. Once the gauze dressings are removed, it is recommended to wear a support bra to stabilize the breasts. After 7 days, you are able to take a shower. Additionally, gentle breast massage is advised to reduce the risk of capsular contracture and enhance a natural appearance.

FAQs

Can I have breast augmentation without taking female hormones before?

Yes, it's possible, but note that the post-op appearance may be less natural compared to those who took hormones before.

How can I choose the breast implant size?

Typically, breast augmentation can increase size by 1-3 sizes. During the consultation, our surgeon will measure your breasts and suggest a size that suits your body. You can also discuss your size preferences with the surgeon.

Is it a good idea to have breast augmentation with GRS?

It depends on your preference. Some opt for breast augmentation before GRS for a notable female characteristic. Combining GRS and breast augmentation in a single anesthesia session can save recovery time and offer effective pain management during an extended hospital stay.

Facial Feminization Surgery (FFS)
Facial Feminization Surgery (FFS)
What you need to know about Breast augmentation?

Surgery time  : 1-6 hours 
Period of stay in Thailand : at least 12 days
Anesthetic : General anesthesia
Hospital stay : 1-3 nights
Time off work : 2-6 weeks
Exercise : 3 months
Downtime : 3-12 months

Read more

During puberty, testosterone influences the development of facial bones and cartilage in Male-to-Female (MtF) bodies. While hormone therapy post-puberty can soften facial skin and induce minor fat/muscle changes, the fundamental bone and cartilage structure can only be altered through surgery.

MtFs have diverse perspectives on facial and neck surgery, considering it either crucial for alleviating gender dysphoria or expressing concerns about societal pressures. Facial Feminization Surgery (FFS) encompasses both bone and soft tissue techniques, with bone reconstruction informed by average male and female skull differences. 

FFSProcedures:

  •  Brow shaving: Involves grinding orbital rims to reduce brow bossing.

  • Forehead implant: Utilizes synthetic bone-filler for a rounded forehead.

  • Brow lifting: Tightens forehead skin and raises eyebrows.

  • Scalp advancement: Brings the scalp and hairline forward.

  • Jaw reshaping: Entails removing bone from the back jaw corner, potentially involving part of the masseter muscle.

  • Chin reshaping: Aims to reshape and taper the chin.

  • Chin augmentation: Utilizes implants to address a receding chin.

  • Nose reshaping/reconstruction (Rhinoplasty): Modifies the bridge, width, and tip of the nose.

  • Tracheal shave: Focuses on reducing the size of the laryngeal prominence.

Timing of FFS

Most FFS techniques can be performed at anypoint in transition, whether at the beginning, middle, or after other surgeries.  

Risks and Complications

  • adverse reactions to anesthesia

  • blood clots

  • temporary numbness

  • scar problems

FAQs

What kind of result should I expect from FFS?

FFS can enhance your facial features, making them appear softer and more feminine. However, it won't completely change your face. The improvement is subtle, creating a more refined, feminine version of yourself.

Can I combine FFS with GRS in one shot?

Combining FFS and GRS in one general anesthesia isn't advisable due to extended operating times. However, both procedures can be managed in the same trip, allowing for a longer stay in Thailand to accommodate both surgeries.

Should I do FFS all in one shot or take it slowly?

The decision depends on your preference. Opting for a full FFS at once can reduce overall recovery time. If uncertain about specific procedures, you can prioritize the areas you want to enhance the most. Some non-reversible procedures make it beneficial to proceed gradually, allowing for better decision-making based on initial results.

Gender Affirming Surgery, often known as Sex Reassignment Surgery, is a critical intervention intended for individuals facing gender dysphoria or a sense of discomfort due to a mismatch between their appearance and their true gender. This surgery is aimed at significantly improving the quality of life for these individuals, allowing them to live comfortably in a gender that truly represents their inner identity.

