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+66 (0) 2 715 0111
consult@pai.co.th
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overview

Trans man is a man who was assigned in wrong body or female at birth. Trans men have a male gender identity and many trans men choose to go for gender affirming surgery. An ultimate goal is to align the body with identified gender, and undergoing metoidioplasty (FtM bottom surgery) could be a crucial step in that direction. Metoidioplasty surgery, patients must follow endocrinologist (testosterone replacement therapy minimum one year) and persistent gender dysphonia document by qualified mental health professional before transition surgery.

Female to Male surgery, there are generally break through into four main steps such as Top surgery (mastectomy), Hysterectomy + ovary removal, lower or bottom surgery (FtM surgery, Genital Reconstruction Surgery) but closed vagina as an optional. Testicle implant or ball implant is also optional the latest step for trans man surgery. More often, a vaginectomy (closed vagina) is performed at the same time with metoidioplasty.

What is Metoidioplasty ?

Metoidioplasty is also sometime spelled”metaoidioplasty,” “a surgical change toward the male from transgender Female to Male surgery” (bottom surgery.)

Metoidioplasty is sometimes referred to as a “clitoral free-up” or “clitoris release” (the clitoris is freed from some of its surrounding tissue and brought forward on the body) in a manner that makes it appear like a small penis. The surgical is by cutting the ligament that holds the clitoris in place under the pubic bone, as well as cutting away some of the surrounding tissue, the surgeon is able to create a small phallus from the elongated clitoris.

Metoidioplasty can performed with multiple procedures vaginectomy, hysterectomy+ ovary removal and Top surgery at the same trip.

Testicle implant is highly recommend in a separate trip because skin tissues need more elastic expand as well eliminate risk of infections at least ten months after metoidioplasty.

Metoidioplasty or Bottom surgery (Female to Male surgery), this is important that patients are realistic about what reconstructive surgery and treatments can and cannot do. Assoc.Prof.Preecha Tiewtranon MD, Burin Wangjiraniran MD and Sutin Khounsongserm MD (Board of Cosmetic & Reconstructive surgery) are in the best position to address these issues and for that reason frank an open dialogue is recommended to avoid any misunderstanding.

In the future, if patient want to continue with Long Penis (Phalloplasty). This can continue long Penis by using abdominal Skin Phalloplasty (After Metoidioplasty)

Read more trans man procedures and more cosmetic procedures at Preecha Aesthetic Institute.

SUITABLE CANDIDATES Metoidioplasty (FtM surgery)

Best Candidate for Metoidioplasty at PAI.

PAI (Preecha Aesthetic Institute), we are following WPATH/HBIGDA or SOCs or Asia PATH.

These are Standards of care for gender identity disorders - WPATH (World Professional Association for Transgender Health) the earliest sets of clinical guidelines for the express purpose of ensuring “lasting personal comfort with the gendered self in order to maximize overall psychological well-being and self-fulfillment.” These standards are still the most well-known; however, other sets of SOCs, Asia PATH protocols and guidelines do exist, especially outside the USA.

  • Much of the criticism surrounding the WPATH/HBIGDA/Asia PATH
  • Psychological evaluation letter by qualified mental health professional (written in English)
  • Must undertake testosterone at least 12 months
  • Real-Life experience
  • Physically healthy and emotionally stable with realistic expectations
  • At least 18 years old (need a parent’s show up sign permission to pursue metoidioplasty surgery) ; if fully 20 years old able to come by yourselves

Metoidioplasty package's included

Package is included with Metoidioplasty :

  • Accommodation for 3 days in an international standard hospital private room after surgery ( JCI accredited )
  • Operating room charges: OR room use, recovery room, scrub & circulate nurse
  • Regular menu food charges
  • Laboratory testing: necessary for the procedure as CBC, EKG, UA, Anti HIV, Chest X-Ray (If age over 45 need to check cardiology.  An extra charge is 100 US Dollars + -)
  • Medical equipment and medical supplies
  • General anesthesia - Pre anesthetic drugs, anesthesia and medical gas (oxygen, nitrous oxide)
  • Medical treatments
  • Doctor fees
  • Anesthesia fees
  • Nursing services
  • Take home medication and supplies
  • Post op cares
  • Transportation pick up (optional)

PREECHA AESTHETIC INSTITUTE AND AFFILIATED HOSPITALS - JCI-ACCREDITED INTERNATIONAL HOSPITALS

Preecha Aesthetic Institute (PAI) is the first multidisciplinary Aesthetic and Reconstructive center also best well known the pioneer in Sex Reassignment Surgery (Male to Female and Female to Male) Thailand since 1980. The center has the most advanced 10 consultation rooms, 6 operation rooms (local anesthesia), equipment to any leading Aesthetic Plastic Surgery completed with recovery rooms and the internationally accepted standard of hygienic system.

