overview

Penile Skin Inversion with Scrotal Skin Graft – Sex Reassignment Surgery

Penile Skin Inversion with Scrotal Skin Graft (Sex Reassignment Surgery, Male to Female) is the procedure that combines the techniques of penile skin envelope, glans penis using extra skin tissue to reconstruct more depth for neovagina. Additional skin graft may come from scrotal skin, abdomen or groin.

Penile Skin Inversion with Scrotal Skin Graft (PSI + SSG) is an inverted peno-scrotal flap for vaginoplasty in male-to-female (MtF) surgery. This procedure gives patients a reconstructed graft that comes from glans penis, penile skin envelope, and scrotal skin a, as well as abdomen or groin.

Dr. Preecha is also renowned as the Pioneer Sex Reassignment Surgery in Thailand. His surgical team has a long standing reputation for disciplinary excellence for Gender Reassignment Surgery under PAI.

Penile Skin Inversion with Scrotal Skin Graft’s technique (GRS, SRS, MtF surgery), which is performed by Burin Wangjiraniran MD FRCST, Sutin Khobunsongserm MD or Assoc.Prof.Preecha Tiewtranon MD (Board of Plastic & Reconstructive Surgery Thailand) also given advance techniques and emphasizes te importance of trans women MtF surgery to achieve more adequate vaginal depth, preserve orgasmic capabilities, minimize and hide scarring, and to create a realistic neo vagina appearance.

With long experience in gender reassignment surgery and the overall refinements introduced, the result has been possible to achieve very close to the biological female genitalia.

General guidelines and open discussion are highly recommended with PAI surgeon and will be finalized during direct consultation.

  1. Long Penis (> 6 inches (15 cm), when erect) = Penile Skin Inversion (PSI)
  2. Medium Penis (2-6 inches (5-15 cm), when erect) = Penile Skin Inversion (PSI) with Scrotal Skin Graft (SSG)
  3. Short Penis (< 2 inches (5 cm), when erect) = Penile Skin Inversion (PSI, SSG) with Sigmoid Colon Graft (SCG). Sex Reassignment Surgery (Sigmoid colon) transposition is used for patients who need more depth (exceeding 6.5 inches +).

Your doctor is in the best position to address all issues, and for that reason, frank and open dialogue is recommended to avoid any misunderstanding. It is important that the person should be in a realistic limitation about what cosmetic & reconstructive surgery can and can not do for sex reassignment surgery.

More Sex Reassignment Surgery (Male to Female surgery) and Facial Feminization Surgery (FFS) by Preecha Aesthetic Institute.

Package's included for Penile Skin Inversion Scrotal Skin Graft

Package is included Penile Skin Inversion with Scrotal Skin Graft (MtF surgery) :

  • Accommodation for 5 days in hospital private room by Penile Skin Inversion  ( JCI accredited )
  • Operating room charges: OR room use, recovery room, scrub & circulate nurses
  • Regular menu food breakfast, lunch and dinner during recovery period in hospital (vegetarian or vegan is also available)
  • Laboratory testing: necessary for the procedure as CBC, EKG, UA, Anti HIV, Chest X-Ray
    (If age over 45, an extra charge for cardiology test is 100 US Dollars + - )
  • Medical equipment and Medical supplies
  • General Anesthesia – Pre anesthetic drugs, anesthesia and medical gas (oxygen, nitrous oxide)
  • Free basic two sizes of plastic GRS Dilator penile skin inversion
  • A pack of sanitary napkin ring
  • Mirror
  • BETADINE Solution one bottle and Saline water solution
  • Cushion sitting
  • Lubricate gel dilation or BETADINE scrub
  • Anti-biotic powder
  • Condom 2 boxes
  • Kidney shape tray/bowl
  • Rubber ball douching
  • Bed sheet a pack
  • Medical treatments
  • Doctor fees
  • General Anesthesia fees
  • Nursing services
  • Take home medication and supplies
  • Post op cares
  • Transportation pick up

PSI with Scrotal Skin Graft [ SENSATION + AREAS ]

sensation male to female surgery

Sensation + Anatomy ¦ Penile Skin Inversion with Scrotal Skin Graft

  • Mon Veneris
  • Clitoris hood
  • Clitoris
  • Clitoris frenulum
  • Urethral
  • Vaginal
  • Labia Minora + Majora

anatomy male to female surgery post op

Aesthetic, Depth, Sensation, Lubrication and Elastic.

