Male to Female Sex Reassignment Surgery is a complex and irreversible sex change surgery. As a rule I require letters of referral from either apsychiatrist, a physician, an endocrinologist or a psychoterapist, to support patient's request.
The Harry Benjamin Association recommends that six objectives must be met before a sex change operation is undertaken.
You only fax, scan or send me some documents from your clinician or therapist approving you as a suitable candidate for sex reassignment surgery. Please inform your body weight ( we prefer the patient to control their weight not exceed the average too much )
The reason I needed the paper work is because I never know or see you before and there is some chance that I will do the surgery for the inappropriate person. If you have no psychiatric evaluation, please ask your doctor or employer to write something to me about you to show that who you are now. If your parents or your brother/sister still alive and willing to write me something about you, it will be very helpful. If possible, send me your recent photos, electronic or hard copy.
The current technique of vaginoplasty is penile skin flap with scrotum skin graft , sensate pedicle clitoroplasty and labiaplasty with prepuce skin flap attached to Glans penis. Most of them had successful surgery and could have sexual intercourse . None of
my patients had complication with their urethra or rectum. Some patients are advised for secondary labiaplasty in the future for cosmesis. The genital hair will be scraped out as much as possible to prevent hair growing inside vagina canal but there is still some chance that hair may grow up later. So if the patients have enough budget and time to do electrolysis , they can do that.
In many cases , patients have a relatively small penis and scrotum and circumscision had been performed when they were infants or children. So there is not enough tissue to do good vaginoplasty. So, additional skin graft from other part of body such as tummy, love handles, thighs or groins will be needed. I might recommend secondary Rectosigmoid colon vaginoplasty for patients if the vaginal reconstruction is failed .
Rectosigmoid colon vaginoplasty is the procedure that we approach into patients' abdomen by the horizontal surgical incision like the OB-GYN surgeon do Cesarean section. Then we share some part of the colon ( large intestine ) about 4-6 inches to be the future vagina. Usually I recommend to reserve this procedure for secondary vaginoplasty when the penile skin flap and scrotum skin graft vaginoplasty fail to provide functional or deep enough vagina for sexual intercourse. I prefer to wait at least 6 months after SRS before scheduling colon vaginoplasty because the patient should try dilation as much as possible and we need the tissue and scar at that area to be soft enough for next operation.
The surgeon have to transfer that colon very carefully to protect its vascular pedicle intact. In some situation, that pedicle was in jeopardy, we might lose the whole or some part of the colon. Then we turn that colon up side down and pass through the vagina canal we create to join with the previous penile flap and scrotum graft about one inch from the vagina opening. By this method, the red mucosa of the colon could not be seen even the patients separate their thighs. The colon vagina had less tendency to shrink comparing to the standard vaginoplasty. It is self-lubricated by its own mucus. Sometime, the over secreted mucous annoy the patients temporarily or even permanently.
For the patients who concern a lot about the depth of vagina and request colon vaginoplasty to be incorporated during SRS ( one stage SRS with colon vaginoplasty ) , they must have ENOUGH penile skin to do vagina opening. If not, the red mucosa of colon will be seen and there might be constricture at vagina opening that need another surgery to correct.
For the cost of surgery, we quote in package form.
GRS with penile skin flap and scrotum skin graft vaginoplasty, sensate clitoroplasty and labiaplasty using prepuce skin flap and Glans penis costs 8,000US$ and if extra skin graft is needed to provide more depth , it will cost 1,000US$ in additional. This is including the surgeon's fee, anesthesia, operation cost, hospitalization for approximately 2 weeks , and no deposit needed. But it is not including international phone calls and hotel room.
Tracheal shave will cost 800US$.
For secondary colon vaginoplasty, the cost is 7,000US$ including 9-11 days
hospitalization. If combination of colon and extra skin graft needed, It costs 7,500US$.
For cosmetic labiaplasty and urethroplasty, the cost is 1,500 US$.
For breast implants, the package price is 2,800 US$, which includes either saline or silicone gel prosthesis.The incision could be placed either at nipple, breast fold or axilla. Prosthesis also could be placed under or over chest muscle. This operation could be done in the same setting with SRS.
Brow lift/shave costs 2,000US$.
No voice change surgery offered.
The patients should come back for follow check up at the hospital before they leave Phuket. So they will stay at a hotel in Phuket for 4-7 days after released from the hospital. We recommend that patients should plan to stay in Phuket totally for 3 weeks ( SRS ), 2 weeks in the hospital and 1 week in the hotel. The hotel costs 25-50US$ per night and not necessary to make any advance reservation due to uncertainty about the discharge date from the hospital.
