Frequently Asked Questions (FAQs)
Q: When can I start driving?
A: Advise to wait at least 2 weeks after surgery before driving a vehicle. When start driving again, does so over short distances, long distance makes frequent stops to walk and urinate.
Q: How/When can I first start sexual intercourse after SRS?
A: Please wait around 3 months or until no more vaginal discharge before having oral sex or sex with vaginal and anal penetration.
Q: How to feel orgasm after sex change
A: To be reach orgasm is depending on each person. Take time to explore and feel your genitals to rediscover your erogenous zones. Mostly, this is after 2 months surgery.
Q: How did you pick the PAI
A: I was lucky that my mother has a doctor friend, who happens to be a great surgeon. She recommended me to a doctor at PAI. The best thing was their greatest cares.
Q: What came before the operation
A: You must consult with psychologist and see if you are truly ready to get it done.
Q: How did you feel after surgery
A: Based on patient’s, I woke up feeling vey blurry. There were tubes everywhere. The saline drip was inserted into my left hand and the pulse rate meter on the right. There was also a tube attached into the bulging part of my new female sex organ to take the blood out of my body. I was also new to the whole female peeing thing so, they had another tube inserted into my urethra to ease me into the process. On the third day after surgery, my body got used to the new organ and I was ready to pee on my own.
Q: How do you feel now
A: As patients’ feedback, I have more confidence, and feel more like myself. People keep telling me that my body shape really changed and looks more feminine in every way. In terms of sex, I have the same feeling as any women.
Q: I was wondering if you have any combination packages that would involve SRS surgery and a facial feminization surgery
A: Yes. We can set up combination packages for SRS, Facial Feminization and Breast Augmentation together.
Q: Do we have orgasm in this surgery technique?
A: We cannot guarantee, because even natural female do not all have orgasm. But 80-90% of our patients reported orgasm.
Q: What does vagina looks like after surgery? Will it be natural as women’s vagina? Does anyone can recognize with this vagina that we were a boy before? (I have seen the pictures of your surgery in the web site but I would like to ask about it again)
A: The doctor will perform the best for you.
Q: Do I have to aware of external medical expenses?
A: Our price includes all post-operative medical and hospital costs arising from the surgery. However, where additional medical symptoms arise in a patient that are not directly related to the surgery undertaken, but are because of a known or unknown prior medical condition that manifests itself while under the care of Preecha Aesthetic Institute the costs involved with treatment of these is are expressly excluded from the prices quoted. Patients are therefore strongly recommended to arrange medical insurance to cover the eventuality of non-related medical costs arising while staying under our care.
Q: I would like to consult about breast facial surgery and SRS. I want to know which should be done first face or breast since I have not done any surgery. Do you have age limit to proceed with this since I am nearing forty. How many years it takes to complete all surgery from face to bottom. How long is the healing for SRS no of days?
A: There is no age limit for surgery, if you are healthy and passed the lab tests or medical checkup before surgery. You may consider Facial surgery, breast and SRS at the same trip for cost saving or select the procedure that you want as the first trip. But if Breast Augmentation, Facial Surgery with SRS, the healing time in Bangkok is 15 days, after surgery as requirement.
Q: My partner is concerned about the final outcome of the SRS. Is it sensitive (with feeling)? Is she going to be able to have Orgasms?
A: The goal of SRS (MtF surgery) here at Preecha Aesthetic Institute (PAI), all patients must receive appearance and overall realistic.
Q: Can I do Facial Feminization Surgery together with SRS surgery?
A: Yes. Facial Feminization Surgery (FFS) can be performing together with SRS and Breast
Q: Is local Thai’s psychiatrist doctor are necessary?
A: Local Thai’s psychiatrist doctor is a must because we are following WPATH/Asia PATH and Thailand Medical Law. All patients (SRS) must also consult with a Thai’s psychiatrist, if already got at least one letter psychiatrist oversea. We will arrange Thai’s psychiatrist on consultation day.
Q: I want to make surgery, I was thinking about it since I was child and now I feel that I can't wait no longer. I want to make it as soon as possible. As I said previously, I'm on 2 month of HRT and in September I would be on 7 months of HRT. So, I wondering if I can make that surgery without waiting 1 year?
A: If you can provide two psychiatrist letters that proof for your SRS. We may consider to be performing SRS earlier. However, transgender and gender diverse persons may require medically necessary gender affirming hormone therapy to achieve changes consistent with their embodiment goals, gender identity or both at least 12 months.