  • Aesthetic ⇔ Appearance, Labia, Clitoris, Urethra, Vulva, Introitus
  • Introitus ⇔ Vertical, Ellipse, Fourchet
  • Neoclitoris ⇔ Sensate, Location, Size, Hood, Column

Penile Skin Inversion ¦ Penile Skin Inversion with Scrotal Skin Graft ¦ Sigmoid Colon

Assoc.Prof. Preecha Tiewtranon MD, Sutin Khobunsongserm, MD and Burin Wangjiraniran MD FRCST.

An accomplishment Penile Skin Inversion with Scrotal Skin Graft (PSI with SSG) for trans woman surgery is to combined sensations, G spot, aesthetically acceptable vulva which include clitoris, labia minora, majora, vaginal introitus, shortening of the urethra, orchiectimy & penectomy, creation of a urethral opening that allows a downward urinary stream, eliminate of erectile tissue completely (to avoid narrowing of introitus and protrusion of the urethral during sexual arousal as a result to achieve vaginal adequate size, scrotal skin, preserve orgasmic capabilities, minimize hide scarring, appearance, lubrication and overall realistic outcomes as much as possible. 

Gender Affirming Surgery - Penile Skin Inversion with Scrotal Skin Graft - Male to Female surgery is to create sensational glans clitoris, labiaplasty and adequate vaginoplasty combined in one stage. 


There are three techniques are performed at Preecha Aesthetic Institute for Sex Reassignment Surgery (SRS).

Orgasms provided the sensational glans clitoris, labiaplasty and vaginoplasty in one stage.


Lubricate ⇔ Apply KY Gel before sexual intercourse.

Self lubricate ⇔ Lubricate during intercourse.

Candidate Penile Skin Inversion with Scrotal Skin Graft

The best candidate's for Trans woman Penile Skin Inversion with Scrotal Skin Graft who undergo at Preecha Aesthetic Institute:

Preecha Aesthetic Institute (PAI), we are followed and member the World Professional Association for Transgender Health (WPATH/HBIGDA or SOCs) and Asia PATH. This organization is provided in health cares, surgical professionals to assist transgender and gender diverse people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves and overall self-fulfillment. Meets all criteria outlined in the Asia PATH or WPATH Standards of Care.

  • Persistent gender dysphonia document (two letters) by qualified mental health professional
  • Minimum 12 months of continued hormonal therapy, unless there is contraindication or the patient is unwilling to
  • Has a solid plan for gender affirmation
  • Understands the nature and purpose of gender reassignment surgery
  • Retains information and recalls the advantages and disadvantages
  • Understands concepts of permanence and irreversibility
  • Has sufficient intellect and maturity to make the decision
  • Physically healthy and emotionally stable with realistic expectations
  • Real-Life experience
  • Good health conditions
  • Must be 18 years old +

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 sex reassignment surgery (Male to Female and Female to Male) started 1980 in Thailand. 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.

Consultation, medical health checks, preparation and follow up are appoints at Preecha Aesthetic Institute.

  • SRS Penile Skin Inversion and Scrotal Skin Graft (MtF surgery) is performed under General Anesthesia. (must be in hospital for five days).

Under General Anesthesia, Preecha Aesthetic Institute's using two affiliated major private international standard hospitals under  JCI accredited for healthcare promoting center located in Bangkok under the philosophy of "World class quality with Thai hospitality", private patient rooms, 230 - 500 beds, modern medical technology, equipment, 24 hours emergency and hospital receiving accreditation for high-quality. All direct consultations, follow up appointments being set at Preecha Aesthetic Institute.

  • Consultation, medical health checks, preparation and follow up are appoints within Preecha Aesthetic Institute.
  • Two international standard hospitals - JCI accredited international hospitals 
  • Surgical will perform at an affiliated hospital ⇒ General Anesthesia ⇒ International Standard Hospital.
preecha aesthetic institute (PAI)

Preecha Aesthetic Institute

Affiliated hospital

International Standard Hospital (JCI accredited)