  • Metoidioplasty is performed under General Anesthesia. Require to be in hospital for two nights. 

All cases under general anesthesia, PAI's using two major private International Standard Hospitals affiliated - JCI accredited, for healthcare promoting center located in Bangkok under the philosophy of "World class quality with Thai hospitality", private patient rooms, 230 beds, modern medical technology, equipment and hospital receiving accreditation for high-quality.

  • Consultation, Medical health check up and Follow ups will be appoints at Preecha Aesthetic Institute.
  • Two international standard hospitals - JCI accredited International Hospitals.
  • Surgical will perform at affiliated hospitals ⇒ General Anesthesia ⇒ International Standard Hospital.
preecha aesthetic institute (PAI)

Preecha Aesthetic Institute

International Standard Hospital (JCI accredited)

Affiliated Hospital

Affiliated Hospital

Service Accommodation

  • Transportation pick up from airport –hotel-hospital-clinic-airport as well as follow up period (optional)
  • Hotel reservation within 2 KM from PAI's clinic
  • Interpreter services with any language

QUESTION, APPOINTMENT AND SCHEDULE

Dr.Preecha Tiewtranon MD, Dr.Burin Wangjiraniran MD FRCST and Dr.Sutin Khobunsongserm MD (Board of Plastic & Reconstructive Surgery, Thailand).

Dr.Preecha Tiewtranon MD, Dr.Burin Wangjiraniran MD FRCST and Dr.Sutin Khobunsongserm MD, all Board of Plastic and Reconstructive surgery Thailand.

Your questions will be direct answers from PAI's doctors.

  1. Write your question, interest
  2. List your expectations or procedure that you are interest and give us your detail as possible
  3. Email to us at consult@pai.co.th
  4. We will get back to you shortly after receive your question

Risk of Metoidioplasty

All surgery carries risks but can minimize by closely following your surgeon’s advice on follow up care during the healing process. It is important that you are realistic about what cosmetic surgery, reconstructive surgery and treatments can and cannot do. Possibility risks are included rare wound complications, urethral strictures and urethral fistulas. Your doctor is in the best position to address these issues and for that reason frank and open dialogue is recommended to avoid any misunderstanding.

Sample result Metoidioplasty

 

metoidioplasty, female to male surgery, metaoidioplasty, transmen surgery l preecha aesthetic institute

After 12 months metoidioplasty.

Sample result Metoidioplasty

standing and pee metoidioplasty

Metoidioplasty. While stand up to urinate at a toilet.

Sample result Metoidioplasty

metoidioplasty l preecha aesthetic institute

Metoidioplasty. After one year.

 

 

Sample result Metoidioplasty

Metoidioplasty and closed vagina after 12 days and after one year FtM surgery, baby penis FtM surgery

Metoidioplasty + Closed Vagina. After 12 days and After one year.

Set up an appointment with us

1. Write your question, interest at consult us in program form

enquiry

2. Via email consult@pai.co.th

2.1 list your expectations or procedure that you are interest and give us your detail as possible
2.2 email to us
2.3 We will get back to you shortly after receive your question with recommendation from specialize surgeon

Once you know your planning date for surgery. Here is the next step:

1. Consultation with us via email for details and procedure
2. Plan your available date to be surgery and departure from Bangkok
3. We will confirm you for surgery date
4. You may start to book your airline ticket
5. We will confirm you all detail and hotel booking, if require
6. For transportation to be pick up from the airport, we can do for you as optional

surgical details:

During direct consultation with our surgeon – the surgeon will evaluate your general health status and any pre - existing health conditions or risk factors such as examine and take measurements, take photographs, discuss your options and recommend a course of treatment and discuss likely outcomes of Metoidioplasty and any risks or potential complications

Preparation to Metoidioplasty (a small penis)

  • Inform us about any allergies, any serious medical condition(s), and all medications you are
    taking (both prescription and non-prescription)
  • Qualify letter from Psychiatrist doctor or Hormone Therapist
  • No Aspirin 2 days before surgery
  • Stop vitamin E Oil 1 day before surgery
  • Stop smoking 2 days and a month after surgery
  • Stop Hormone, if taken 2 weeks before surgery date
  • Tell doctor if you have any serious medical condition(s)
  • Stop meal and water starting from midnight before surgery
  • Plan to be in Thailand at least 14 days after or at least 17 days (Before and after) surgery