If the patient has an accompanying person, this person may stay in the same room with the patient at a minimal extra charge for meals and laundry. Only one person is allowed to stay with the patient.
The patients can bring their own computer for using online directly from their room .
If the patient needs a letter to confirm her SRS, for passport application, please let us know. We are willing to send a letter asap. The patients have to discontinue Aspirin, female hormones ( Estrogen, Progesterone ) 2 weeks before operation. You might prepare a donut ring cushion to aid seating during flying back home. You are free to dress in any clothes you wish. We provide a set of dilators for everyone to use after operation.
Please let us know asap about your flight number, arrival time and date. In Phuket, the weather is hot ( 30-36 celcius ) especially during January and May. Upon arrival , my driver will wait for you at an exit of a building of Phuket international airport. He will show a banner of your name and Phuket Plastic Surgery name. He will take you to Phuket International Hospital for admission if you arrive one day before surgery date. If you arrive earlier, we will reserve a room at the hotel for you to stay before hospital admission.
Our hospital has staffs who can speak English and Japanese to facilitate the communication.
Waiting list is between 6-8 months.
No deposit needed. Payment by travellers check is advised. If international cashier check is used, 100 US$ extra charge is requested due to delayed clearing from the bank (1-2 months ).
If you need more detail, please contact me at kunaporn@phuket.ksc.co.th
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Augmentation Mammaplasty ( Breast Implants )
Augmentation Mammaplasty or breast enlargement is aimed to increasing breast volume for either genetic women or mtf transsexuals.
Usually I will use the incision at both armpits to insert implants. But there are other incisions such as breast fold or nipple that could be used also depended on patients' preference. I prefer placing implants under the chest muscle to over the muscle, since the outcome is more natural and the risk of capsular contracture is lesser. However, if the breasts are sagging or a little bit flabby, I will place implants over the chest muscle to avoid the double-contour effect.
We normally use round shape silicone ( cohesive gel) or saline-filled implants due to patients' need.
Usually the patient will rest 1-2 days at the hospital after surgery and then can go back to stay at a hotel. The stitches will be taken out 5-6 days after operation. Then they can travel back home on next day and resume their normal light activities ; driving, shopping etc. But for exercise, they can start 3-4 weeks after surgery.
Please inform me your personal and medical point such as age, height, weigth, smoking habbit, alcoholic habit, heart disease, hypertension, drug allergy, Diabete mellitus, surgery history.
One month notification before surgery is recommended.
Breast implants cost 2,800 US$ ( 3,600 AUS$ or 1,500 English Pounds ). This includes surgeon fee, anesthetist fee, mammary implants ( silicone or saline water ), room and meals at the hospital for 2 days, transportation between hospital and airport or hotel. We can book a room at the hotel in the city or at beach if you have no idea where to stay after released from the hospital. The room costs between 15-100US$ per day.
You can send me photos of breasts for evaluation through email. Please let me know if you are interested or need more detail.
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Breast Reduction
Breast reduction or Reduction mammaplasty is a procedure to reduce breast volume and lift in the same time.
The most concern that the patient should be aware of is the scars. There will be the scars around the nipple, at breast fold and the junction between those two scars. The quality of the scar is depended on the nature of the patient's healing. Some heals good, some heals very bad and end up with keloid scar. We may use a silicone sheet to protect the scar for several months after surgery to prevent keloid formation but it can not be guaranteed.
Breast reduction costs 3,500US$ including hospitalization for 3 days, surgeon fee, anesthetist fee and transportation between hospital and hotel.
You may send me photos of your breasts for evaluation by email before making decision.
Please let me know if you are interested or need more detail.
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Breast Lift
Breast lift or Mastopexy is a procedure to lifting breast by remove excess droopy skin and relocate nipple-areolar complex to the better position in the same time. Breasts will become smaller after lifting. If the patient need breast implants, it is advised to wait at least 6 months after the operation.
The most concern that the patient should be aware of is the scars. There will be the scars around the nipple, at breast fold and the junction between those two scars. The quality of the scar is depended on the nature of the patient's healing. Some heals good, some heals very bad and end up with keloid scar. We may use a silicone sheet to protect the scar for several months after surgery to prevent keloid formation but it can not be guaranteed.
Breast lift costs 3,000US$ including hospitalization for 2 days, surgeon fee, anesthetist fee and transportation between hospital and hotel.
You may send me photos of your breasts for evaluation by email before making decision.
