Dr. Chettawut answers your general inquiries
regarding Sex reassignment surgery
Dr.Chettawut recommends patients to keep the dilation routine schedule every day for 2 years in order to maintain original depth.
The dilation will be for life but the frequency of dilation time can be adjusted for 2-3 times per week after 2 years.
Each surgeon has developed their own technique and we do not know the details of each surgeon’s technique.
For Dr.Chettawut’s SRS technique, we can assure that our SRS patients will receive excellent sensation, natural aesthetics for all genital structures and maximum depth of vagina.
All Standard SRS (Sex Reassignment Surgery) will be performed by penile NON inversion technique which means Dr.Chettawut do not intend to use the valued penile and prepuce skin to be inverted inside the vagina in order to be the skin lining of the vaginal wall.
In contrary, the penile and prepuce skin will be utilized mainly for the aesthetically sensate inner labia (like a lip in a biological female) as well as a good formed vaginal opening.
Dr.Chettawut explains that with his SRS technique, all of his SRS patients will always be able to achieve special female erotic sensations as well as being able to naturally experience orgasm (climax).
Dr.Chettawut’s technique maintain these sensations by meticulous preservation of almost every sensate tissue from the glans penis and its prepuce skin (the foreskin which cover the glans penis) as well as all specific sensory nerves (branches of pudendal nerve) supplied to the following structures.1. Clitororal hood
2. Clitoris (normal size as in biological female, not oversized)
3. Clitoral frenulum
4. Vulva vestibule
5. Inner part of inner labia (labia minora)
6. Outer part of inner labia (labia minora)
7. Side wall of vaginal opening
The scrotal skin will be used for both outer labia construction and also skin graft material.
The naturally beautiful appearance of outer labia (labia majora) can be always expected from Dr.Chettawut’s work.
His skin graft technique by using scrotal skin and sometimes with additional groin skin always provide adequate skin lining inside vaginal canal which will be created as deep as possible to individual pelvic anatomy.
The achievement of depth of vagina between 6-7 inches is normal and Dr.Chettawut can guarantee that there will be NO hair inside your vagina.
The average time for SRS operation is 6.5 hours. Dr.Chettawut is always the only surgeon who performs your surgery from the start to the end and he strives to obtain full satisfaction in the reconstruction of all new genital structures as well as the best possible scarring.
This process depends on the requirement of your city/state/country system.
It is your responsibility to find out whether your SRS certification needs notarization by your country’s Embassy in Bangkok.
From our experience, some states in US such as Florida, Illinois require the SRS certification to be notarized by the US Embassy in Bangkok.
Because the embassy does not keep record of licensed Thai surgeons, they will ask you to first visit and to certify your SRS certificate at Ministry of Foreign Affairs in Bangkok, Thailand located at Chaengwattana Road.
Once the certificate is notarized by Ministry of Foreign Affairs then the embassy will notarize your SRS certificate without any question.
The trip to visit Ministry of Foreign Affairs and US embassy should be planned in separate days since the location of each place is very far from each other and usually the process at Ministry of Foreign Affairs will take 1 full day.
Please be advised that the US Embassy will not accept walk-ins therefore you should make an appointment in advance at least 1 week prior your departure date so that the notarization process will be completed on time.
The Ministry of Foreign Affair is located at
Consular Service at Chaengwattana Building – 123 Changwattana Rd., Laksi District Bangkok 10210
Tel (662) 981-7171
Operation hours: Monday – Friday from 8.00 am – 16:00 pm (No need to make appointment)
To visit the Ministry of Foreign Affairs website, click The Ministry of Foreign Affairs.
The process of visiting Ministry of Foreign Affairs Thailand (written by one of our former patient based on her personal experience) can be requested upon e-mail and we will send the attachment file to you.
Concern of vaginal depth in related to available genital skin
Dr.Chettawut’s non inversion technique is suitable for all variation of penis sizes.
If you have a short penis, it will NOT affect the depth of your vagina because the skin graft lined inside vagina come from the scrotal skin and in some case combined with extra groin skin.
With non-penile inversion technique, the penile skin is used for only external genital structure, mainly for natural look (lip-like) labia minora and part of vaginal opening.
For those who have very short penis, the size of labia minora may be small. However the good look and definition of labia minora can be still expected.
Before SRS operation, the sufficient skin graft must be well planned and prepared for your neo-vagina.
In case your scrotal skin (the skin that covers testes) is insufficient (too short), it is necessary to add “Extra groin skin graft procedure” to get a more skin graft so that the total amount of skin graft will be enough for creating a neo-vagina as deep as possible.
Note: The groin skin graft is an additional work during SRS by taking the nearby groin skin without creating another incision or scar.
There will be an extra charge of 32,000 THB of this additional groin skin graft procedure of which Dr.Chettawut will confirm if you need it or not after physical examination on consultation day.
In summary, good depth of vagina between 6-7 inches can be achieved by the combination of scrotal and groin skin graft for those who have small scrotal skin.
Concern of choosing between standard sex reassignment surgery and primary colon vaginoplasty
No, it is NOT necessary to choose primary colon vaginoplasty because the standard sex reassignment surgery with skin graft can provide a good vaginal depth of 6-7 inches even in case of very short penis.
It is true that the colon vaginoplasty can provide a vagina depth of 7-8 inches, however few patients realize that the deep part of vagina from colon vaginoplasty (the part that is deep beyond 6 inches) may be difficult to access by normal dilation or penile penetration due to its upward direction along the curve of sacrum (bone at the upper, back part of the pelvic cavity).
In summary, Dr.Chettawut always recommends the standard SRS with skin graft for primary sex change surgery which is safer and cheaper surgical procedure than the primary colon vaginoplasty.
With the standard SRS with skin graft, the skin lining inside neo-vagina will not create self-lubrication.
However, Dr.Chettawut’s non penile inversion technique preserves the cowper’s gland, the prostate gland and small glands around the urethral opening which can secrete some lubrication during sexual arousal.
These self-lubrications are useful as they come from the patient’s physiological response during sexual arousal; however they are considered NOT enough for adequate lubrication during routine dilation or sexual intercourse.
Compared to self-lubrication from SRS with colon graft (sigmoid colon vaginoplasty), the discharged lubrication come from nature secretion of colon mucosa which is not directly related to sexual arousal. The amount of self-lubrication from colon graft varies individually and is difficult to predict before surgery. One drawback of colon vaginoplasty is the colon may secrete too much discharge (lubrication) which leads to dampness and unpleasant smell.
In Dr.Chettawut’s opinion, the vagina which made from either skin graft technique or colon graft technique always need the application of water soluble lubrication (for example KY jelly or QC jelly) in order to avoid a risk of irritation or tearing during vaginal dilation or sexual intercourse.
Since the skin graft or colon graft is the lining inside neo-vagina so they normally cannot be seen from outside.
Therefore so the external appearance between SRS with skin graft and SRS with colon graft will be no different.
However the patients who have a small penis and plan to choose SRS with colon graft technique should concern of the red color of colon which can possibly be seen from outside.
(A small penis causes short of skin around vaginal opening which leads the colon part to be closer to the vaginal opening).