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

Questions & Schedule

Preecha Aesthetic Institute (PAI) is the leading in sex affirmation surgery (Pioneer Sex Reassignment Surgery Thailand) located at Bangkok Thailand by Assoc.Prof. Preecha Tiewtranon MD, Sutin Khobunsongserm MD and Burin Wangjiraniran MD FRCST. We have been developed the surgical technique for vaginoplasty. Many refinements have been introduced during the past 40 years with 6000+ operated on SRS Penile Skin Inversion, Penile Skin Inversion with Scrotal Skin Graft and Sigmoid Colon “(Source by Male-to-female vaginoplasty: Preecha’s surgical technique, NCBI Literature Resources, 2022 Oct 30)

Well innovation researcher, oversea academic medical university guest speakers, we are performed sex reassignment surgery all ages and well reputation for a specialized reconstructive center. SRS Male to Female surgery (Penile Skin Inversion with Scrotal Skin Graft) is performed by Doctor Preecha Tiewtranon MD, Doctor Burin Wangjiraniran MD FRCST and Doctor 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.

 

All 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

Once all are confirmed. To set up direct consultation and schedule surgery date.

  • Plan your available date to be surgery and departure from Bangkok
  • We will confirm you for surgery date
  • You may start to book your airline ticket
  • We will confirm you all detail and hotel booking, if require
  • For transportation to be pick up from the airport, we need you to confirm your airline flight itinerary

RISK AND SAFETY PENILE SKIN INVERSION and Scrotal Skin Graft

Penile Skin Inversion Scrotal Skin Graft (PSI + SSG), Vaginoplasty, MtF surgery is a safe procedure. But understands that there is a 1-3% risk to transition and accepts this risk. While complications may occur. Most are self-limited or can be treated with minor interventions. Minor complications include issue such as the formation delay wound healing but can minimize by closely follow surgeon’s advice on follow up cares during the healing process.

HEALTH CONCERN

An extra charge is 50% from surgery fee, if HIV +. This is a protocol by infectious control center.

  • CD 4 must be > 500 +
  • Viral load must undetectable
  • Good health condition

sample result

post op sex change male to female surgery after 20 days and four month l preecha aesthetic institute

Penile Skin Inversion with Scrotal Skin Graft after 20 days and 4 months

sample result

m2f scrotal skin graft surgery post op l Preecha Aesthetic Institute

Penile Skin Inversion with Scrotal Skin Graft after 2 months.

sample result

Penile Skin Inversion with Scrotal Skin Graft after 4 months

Penile Skin Inversion with Scrotal Skin Graft after 4 months.

sample result

male to female surgery post op one year l preecha aesthetic institute

Penile Skin Inversion with Scrotal Skin Graft after 12 months.

sample result

srs mtf surgery result after one and three month dilator l Preecha Aesthetic Institute PAI

Penile Skin Inversion with Scrotal Skin Graft after 1 month and after 3 months with dilator size # 2.

sample result

post op three month sex change male to female l Preecha Aesthetic Institute bangkok thailand

Penile Skin Inversion with Scrotal Skin Graft after 3 months.

sample result

Penile Skin Inversion with Scrotal Skin Graft after one year

Penile Skin Inversion with Scrotal Skin Graft after 12 months.

SAMPLE RESULT

best sex change clinic male to female l preecha aesthetic institute is leading sex change surgery bangkok thailand

Penile Skin Inversion with Scrotal Skin Graft after 2 months.

sample result

sex change male to female good result surgery best sex change doctor in Thailand

Penile Skin Inversion with Scrotal Skin Graft after 2 months.

sample result

transgender male to female center bangkok thailand post op results

Penile Skin Inversion with Scrotal Skin Graft after 5 months and 8 months post op.

sample result

Dr.Preecha Tiewtranon MD, Dr.Burin Wangjiraniran MD and Dr.Sutin Khounsongserm MD male to female surgery, srs thailand

Penile Skin Inversion with Scrotal Skin Graft after six weeks post op.

 

sample result

sex change penile skin inversion scrotal skin graft male to female surgery

Penile Skin Inversion with Scrotal Skin Graft after twelve weeks post op.

 

sample result

gender affirmation surgery after two years l preecha aesthetic institute

Penile Skin Inversion with Scrotal Skin Graft after two years post op.

sample result

sex change mtf surgery after six years preecha aesthetic institute

Penile Skin Inversion with Scrotal Skin Graft after six years.

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:

GRS/SRS - Penile Skin Inversion with Scrotal Skin Graft 

SRS - Penile Skin Inversion with Scrotal Skin Graft. The technique is inverted peno-scrotal flap and considered a standard technique for vaginoplasty in male-to-female transsexuals.