Please let me know if you are interested or need more detail.
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Blepharoplasty
The Upper Blepharoplasty operation is aimed to remove excess hanging skin, and underneath fat at upper eyelids and create the double fold. It takes one and a half hour.It could be done under local anesthesia in my office. There is no need for hospitalization. Usually all the stitches will be removed 3-4 days after surgery. You are advised to stay in Phuket totally for 5-7 days. There will be bruise and swelling for 7-10 days but you can resume your activities and using the sun glasses to cover the eyes. The surgery costs 700 US$.
The Lower Blepharoplasty operation is aimed to remove the fat pad under your eyes and tightening the skin around that area. The surgery takes one and a half hour. It could be done under local anesthesia in my office also. There is no need for hospitalization. Usually all the stitches will be removed 3-4 days after surgery. You are advised to stay in Phuket totally for 5-7 days. There will be bruise and swelling for 7-10 days but you can resume your activities and using the sun glasses to cover the eyes. The surgery also costs 700 US$ .
Both procedures can be done in the same setting if the patient is able to lie on operation table for 3 hours.
Please let me know if you are interested or need more detail.
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Otoplasty
Otoplasty or correction of prominent ear is aimed to swing the ear back. It is done under local anesthesia at my office , no hospitalization needed. It takes 30 minutes per side. There will be some swelling and bruise for one to two weeks after surgery. The sutures will be removed 5-6 days after surgery.
The technique we use is called anterior scoring by placing incision at the back of the pinna and then cut and score the ear cartilage until it swing backward. Then we close the incision with nylon suture.
The operation costs 500US$ per side.
If you are interested with the surgery, please contact our clinic again.
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Face Lift ( Rhytidectomy )
Face lift is done by undermining and excising excess skin around forehead, temper, cheek, jowl, chin and neck. I usually do SMAS lift technique under general anesthesia. The patient must stay in the hospital for 3-4 days. There will be some drain tubes that will be removed two days after surgery. The stitches will be removed 5-7 days after surgery. Swelling and bruise will disappear after 2-3 weeks.
The patient need to stop Aspirin if used at least 10 days before surgery. Please inform me your personal and medical data such as age, height, weight, smoking habbit, alcoholic habbit, heart disease, hypertension, drug allergy, Diabetes mellitus, surgery history.
The costs of mid face lift is 4,000US$. If the patient need forehead lift, it costs 2,00US$ in additional and another 2,000US$ for neck lift if considering. This quotation is including surgeon fees, operation, anesthesia and hospitalization for 3-4 days. Transportation between the hotel/hospital/airport is also included.
If possible, send us photos of close up face, front and profile view so we can evaluate and give you our advice.
If you are interested or need more detail, please email us.
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Abdominoplasty ( Tummy Tuck )
Abdominoplasty or Tummy tuck is to undermining and cut out the redundant skin from the lower abdominal area and move the navel to the better upper position. There will be a permanent scar at the lower abdomen and can be hidden under a bikini and also around the navel. The muscle and sheath under the abdominal skin will be tightening also. In some occasion, there will be another scar running vertically from the center of bikini scar to join the navel.
The quality of the scar is depended on the nature of the patient's healing. Some heals good, some heals very bad and end up with keloid scar. We have to use a silicone sheet to protect the scar for several months after surgery to reduce a risk of keloid but it can not be guaranteed. The good candidate patient should not be obese one.
Tummy tuck costs 3,500US$ including hospitalization for 3-4 days. It is always done under general anesthesia. This quotation include surgeon's fee, anesthesia, operation, transportation between hospital and hotel. After released from the hospital, you will stay at the hotel for a few more days before going back to see me to have all stitches removed. We have a staff to help you reserving a room at any hotel, on beach or in town, and at any budget you prefer.
You may send me a picture of your tummy for evaluation by email or hard mail if you need pre-op consultation.
Please let me know if you are interested or need more detail.
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Augmented Rhioplasty ( Nose Enlargement )
Augmented Rhinoplasty is done by using customized fabricated silicone prosthesis placing inside the nose and above the nasal bone and septal cartilage . Usually it will be done under local anesthesia in my office. The operation takes 1 hour and you can go back to stay at your hotel room immediately after operation. The swelling and bruise will disappear in 1-2 weeks.
The cost of surgery is 600US$. However, I select the patient carefully because not everyone will be a good candidate for this operation. If you can send me your photo, I can tell you before that you should have this operation or not.
I do not perform western style or reduction rhinoplasty.
Please let me know if you are interested or need more detail.
