Patient Selection Criteria & Patient Instruction

For prospective patients who are planning their surgery with Dr.Chettawut, kindly review our patient selection criteria as follows

1. Age:

One must be completely 18 years old at least, and 70 at most.

Teens whose age are between 18 – 20 years must be accompanied with their parent (father and/or mother) or guardian to Thailand as he or she is required to sign our parental consent at Chettawut Plastic Surgery Center on the consultation day.

The parent or guardian is expected to provide the legal document(s) stated the relationship between he or she and the patient.

2. Health condition(s)

Patients are expected to be healthy fit and have no physiological, biochemical or psychiatric disturbance.

The following lists are considered contra-indications for scheduling any major surgeries required general anesthesia:

2.1 Heart disease

2.2 Lung disease

2.3 Kidney disease

2.4 Liver disease or chronic hepatitis type B and C

2.5 HIV (both symptomatic and asymptomatic HIV positive)

2.6 Deep vein thrombosis

2.7 Post status cancer or any chronic illness which can possibly increase the risk of complications.

In highly special cases, the exceptional approval for scheduling the surgery may be granted to those patients who are considered minimal risk.

All necessary lab and referral letter from the specialist who closely take care of the above condition can be provided for consideration.

3. Weight: Height

To qualify for surgery, one’s body mass index (BMI) must be less than 33.

The only exception is the colon vaginoplasty which we require the patients’ BMI to be less than or equal to 25.

The body mass index (BMI) is a measure of relative weight based on an individual's mass and height and it is defined as the weight in kilograms divided by the square of the height in meters (kg/m2).

How to calculate your BMI:

- Divide your weight in kilograms (kg) by your height in meters (m)

- Then divide the answer by your height again to get your BMI

For example:

- If you weigh 70kg and you're 1.75m tall, divide 70 by 1.75. The answer is 40.

- Then divide 40 by 1.75. The answer is 22.85. This is your BMI.

For upper limit of BMI as 33:

If your height is 170 cm, the accepted maximum weight will be 95 kg

If your height is 175 cm, the accepted maximum weight will be 101 kg

If your height is 180 cm, the accepted maximum weight will be 107 kg

If your height is 185 cm, the accepted maximum weight will be 113 kg

Patient Instruction

General instruction -Before travelling

no_smoking-before-and-after-sex-reassignment-surgery 1. If you smoke, we highly recommend you to cut down and quit at least one month before surgery.

The toxic constituents of cigarette smoke particularly nicotine and carbon monoxide reduce oxygen and nutritional blood flow to the skin, resulting in tissue ischemia and impaired wound healing.

2. There is no need for any vaccination before travelling.

3. We highly recommend you to finalize your remaining fee by wire transfer which should be not later than one month before travelling.

4. You must stop taking aspirin or any blood thinner medication, estrogen hormone, all NSAID drugs: for example, Ibruprofen (Advil), Diclofinac (Votaren) at least 2 weeks before traveling.

5. For SRS patients, apart from sending the copy of your SRS recommendation letters via email to Dr. Chettawut, it is necessary to bring the original SRS recommendation letter(s) showing handwritten signature of your mental health professionals to Dr. Chettawut on your consultation day.

6. All required documents & laboratory reports should be sent as jpeg or pdf file via email as soon as you have them in hands so that your health condition can be evaluated thoroughly in advance.

The instruction to meet our staff at the airport including our staff’s contact number must be printed and kept with you during your flight.

General instruction – The day of your surgery

1. Shampoo your hair and take a shower or bath in the morning of your surgery.

2. Do not remove or shave hair from the surgical site yourself. If hair needs to be removed (for example SRS surgery), this will be done by Dr. Chettawut’s nurse on the day of surgery.

3. Wear loose, comfortable clothing.

Specific instruction

1. Before surgery, you are asked to fast in order to allow for sufficient gastric emptying time to prevent aspiration. Three components of gastric contents can potentially cause problems when aspirated into the lungs: particles (causing airway obstruction), acid (causing chemical burns and inflammation), and bacteria (causing pneumonia).

If your surgery is set in the morning (before 12:00), do not eat or drink anything after midnight.

If your surgery is set in the afternoon (after 12:00), do not eat or drink anything after 7 a.m. (7:00) in the morning of your surgery day.

Oxygen-monirtoring-during-surgery-at-Chettawut-Plastic-Surgery-Center 2. All types of nail polish at index and middle fingers both hands need to be removed at least one day before surgery date.

During your surgery, a sensor of oxygen saturation monitoring will be put over your finger at un-polished nail to measures the amount of oxygen in your blood.

3. All type of jewelry, for example rings & earrings and body piercings made from metal need to be removed at least one day before surgery.

During your surgery, a cauterized instrument relies on an electrical current. If you are wearing metal jewelry which is in contact with your skin, you might receive an electrical burn in the area of contact.

Pain management after surgery

After the surgery, your pain will be assessed to ensure that you are comfortable and safe.

Pain is highly subjective which means it is only you who knows the level of pain that you are experiencing.

To help determine your level of pain, our medical team will ask you to rate your pain using the pain assessment scale from 0-10.

The type of provided pain medication will depend mainly on your intensity or level of pain.

Normally, the pain will be controlled by strong pain killer drugs administered via injection during the first 6 hours after surgery, then followed by oral pain medications (e.g. tramadol which will be provided every 4-6 hours)

In case of severe pain, an appropriate dose and interval of Morphine or Demerol (Pethidine) will be administered intravenously (through the IV line) or intramuscularly (usually the deltoid or arm area).


Pain Score used at Chettawut Plastic Surgery Center