Pre-Operative Gender Affirming Surgery. SRS, Penile Skin Inversion with Scrotal Skin Graft.

  1. Take breakfast as normal on consultation date. But light meals.
  2. Do not eat or drink anything from the midnight prior to your surgery including water, or chewing gum but little cup of water before 8:00AM is acceptation.
  3. Do not wear any make up.
    Wear clothes that are loose and comfortable. A button down shirt, flat shoes and loose pants are recommended.
  4. If you wear glasses, contact lens or dentures, bring a case with you.
    Take shower and wash your hair the night before or the morning of your surgery. Do not apply hair gel, hair spray.
  5. Do not smoke at least 2 weeks, if you can. This may interfere with healing.
  6. Stop multiple vitamins at least two days before surgery.
  7. Stop Aspirin two weeks before surgery.
  8. The prescriptions you were given are for after surgery. Have them filled ahead of time or we will be given to you prior to discharge from hospital.
  9. Pre-admission testing (Labs) will be required before surgery.
  10. Stop hormone, if taking 14 days before surgery date and able to continue 7 days after surgery date.
  11. Bring cloth napkins (Certainty bed pads). You might need to be use on hotel bed.
  12. Bring passport to clinic on consultation date.
  13. Surgery fee can be pay by cash (AUD, USD, JPY, EURO, CNY, THB, SGD, GBP, HKD and NZD). Please kindly prepare newest version bill and possible without scratch over bill.
  14. If pay surgery fee by VISA or Master Card. An extra charge is 3%.

 

Things should bring from home for (MtF surgery)

Penile Skin Inversion with Scrotal Skin Graft.

  • Button-up shirts in large sizes
  • Skirts (not too tight)
  • joggers or loose pants
  • Slip-on shoes or slippers
  • Phone charger, long phone charger
  • Books, magazines
  • Travel neck pillow
  • Personal medicines / HRT
  • Regular sanitary napkins, if prefer specific brand
  • Underpads

Sex Reassignment Surgery by Preecha Aesthetic Institute, PAI.

  •  Day 0 - Arrival date (check in hotel)
  • Day 1 - Consultation and Prepare for Laboratory Testing at PAI's clinic
  • Day 2 - Prepare and take liquid laxative for bowel clearance
  • Day 3 - Surgery date (check out hotel)
    Day 3 to Day 8 - Stay in hospital for recovery period with doctor visits
  • Day 8 - Discharge from hospital in the afternoon
    Day 8 - Check in hotel in the afternoon
  • Day 8 to 18 - Stay in hotel for recovery periods
  • Day 10 to 17 - Follow up by appointments at PAI's clinic
  • Day 18 - Departure date (check out hotel)

Totals stay for Penile Skin Inversion with Scrotal Skin Graft. Minimum must be at least 18 days included before and after surgery.


 

The pioneer Sex Reassignment Surgery and The first multidisciplinary plastic surgery center, Bangkok Thailand.

wpath 2014 Dr.Preecha and development srs thailand surgery dr.preecha tiewtranon MD. WPATH2014 Bangkok Thailand Sutin Khobunsongserm MD Burin Wangjiraniran MD FRCST. WPATH 2014


 

Senses of Penile Skin Inversion with Scrotal Graft Male to Female Reassignment Surgery at Preecha Aesthetic Institute (PAI)

  • To create of a sensate, G spot and aesthetically acceptable vulva which include clitoris, labia minora, majora and vaginal introitus.
  • Use a part penile skin, scrotal skin, abdomen, groin graft.
  • Shortening of the urethra, with creation of a urethral opening that allows a downward urinary stream.
  • To eliminate of erectile tissue completely (to avoid narrowing of introitus and protrusion of the urethral during sexual arousal.
  • To achieve adequate vaginal depth.
  • To preserve orgasmic capabilities.
  • To minimize and hide scarring.
  • To make neo vagina, appearance and overall realistic.

 

  • All consultation, medical health checks, preparation and follow up are appoints within Preecha Aesthetic Institute.
  • SRS Penile Skin Inversion Scrotal Skin Graft (MtF surgery) is performed under general anesthesia (required five days in hospital).
  • Surgery time required: 4 hours +.
  • Anesthesia: General Anesthesia.