 

                   Package is include with Metoidioplasty

  • Accommodation for 3 days in hospital private room after surgery
  • Operating Room Charges: OR Room Use, Recovery Room, Scrub & Circulate Nurse
  • Regular menu food charges
  • Laboratory Testing: necessary for the procedure as CBC, EKG, UA, Anti HIV, Chest X-Ray. An extra charge is 50%, if HIV+ from surgery fee
  • Medical Equipment’s and Medical Supplies
  • General Anesthesia - Pre Anesthetic Drugs, Anesthesia and Medical Gas (Oxygen, Nitrous Oxide)
  • Medical Treatments
  • Doctor fees
  • Anesthesia fees
  • Nursing services
  • Take home medication and supplies
  • Post op cares
  • Transportation pick up (optional)

 

                Metoidioplasty Surgical Dates 

Day 0 - Arrival date (check in hotel)

Day 1 - Consultation and Prepare for Laboratory Testing

Day 2 - Medical Health checks

Day 3 to Day 5 - Check out hotel. Surgery date (2 nights in hospital)  and 3 days in hospital private room after surgery

Day 5 - Discharge from Hospital

Day 5 to 17 – Stay in hotel for recovery period and follow up on doctor appointments

Day 7-10 – Stitches removal

Day 17 - Final checkup and prepare for letter fit to fly and issue for a new letter with gender name change

Day 17 - Safe to fly

Things should bring from home.

  • Button-up shirts in large sizes
  • Sweatpants / Short Pants
  • Slip-on shoes or slippers
  • Phone charger, long phone charger
  • Books, magazines
  • Travel neck pillow

Metoidioplasty - The procedure is perform by cutting the ligament that holds the clitoris in place under the pubic bone, as well as cutting away some of the surrounding tissue, the surgeon is able to create a small phallus from the elongated clitoris.

This is why metoidioplasty is sometimes referred to as a "clitoral free-up" or "clitoris release" (the clitoris is freed from some of its surrounding tissue and brought forward on the body) in a manner that makes it appear like a small penis.

In order to further enhance the result, fat deposit from those areas may be remove from the pubic mound and skin and pull upward to bring the phallus even farther forward. Metoidioplasty surgery is involving a urethral lengthening procedure to allow the patient to urinate through the penis while standing.

Under General Anesthesia : 3 - 4 hours

Post operative recovery :

  • Metoidioplasty, the patient is required to be in hospital 2 nights. All conditions will check by doctor daily and nurses.
  • Pain that is easily controlled by medication usually will subside in a few weeks.
  • Sutures will be removed after seven to ten days of surgery date.
  • Although the surgeon has made every effort to keep scars as inconspicuous as possible. They are the inevitable result of surgery.
  • Minimal swelling and discoloration will disappear rapidly.
  • The use of catheter to urinate should take less than 10 days after surgery for no signs infection such as redness and swelling .
  • Surgeon of PAI will provide detailed instructions on how to care for the catheter
  • Mostly, the patient is able to walk around with light activity within a week after surgery.
  • Healing enough to go back/safe to fly after 2 weeks of surgery date.
  • Since Metoidioplasty is a long healing process. All activities may take up to twelve weeks.
  • Natural healing process can take up to 8-12 months.

 

Recovery from metoidioplasty (Female to Male surgery) may be differently from everyone. But most commonly are

  • Discomfort and pain will be most prevalent for a week follow surgery. This is normal. All can control by medicines and doctor cares.
  • Sleep on your back for at least the first week after surgery date.
  • Drink a lot of clear waters.
  • Swelling and bruising will decrease after 3 weeks but may take longer for some people. This is normal.
  • To help the healing process you need to rest, eat healthily, refrain from smoking.
  • Not to lift above your head for at least 2 to 3 weeks after surgery.
  • You can typically resume physical exercise such as sports, lifting, and running after 12 weeks.