Vaginoplasty, a comprehensive surgical procedure performed in a single step, involves creating a vaginal cavity, orchidectomy, Clitoroplasty, urethroplasty, and labiaplasty. The primary objectives of this surgery are to construct a natural-looking and fully functional vagina, enabling sexual satisfaction, including the potential for orgasm, and ensuring sufficient size for sexual activities.

TechniquesSkin Graft Technique (Penile Skin Inversion/Scrotal Skin Graft/Abdominal Skin Graft):

Procedure: Utilizes penile and scrotal skin to line the vaginal cavity. Abdominal skin graft is an option if there’s insufficient genital skin for adequate depth.

Recovery: Known for quicker recovery and no diet restrictions.

Stability: Considered a standard and stable technique with over 30 years of use, offering predictable long-term results.

Limitations: Does not create a self-lubricating vagina, necessitating the use of lubricating gel for dilation and sexual intercourse.

Sigmoid Colon Graft Technique:

Procedure: Involves using a section of the sigmoid colon to create increased depth and a self-lubricating vagina.

Recovery: Longer recovery time and requires diet restrictions before and after surgery.

Risk: More complex procedure with increased risks of post operative complications, not recommended for patients with certain health conditions.

Criteria: Recommended for patients with very short genitals or those experiencing vaginal stenosis post-primary sex reassignment surgery. The patient’s BMI must be less than 23.

Approval Criteria for Sex Reassignment Surgery

The eligibility criteria for sex reassignment surgery are as follows:

  • Age Requirement: Patients must be a minimum of 18 years old. For patients under 20, parental consent in person is mandatory.

  • Diagnosis: Patients must have a diagnosis of Gender Identity Disorder, Gender Dysphoria, or associated conditions, and must obtain approval from a licensed psychiatrist (MD), psychiatric social worker (PhD), or clinical psychologist (PhD).

  • Hormone Therapy: Patients are required to have undergone at least one year of hormone therapy as part of their transition.

  • Real-Life Experience: Patients must have lived full-time in the cross-gender role for a minimum of one year before being considered for surgery.

Risks and possible post-op complications and how to prevent/resolve

  • Adverse reactions to anesthesia

  • Blood clots

  • Fistula

  • Bleeding

  • Urine obstruction

  • Wound separation 

  • Infection

  • Hematoma

  • Necrosis

What to expect as a result?

Immediately after surgery: what to expect?

  • Swelling and bruising

  • Minor bleeding

  • Asymmetry due to swelling

  • Unpleasant odor/ secretion

Long term

  • Natural look vagina

  • Adequate depth for sexual intercourse

  • Sexual sensation with possibility to have orgasm

  • scar

FAQs

Is genital hair removal necessary before GRS?

Hair removal around the perineum area is recommended if you're concerned about hair growth near the entrance of your vaginal cavity. For more details, please refer to this blog. (Link : Understanding the Importance of Pre-operative Genital Hair Removal for MtF Gender Reassignment Surgery

Can I come to Thailand alone for surgeries?

Approximately 30% of my clients come here alone. After hospital discharge, you'll be self-sufficient, but be mindful of potential loneliness. Bringing a friend or family member is a good idea.

Is a diagnosis of Gender Dysphoria required for GRS eligibility?

While Thai law mandates approval from two Thai psychiatrists, they readily provide letters if you have a diagnosis from your country or a gender change on your passport.

How long is dilation required after GRS?

All GRS techniques necessitate dilation to maintain vaginal cavity width and depth. During the first post-op year, dilation is required twice daily. After one year, you can gradually reduce dilation frequency until finding a suitable routine.

Estrogen can have a notable impact on breast size and shape for some MtFs. While breast growth commences shortly after starting estrogen, it’s a gradual process, typically taking two or more years to reach maximum size. If hormonal, waiting at least 12 months is recommended for optimal development, aiding nipple growth and chest skin stretching for a more natural implant appearance.