Affiliated hospitals : International Standard Hospital (JCI’s Accredited, HA)

Recovery Sex Reassignment Surgery PSI + SSG require to be in Bangkok 14 days after surgery

Back to work: after 20 days more

Strenuous activity: 6 - 8 weeks

Fading of scars: several months to a year  


 

sex change surgery

Post-op recovery for Penile Skin Inversion with Scrotal Skin Graft.

  • After reassignment surgery PSI + SSG, pain that is easily controlled by medication usually will subside in a few days. 
  • Dressings have been applied and are replaced a few days.
  • Sutures will be removed within a week of surgery. 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.
  • Healing process may occur for weeks or even months following surgery.  
  • Dilation will be given with instructions during follow up visits at Preecha Aesthetic Institute. 
  • The decision on when to return to work and normal activities depends on how fast you heal and how you feel. 
  • To permit proper healing, you should avoid over activity and refrain from overhead lifting 3 months.

 

dilator set penile skin inversion sex change surgery

 

GRS Dilator by Preecha Aesthetic Institute for Medical used only.

Penile Skin Inversion + Scrotal Skin Graft

  • Range from 25 mm, 28 mm, 32 mm and 36 mm
  • Lengths from 15.3 cm (6 inches and up by 0.5 inch)
  • Easy to use
  • Best for most skin types
  • Special designed for women following genital reassignment surgery

For local’s patient - You may resume to work after eighteen days surgery but must avoid heavy lifting object over the head or fast movement during 8 to 12 weeks after surgery date.

For international patient - Please plan to be in Bangkok at least 18 days all together. Stitches will remove day 7 to day 10 after surgery date. After departure from Thailand, you may resume to work within a few days but must avoid heavy lifting object over the head or fast movement during 8 to 12 weeks after surgery date.

◊ Any bruising and swelling will usually dissipate within 4 to 8 months after sex reassignment surgery Penile Skin Inversion with Scrotal Skin Graft.


 

During the recovery period in Bangkok and after each dilation session and more details will be giving by doctor case by case.

  • Post-operative checks by our nursing staff on a daily basis throughout your stay with us in hospital.
  • Post-operative check-ups by PAI’s surgeon at least twice weekly and more frequently if necessary, while here.
  • The wound should be washed gently with Hibiscrub (pink color) in the shower followed by douching while seated in the toilet:
  • Douche solution (proportion) = 5-10 ml (cc) of Betadine solution mixed with 1L of water or until the container is full.
  • Insert the douche to full depth, squeeze, and hold tightly the container.
  • While holding tightly the container, extract the douche.
  • Keep the wound dry and apply Betadine solution with cotton balls; and apply Kemicitine ointment with a cotton applicator. If there is some bleeding, press or apply pressure with a dry cotton ball to the site for 15 minutes. During the first weeks after surgery, feminine sanitary pad should be changed several times per day due to normal vaginal bleeding during recovery.
  • After two to three months of SRS operation you may start to applying Premarin cream (estrogen vaginal gel) to your neo-vagina. Apply two times a day for soften your neo-vagina. This would generally take around six months (optional).
  • You can return to female hormones after a week surgery. You should consult your endocrinologist to re-adjust the dosage. A sudden change in hormone levels individual may result in the fluctuation of emotion.

 

Recovery Timeline Penile Skin Inversion and Scrotal Skin Graft (SRS)

  • The day after surgery, the PAI's surgeon will visit as daily until discharge from hospital.
  • Able to walk slowly after day 3.
  • Removing incisions will appointment 7 to 10 days after surgery.
  • Other dissolve stitches will also remove in times.
  • No heavy exercise 8 to 12 weeks after surgery.
  • To maintain with more depth of vaginal canal, continue dilation everyday at least twice a day, 15 minutes each time during eight to twelve months after surgery by switching size dilators.
  • Dilate is highly recommend at least once a day after one year to maintain current and more depth vaginal canal. Instruction and how to will provide by the surgeon during follow ups surgery at Preecha Aesthetic Institute.
  • Sexual intercourse is recommend after 3 months surgery. Start with gentle, relaxation movements and apply lubrication gel before intercourse. No dilation is need, if sexual intercourse.

 

The pioneer Sex Reassignment Surgery and The first multidisciplinary plastic surgery center, Bangkok Thailand.

pai clinic bangkok thailand sex change center preecha aesthetic institute location sukumvit 55 bangkok thailand

 


 

Treatment after surgery
during the first 7 days

Common normal after Male to Female surgery – Penile Skin Inversion with Scrotal Skin Graft

Light or Discomfort – This may experience pain during the first few weeks after sex reassignment surgery.