 

Surgery Schedule (required at least seventeen days in Bangkok for Metoidioplasty)

Day 0 - Arrival date (check in hotel)

Day 1 - Consultation and Prepare for Laboratory Testing

Day 2 - Medical Health checks

Day 3 to Day 5 - Check out hotel. Surgery (2 nights in hospital) 3 days in hospital private room after surgery

Day 5 - Discharge from Hospital

Day 5 to 17 - Stay in hotel for recovery period and follow up on doctor appointments

Day 7 to Day 10 - Stitches removal

Day 17 - Final checkup and prepare for letter fit to fly and issue for a new letter with gender name change

Day 17 - Safe to fly

 

Recovery Timeline Metoidioplasty

  • The day after surgery before discharge hospital. PAI doctor team will visit to discharge from hospital.
  • Able to walk slowly after day 3.
  • Removing incisions will appointment 7 to 10 days after surgery.
  • No heavy exercise 4 - 8 weeks after surgery.
  • The decision on when to return to work and normal activities depends on how fast you heal and how you feel.

Recovery times for Metoidioplasty surgery may take from 4 to 8 weeks. The patient won't be able to do any strenuous activity or lift heavy objects for at least a four weeks after surgery. Any activities should wait until the surgery site has fully healed before having sexual intercourse. Fully healing can take up to 8 -12 months.

 

For local’s patient - You may resume to work after ten to fourteen days surgery but must avoid heavy lifting object over the head or fast movement during four to six weeks after surgery date. Stitches are remove seven days to ten days after surgery date.

For international patient - Plan to be in Bangkok at least seventeen days all together. Stitches will remove seven  to ten days after surgery date. You may resume to work two weeks but must avoid heavy lifting object over the head or fast movement during four to six weeks after surgery date.

◊ Any bruising and swelling will usually dissipate within 3 to 8 months after metoidioplasty FtM surgery.

Treatment after surgery
during the first 7 days

  • Removing incisions seven to ten days after surgery
  • Light walk is recommend after 3 nights surgery
  • No heavy exercise three months after surgery
  • Scars are usually well hidden and normally fade in time
  • Swelling and bruising can be minimized with one to three month (s)
  • Frequent naps are recommend 

surgery info:

services icon 1 150x150 1
TIME REQUIRED

3 - 4 Hours

services icon 2 150x150Anesthesia
ANESTHESIA

General Anesthesia

BACK TO WORK

21 days

services icon 4 150x150 Strenous Activity
STRENUOUS ACTIVITY

6 weeks

FADING OF SCARS

8 - 12 months

Swollen & Bruise

1 - 2 month (s)

Logo Preecha Aesthetic Institute
Metoidioplasty (Female to Male surgery)

is called Bottom surgery in a manner that makes it appear like a small penis.

Surgery Schedule

Schedule Appointment Consultation / Surgery / Question Metoidioplasty Female to Male at Preecha Aesthetic Institute.

Once you know your planning date for surgery

Trip's planning :

  • Day 0 - Arrival date (check in hotel)
  • Day 1 - Consultation and Prepare for Laboratory Testing
  • Day 2 - Medical Health checks
  • Day 3 to Day 5 - Check out hotel. Surgery date (2 nights in hospital) and 3 days in hospital private room after surgery
  • Day 5 - Discharge from Hospital
  • Day 5 to 17 - Stay in hotel for recovery period and follow up on doctor appointments
  • Day 7-10 - Stitches removal
  • Day 17 - Final checkup and prepare for letter fit to fly and issue for a new letter with gender name change
  • Day 17 - Safe to fly

testimonials

useful information

ADDRESS

PAI (Preecha Aesthetic Institute)
898/1 Sukumvit 55 Wattana, Bangkok
10110 Thailand

Tel: +662-715-0111

Fax: +662-715-0113

Email: consult@pai.co.th

MEETING POINT (AIRPORT)

The driver will be waiting for you at door number 4 (Meeting point) after exit from customs. The driver will stand by with your name and PAI  logo. [Suvarnabhumi International Airport (BKK)]

HOTEL

Hotels are under cooperate and nearby PAI, starting from 50 USD to 100 USD. Rates are quoted in THB, USD/net/included of taxes and service charges. All non-commissionable rate. VISA/Master card is accepted.

  • Special apartment 68 sq.m-131 sq.m with one to two bedroom/1 queen/master size bed, 1 bathroom (shower and bathtub), pantry and dining area, 2 Bottled water – complimentary for daily contract, bathroom (separated shower & bath tub), cable / Satellite TV, free wifi, dining Table/Chairs, Internet Access (wireless), kettle, LCD TV, refrigerator, slipper, toaster, air Conditioner, bath amenities - complimentary for daily, electronic Door Lock, iron & Ironing Board (on request), kitchenette - Full Equipment, microwave, safety box.