Surgery can be a standalone procedure or follow other SRS types. In some SRS programs, MtF breast augmentation and genital surgery can be performed simultaneously to minimize anesthesia exposure.

Augmentation incisions, including periareolar, inframammary, and transaxillary, offer various options. 

During consultations, candidates discussimplant types, silicone shell texture, breast shapes, placement(subglandular/submuscular), and sizes (100 cc. - 800 cc.).

Risks and complications:

  • Anesthesia reactions

  • Blood clots

  • Infection

  • Hematoma

  • Temporary numbness

  • Scarring issues

  • Capsular contracture

  • Lopsided results

  • Nipple placement discrepancies

  • Skin wrinkling

  • Implant problems

  • Changes in nipple/breast skin sensation.

Following the surgery, gauze dressings are initially applied. Once the gauze dressings are removed, it is recommended to wear a support bra to stabilize the breasts. After 7 days, you are able to take a shower. Additionally, gentle breast massage is advised to reduce the risk of capsular contracture and enhance a natural appearance.

FAQs

Can I have breast augmentation without taking female hormones before?

Yes, it's possible, but note that the post-op appearance may be less natural compared to those who took hormones before.

How can I choose the breast implant size?

Typically, breast augmentation can increase size by 1-3 sizes. During the consultation, our surgeon will measure your breasts and suggest a size that suits your body. You can also discuss your size preferences with the surgeon.

Is it a good idea to have breast augmentation with GRS?

It depends on your preference. Some opt for breast augmentation before GRS for a notable female characteristic. Combining GRS and breast augmentation in a single anesthesia session can save recovery time and offer effective pain management during an extended hospital stay.

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During puberty, testosterone influences the development of facial bones and cartilage in Male-to-Female (MtF) bodies. While hormone therapy post-puberty can soften facial skin and induce minor fat/muscle changes, the fundamental bone and cartilage structure can only be altered through surgery.

MtFs have diverse perspectives on facial and neck surgery, considering it either crucial for alleviating gender dysphoria or expressing concerns about societal pressures. Facial Feminization Surgery (FFS) encompasses both bone and soft tissue techniques, with bone reconstruction informed by average male and female skull differences. 

FFSProcedures:

  •  Brow shaving: Involves grinding orbital rims to reduce brow bossing.

  • Forehead implant: Utilizes synthetic bone-filler for a rounded forehead.

  • Brow lifting: Tightens forehead skin and raises eyebrows.

  • Scalp advancement: Brings the scalp and hairline forward.

  • Jaw reshaping: Entails removing bone from the back jaw corner, potentially involving part of the masseter muscle.

  • Chin reshaping: Aims to reshape and taper the chin.

  • Chin augmentation: Utilizes implants to address a receding chin.

  • Nose reshaping/reconstruction (Rhinoplasty): Modifies the bridge, width, and tip of the nose.

  • Tracheal shave: Focuses on reducing the size of the laryngeal prominence.

Timing of FFS

Most FFS techniques can be performed at anypoint in transition, whether at the beginning, middle, or after other surgeries.  

Risks and Complications

  • adverse reactions to anesthesia

  • blood clots

  • temporary numbness

  • scar problems

FAQs

What kind of result should I expect from FFS?

FFS can enhance your facial features, making them appear softer and more feminine. However, it won't completely change your face. The improvement is subtle, creating a more refined, feminine version of yourself.

Can I combine FFS with GRS in one shot?

Combining FFS and GRS in one general anesthesia isn't advisable due to extended operating times. However, both procedures can be managed in the same trip, allowing for a longer stay in Thailand to accommodate both surgeries.

Should I do FFS all in one shot or take it slowly?

The decision depends on your preference. Opting for a full FFS at once can reduce overall recovery time. If uncertain about specific procedures, you can prioritize the areas you want to enhance the most. Some non-reversible procedures make it beneficial to proceed gradually, allowing for better decision-making based on initial results.