Freqently asked questions on sex reassignment surgery

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Dr.Chettawut's answers for your questions regarding sex reassignment surgery

1. Short penis
Question: My penis is very short, Do I need primary colon vaginoplasty?

Answer: No need to have colon vaginoplasty, I can make a funtional vaginal depth for you (not less than 5 inches) by SRS with scrotal skin graft.

In case your scrotal skin is not enough for skin graft, the abdominal skin graft will be performed as additional procedure (extra 1,600 USD).

2. Short scrotum
Question: How can I know if my scrotal is enough for skin graft?

Answer: You can send me your pictures for evaluation as follow:

1. Hold your penis up while standing.

2. Hold your penis up while lying. (knees up and separate you legs)

3. SRS Technique
Question: Is your techniqe penile inversion?

Answer: No, I do not invert penile skin for vagina wall creation. Penile skin will be used mainly for external genital structures (for example: well defined labia minora, vaginal introitus) in one step construction.

The scrotal skin will be used for labia majora construction and then for a skin graft inside neovagina as vaginal wall.

4. Skin graft procedure
Question: Do you do skin graft and sex reassignment surgery in one setting?

Answer: Yes, I routinely sex reassignment surgery with scrotal and/or abdominal skin graft at the same time except there is abnormal bleeding inside newly created vaginal tunnel (very rare). If that is the case, I will delay the skin graft procedure with 1 or 2 days interval.

5. Genital hair growth after SRS
Question: I do not have genital electrolysis. How about my hair growth on new genitalia and inside my vagina after my sex change surgery?

Answer: I assure you that there is no hair on clitoral hood or labia minora (since they are made from the hairless prepuce/penile skin) and also no hair growth inside neovagina becasue I completely removed all hair follicle from skin graft before using for vaginal wall lining.

The originally perineal skin (1 to 1.5 inch from introitus) is the only area which may have potential hair growth but you can easily get electrolysis later if needed.

6. Anesthetic technique for SRS
Question: What is the epidural block technique? Why do you prefer to use this technique combined with general anesthesia?

Answer: Epidural blok make you feel nothing on the area below the navel (like spinal block), but can administer anesthetic agents at interval through a tiny catheter.

For SRS, the combination of general anesthesia and epidural block can help reduce the amount of anesthetic agents (which make you feel less nauseous) and also control your pain (on genital area) after surgery.

7. Hospital stay
Question: How long is my hospitalization for Sex change surgery?

Answer: The timing process for skin graft taking inside your neovagina is 4-5 days.

On postoperative day 4th or 5 th, the vaginal packing will be removed to see the skin graft inside. If everything looks good, you will be discharged on that day.

8. Secondary labiaplasty
Question: Do I need to come back for secondary labiaplasty?

Answer: My technique can create a well defined primary labia minora as well as clitoral hood in most cases, so very few patients (less than 5 %) whose original skin was very tight may need for secondary labiaplasty (at least 3 months apart).

9. Female to male reassignment surgery
Question: Do you do phalloplasty?

Answer: I would like to emphasize to all my patients contemplating female to male reassignment surgery that I perform only breast removal (subcutaneous mastectomy).

I do not perform phalloplasty (penis shaft construction) or testicular implant.

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