Q: I want breasts that will suit my body size; my current ones from 5 years of hormones are a cup at most. Bottom Surgery - to be me. Every time I look in the mirror when I’m naked, it’s the one area that I struggle with, I haven’t had intercourse with my partner since I transitioned, and we both want to carry on a natural and happy sex life. I want to get rid of the bulge, I play sports and wear sports shorts, and it’s noticeable, I can’t wear a swimsuit without shorts, I’ve got genitals that do not match my gender. I've also attached my gender recognition certificate (Legally Female), as well as my psych letter.
A: Base on your questions, you met our general requirements. Sex affirmation surgery or sex-change operation is a term for the surgical procedures. You can firstly fill out a medical form or contact us via email consult@pai.co.th to be prepared surgery. Don’t worries SRS and breast augmentation can be perform at the same time with combine procedures. However, you must be in good health conditions. All information will direct email.
Q: I am a transgender woman with significant genital dysphoria, I have always wanted to have a vagina. Having male genitals causes severe depression and I really need to have SRS. The aesthetic appearance is very important to me, and the anatomy is too. Depth is also important but not as important as the appearance and anatomy of the vulva. So I have chosen scrotal graft vaginoplasty to give as much material as possible to work on the anatomy and natal vagina aesthetic.
A: You can choose srs penile skin inversion with scrotal skin graft. For future information, sample result, please email to consult@pai.co.th
Q: I also want to notify you that i have almost updated my two referrals for surgery . Do I need the last letter from Thai's psychiatrist in Bkk ?
A: Yes. You still need to get one letter from Thai's psychiatrist here. We will refer you to hospital for finalized with Thai's psychiatrist. Please understand that we are strictly with letter because follow WPATH, Asia PATH and Thailand medical law. Your letters from home country are best supportive. Cost of Thai's psychiatrist interview is around 1,800 THB.
Q: What is the average wait-list for penile inversion or other method at PAI?
A: Schedule/planning at least 1 month ahead of time.
Q: Is genital hair removal mandatory for penile inversion?
A: No. (this is not necessary but just an option). For your sake, even thru, the surgeon will also scrape the root of hair from penile and scrotal skin during surgical times (hair follicle scraping).
Q: I cannot undergo genital hair removal pre op for personal reasons.
A: No problem. The doctor here will scrap hair roots during surgery.
Q: Gender Reassignment Surgery (PPV method), I heard this method is most advanced in making cisgender-like vagina, such as self lubricating.
A: The answer is not truly. PPV’s technique is same as Penile Skin Inversion with Scrotal Skin Graft. But some may say PPV’s technique is created more depth + permanent if compare with skin graft. Note: PPV’s technique is not yet qualified in good researchers or paper proof. In addition, PPV’s does not get self-lubricating. Many patients are confusing about PPV’s which claim better than Penile Skin Inversion Skin Graft technique (PSI+SSG). Keep in mind that we are performing SRS all kinds since 1976, more than 46 years experienced (Pioneer Sex Reassignment Surgery Thailand) with no intention about PPV’s technique. Therefore, PPV’s technique needs more development.
Q: IS THERE ANY PROBLEM FOR SRS (PSI with SSG) ? IF I HAVE DONE VOICE SURGERY LONG times AGO.
A: We (PAI), general anesthesia will using tube size 6.5-7 or a little bigger. No smaller size. This must be notice by your voice surgeon. Is there any side effect ? If not, sex reassignment surgery can be perform.
Q: I need the scrotal graft (SRS) method. Unfortunately, being from my country, it is very very dangerous for me to walk into a laser clinic for men or for women to get electrolysis. Is it possible for me to not get electrolysis at all for this method?
A: Electrolysis hair removal, this is not necessary. You can skip. This is just an optional. Dr.Sutin and Dr.Burin, they will also scrape the root of hair from penile and scrotal skin during surgical times (hair follicle scraping).
Q: Is it a must to bring someone with me to take care of me while in Thailand? I am on a very limited budget and I don't really have anyone who would take care of me. I can bring my friend but I would have to take care of his expenses as well. I am not sure if my budget is enough for both of us.
A: Mostly, our patient are foreigners. They come to surgery by themselves. You can come to PAI’s clinic by yourself. But you must be fully 20 years old with all documents preparation. Once you are arrived at Bangkok International airport. You will see a PAI's driver waiting at meeting point.