 

  • Hotel - studio room 46 - 58 sq.m - Features & Amenities: 40-in LED, sofa, in-room safe, minibar refrigerator, refillable tea/coffee/water, blackout curtain, free wifi, slippers, bathroom with rain shower, 100% natural therapeutic spa toiletries Mt. Sapola, hair Dryer, toothbrush and toothpaste, shower cap as well as a washing machine.

LANGUAGE

Thai, Chinese, Japanese, Italian, Spanish, French, German, Turkish and other languages upon request.

PASSPORT AND VISA

PAI can issue the letter to clarify with your local Embassy or Passport.

COST OF MEAL

Cost of living meal per day is 15-20 USD.

PAYMENT

The payment can be prepared in Cash by US dollar, Euro, Japanese Yen, Hong Kong Dollar, Singapore Dollar, Australia dollar. If using credit cards (VISA/Master card), the hospital will charged 3% for international transaction fee. This is only for surgery fees. Hotels are not charged for international transaction fee. An extra charged for HIV is 50% from total cost.

TOURIST VISA EXEMPTION (30 DAYS WITHOUT VISA)

Australia, Austria, Belgium ,Brazil ,Bahrain , Brunei Darussalam ,Canada, Denmark ,Finland ,France, Germany ,Greece ,Hong Kong ,Iceland ,Indonesia ,Ireland ,Israel ,Italy ,Japan ,South Korea ,Kuwait ,Luxembourg , Malaysia ,Monaco ,Netherlands ,New Zealand ,Norway ,Oman ,Peru ,Philippines ,Portugal , Qatar , Singapore ,Spain ,South Africa ,Sweden ,Switzerland ,Turkey ,United Arab Emirates, United Kingdom ,United States of America ,Vietnam.

AIRPORT IMMIGRATION AND CUSTOMS

Please present the supporting documents confirming the scheduled operation upon request. Please do not carry any unnecessary drugs or dangerous objects in your luggage.

Frequently Asked Questions (FAQs)

Q: I want FtM sex change surgery By PAI’s doctor as I read a lot about you so kindly guide me about the procedures of hormone therapy and psychiatrist certification from my country or from Thailand? First I should start hormone therapy or not? Kindly help me and prefer me to start this procedure thank you and waiting for your reply

A: For FtM surgery, you should take testosterone or contact therapy in your country at least one year with written proof of therapist or psychiatrist letter. There is still two more request by THAI's psychiatrist, which will refer to hospital while direct consultation.

Q: As I have done my Top surgery and Hysterectomy surgeries and I have a long period of testosterone intake since 4 to 5 years ago So now I’m planning to have my final procedure (Metoidioplasty) completed as soon as possible kindly tell me the complete cost.

A: Base on your general information, you are looking good and a good candidate for metoidioplasty. However, please also fill out your medical form or contact us via email for more information.

Q: Can you perform metoidioplasty and closed vagina without hysterectomy removal ?

A: No. The reason is you should do hysterectomy removal before metoidioplasty or together with metoidioplasty, if also consider closed vagina.

Q: Is there a possibility of Hysterectomy + Ovary removal, without closeing vagina (at all) and metoidioplasty at the same trip or two trips?

A: Metoidioplasty must be with closed vagina. If no closed vagina, there are many chance of infections / complications such as metoid leakage, urethral leakage and etc.

Q: Want to know metoidioplasty (FtM) with no vaginectomy. I just want clitoral release. I have all supporting documentations and have been living legally as male for over 10 years.

A: You can consider metoidioplasty without vaginectomy, if you have already removed hysterectomy and ovaries. But most importantly must be in good health conditions.

Q: I am (FTM) transgender male. I have had top surgery and been on Testosterone Hormones for 2 years now. I am planning to have bottom surgery: full hysterectomy, salpingo-oophorectomy, vaginectomy and metoidioplasty.

A: Yes. Hysterectomy + Ovary Removal, Metoidioplasty and close vagina can be perform at the same trip. But require longer recovery periods in Bangkok Thailand. If all will be perform at the same trip. You must be in Bangkok at least 3-4 weeks all together. However, if you don't want to stay long in Bangkok. You may first consider hysterectomy + ovary removal to perform in your country and then wait at least 3 months to come to Preecha Aesthetic (PAI) for metoidioplasty + closed vagina. If just metoidioplasty + closed vagina, you may plan to be in Bangkok for 2 weeks all together.

Q: Can the surgeons and staff communicate in English comfortably? Or will an external translator be needed?

A: Yes. We are all communicate in English comfortably.

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Set up an appointment with us.

Write your question, interest at consult us in program form

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