Bleeding – Some may experience bleeding in the days following procedure. The bleeding may vary.

Swelling – it is normal to see swelling in the vulva. This may take at least four weeks before subsides. Vaginal discharge such as bloody, then yellowish may occur during the first 2 months and will become clearer eventually stop completely.

Bruises – Ecchymosis can extend navel to hips to thighs. They take at least three to four weeks to heal.

A skin graft of donor site- The color of donor site will decrease as healing processes within a year.

Labia and clitoris- Improvement will be seeing after swelling decrease. Fully heal may take between 6-10 months. Clitoris can difficult to see during one to four weeks because swelling and presence of a blood clot. The clitoris can also hide under the labia minora. Color of labia minora and clitoral hood will change from red to pink about ten month after surgery.

Sensations – Small nerve endings on the surface of the skin at incisions made during MtF surgery may cause slight local numbness. Sensitivity will gradually return after nerve fully recovery and may take six months after surgery. Feeling of small electric shocks may be a sign of nerve healing. Soft massage can help alleviate.

Dilation + Follow up at PAI’s clinic after surgery for sex reassignment surgery

After release from hospital you will recover with the aid of liaison at the hotel nearby PAI. During follow up visit in clinic whole trip, the doctor will provide instructions cleaning, dilator to be use. A full post-operative care kit necessary for dilation, including a -piece dilator set specially manufactured for GRS as design by Preecha Aesthetic Institute.

-Dilating is the most important thing you can do to ensure the success of your surgery. If you do not keep dilate as daily basis, the result SRS Penile Skin Inversion with Scrotal Skin Graft may cause of shortening depth and scar contraction.

-Failure to dilate properly can result in serious injury. Your surgeon will giving instruction how to gently dilate into the right direction after the vaginal packing is removed at Preecha Aesthetic Institute.

- The first time dilation may a bit painful for the first weeks. Continue dilation is essential to developing maximum depth vaginal canal.

Dilator set of Penile Skin Inversion

surgery info:

logo preecha aesthetic bangkok
Penile Skin Inversion with Scrotal Skin Graft

is the inverted peno-scrotal flap. The use of skin graft, scrotal skin graft is perform to extend vagina depth.

services icon 1 150x150 1
TIME REQUIRED

4.5 hours+

services icon 2 150x150Anesthesia
ANESTHESIA

General Anesthesia

BACK TO WORK

20 days

services icon 4 150x150 Strenous Activity
STRENUOUS ACTIVITY

12 weeks

FADING SCARS

Several months to a year

Surgery Schedule

Sex Reassignment Surgery’s planning times Penile Skin Inversion with Scrotal Skin Graft

Day 0 - Arrival date (check in hotel)

Day 1 - Consultation and Prepare for Laboratory Testing at PAI's clinic

Day 2 - Prepare and take liquid laxative for bowel clearance

Day 3 - Surgery date (check out hotel)
Day 3 to Day 8 - Stay in hospital for recovery period with doctor visits

Day 8 - Discharge from hospital in the afternoon
Day 8 - Check in hotel in the afternoon

Day 8 to 18 - Stay in hotel for recovery periods

Day 10 to 17 - Follow up by appointments at PAI's clinic

Day 18 - Departure date (check out hotel)


Transportation during recovery period in Bangkok will be accompanied by PAI. This must be within 2 KM from Preecha Aesthetic Institute.


For HIV positive - An extra charge is 50% from total cost of surgery fee. CD 4 must be > 500 +. Viral load must be undetectable with good health conditions. 

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: 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.

Q: How would hospital stay work for guest? Can they stay in hospital or can they stay in post recovery hotel? How would that work?

A: A guest can stay with you while recovery in hospital.. The hospital will provide a sofa bed, pillow and blanket (free of charge). They are many local and international cafeteria located inside hospital. Your guest can also enjoy meals. However, if they don't wish to stay in hospital while you are recovering. They may also stay in a hotel until you are discharge from hospital.

Q: What would be the rate for me and travel companion in recovery hotel for the 10 days?

A: There are many hotels (3 to 5 stars) nearby PAI's clinic under cooperated. There is no need to stay at any expensive hotel. But cleans and hygiene. Hotels nearby PAI are between 50 USD - 70 USD per night include breakfast for 2 persons. All details can provide by PAI's assistance.

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