Q: I have been on HRT since October 2022, and have been presenting as a woman at school and workplace since December 2022. I currently have a doctor's certificate for Gender Dysphoria/Gender Identity Disorder, written in both English. May I consultation session(s) beforehand. If yes, can it be done via email ?
A: Yes. Our doctors are willing to consultation via email beforehand. This is also included your health issue. However, you still need to finalize direct consultation before surgery. So the finalize need direct consultation here at PAI's clinic.
Q: I am a transgender woman who is interested in penile skin + scrotal graft bottom surgery. I have been hormonally transitioning since June of 2019 and have been living full time in my work and social life as a woman since early 2022. I have a psychiatric specialist who will be able to provide a letter of recommendation and believe I meet all other medical criteria. Questions are related to pricing and scheduling primarily
A: All related to SRS (MtF surgery), please direct email by consult@pai.co.th
Q: I am also curious as to hair removal necessity. With a scrotal graft is that a pre requisite or not.
A: Electrolysis hair removal from Penile Skin Inversion or with Scrotal Skin Graft, these are optional. The surgeon will also scrape the root of hair from penile and scrotal skin during surgical times (hair follicle scraping). Indeed, still comfortable with electrolysis hair removal ahead of times before arriving to be surgery. We are recommend at least two sessions and should be finished at least four weeks before arrival Bangkok. The area should be considered for electrolysis hair removal at middle part of scrotum.
Q: Whether Bulbourethral glands will manage to be kept?
A: Bulbourethral glands, these are keep.
Q: What tissue will the labia minora be constructed from?
A: From penile skin and prepuce.
Q: Whether to manage to preserve the glans tissues as much as possible, where will they be used?
A: Reconstruction clitoris and the less will be place in the area between clitoris and size of urethra.
Q: I am now aged 31, BMI is within 24 and no HIV from blood tests. Understand you will confirm in Thailand. I shall be able to maintain healthy (or lose a bit more weight)
A: Your BMI’s should not be over than 24.80. If over than 24.80, an extra change maybe applied.
Q: Is it likely I am good to go 14 days after surgery, or would you prefer me to arrange longer stay for recovery or check-up?
A: Fourteen days after surgery date are minimum requirement to undergo SRS by Penile Skin Inversion with Scrotal Skin Graft.
Q: For the post-op care after leaving your clinic, what is the frequency of dilation recommended, and do I need to lie down to do it? I would like to plan ahead about my work arrangements.
A: Post op dilation, this is a must to do for all sex reassignment surgery techniques. You have to keep dilate at least 2 times a day (10 min each time+) and then increasing size of dilation after a month. To dilate, these can be morning and evening times. But if you have sexual intercourse after 3 months surgery, you can skip to dilate that day too.
Q: What's the difference between plastic and acrylic dilator?
A: Same.
Q: I have been wanting reassignment surgery ever since I started transitioning back in 2020. I want to be able to have a body that is similar to that of a cisgendered woman, and to be able to have a functional vagina as I have severe genital dysphoria.
A: Key requirements, you must provide at least one or two referral letters from qualified mental health professional and this can be hormone therapist. Understands the nature and purpose of gender reassignment surgery with good health condition and then question can be ask via email at consult@pai.co.th
Q: Do I need have electrolysis or laser hair removal on the genital area before having Sexual Reassignment Surgery ?
A: Laser hair removal or Electrolysis hair removal on genital area before having sex reassignment surgery, this is just an option. During surgical, the surgeon will also scrape the root of hair from penile and scrotal skin (hair follicle scraping). However, if you are too worried. Laser hair removal or electrolysis hair removal should be finished at least a month before surgery date.
Q: About the letter from a psychiatrist. I have a letter confirming I am receiving HRT and additionally I should be able to get a letter from my doctor saying I have been put forward for surgery elsewhere. Would this be adequate?
A: Preecha Aesthetic Institute is also followed a standard health care by Thailand Medical Health Regulation as well as WPATH/AsiaPATH. All patients (MtF surgery) must also finalize by Thai's psychiatrists in Thailand. We will refer all Trans to consult with Thai's psychiatrists at international standard hospitals. However, your HRT or psychiatrist's referral letters from country are best supportive documents.
+66 (0) 2 715 0111
consult@pai.co.th
