overview

Penile Skin Inversion for Sex Reassignment Surgery (Male to Female surgery)

Transsexual is someone who was born into the wrong body. Their anatomy doesn’t match a gender identity, feeling great distress with gender dysphoria in their current genitals. Many have difficulty living with part of body don’t belong cause both physical and mental pain.

Base on clinical interviewed with trans women patients background history, “as a child throughout school if the children were divided into gender groups, she always wanted to be with the girls. She described envy of girls dresses and dislike of her own masculine features. By the time before transition (MtF surgery), she began to grow hair, paint nails, presented as more feminine and described experimenting with gender, relationships and sexuality”.

Sex Reassignment Surgery (SRS), Genital Reconstruction Surgery, Sex Affirmation Surgery, Sex Reconstruction Surgery, Sex Realignment Surgery, Sex Change Operation, Male to Female surgery, these are part of Male to Female surgery for trans woman (transgender).

General surgery guidelines and open discussion are highly recommended with PAI’s surgeon on-line consultation or direct consultation to be finalize sex reassignment surgery technique.

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 +).

Penile Skin Inversion’s technique for male to female (trans woman) “Sex Reassignment Surgery”.

SRS by Penile Skin Inversion (PSI) is combined with sensations, G spot, aesthetically acceptable vulva which include clitoris, labia minora, majora, vaginal introitus, shortening of the urethra, 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 standard depth, preserve orgasmic capabilities, minimize hide scarring, appearance, lubrication and overall realistic outcomes as much as possible.

Penile Skin Inversion technique, MtF surgery, all appearances and functions have been positively to achieved the result that very closed to the biological female genitalia.

Outcomes from MtF surgery by Penile Skin Inversion’s (PSI) is provided sensational glans clitoris, labiaplasty and vaginoplasty in one stage.

Male to Female surgery Penile Skin Inversion technique at Preecha Aesthetic Institute (all Board of Plastic & Reconstructive surgery Thailand) by Assoc. Prof. Preecha Tiewtranon MD, Burin Wangjiraniran MD FRCST and Sutin Khobunsongserm MD.

This is important that the person should be in a realistic limitation about what cosmetic & reconstructive surgery can and can not do. 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.

More techniques sex reassignment surgery (MtF surgery) and facial feminization surgery (FFS) at Preecha Aesthetic Institute. Zero depth vagina or minimum depth is an optional as a part of gender affirming surgery.

Key anatomy Gender Reassignment Surgery Results

Penile Skin Inversion by Preecha Aesthetic Institute (PAI) - key success areas

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

Penile Skin Inversion (MtF surgery) four years after surgery

two months post op showing vulva

After sex change surgery mtf surgery show valva 2 months surgery

male to female surgery after one year

Gender Affirmation Surgery after one year

Package is include Penile Skin Inversion

Package is included Penile Skin Inversion (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

Candidate with Penile Skin Inversion

Preecha Aesthetic Institute (PAI) has been followed by the World Professional Association for Transgender Health (WPATH/HBIGDA or SOCs) or Asia PATH. This organization is to provided 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.

The best candidate for Penile Skin Inversion (Male to Female surgery) :

  • 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
  • Understands concepts of permanence and irreversibility
  • Retains information and recalls the advantages and disadvantages
  • Physically healthy and emotionally stable with realistic expectations
  • Has sufficient intellect and maturity to make the decision
  • 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 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.

  • SRS Penile Skin Inversion (MtF surgery) is performed under General Anesthesia (required five days in hospital).

All cases 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, emergency and hospital receiving accreditation for high-quality. All direct consultations and follow up appointments are set at Preecha Aesthetic Institute.

  • All 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 an affiliated hospital ⇒ General Anesthesia ⇒ International Standard Hospital.
preecha aesthetic institute (PAI)

Preecha Aesthetic Institute (main's clinic)

Affiliated hospital

International Standard Hospital (JCI accredited)

Affiliated hospital

SERVICE ACCOMMODATION

  • Transportation pick up from airport –hotel-clinic-hospital-airport as well as follow up period (optional)
  • Hotel reservation 2 km from Preecha Aesthetic Institute
  • Interpreter services with any language

QUESTIONS & SCHEDULE

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) 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.

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)

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

Penile Skin Inersion Vaginoplasty (MtF surgery) is a safe procedure. 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.

Methods be perform at Preecha Aesthetic Institute for Sex Reassignment Surgery (SRS)

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

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

Aim accomplishment Penile Skin Inversion (PSI) 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 standard depth, preserve orgasmic capabilities, minimize hide scarring, appearance, lubrication and overall realistic outcomes as much as possible. 

Our goals for Male-to-Female Sex Reassignment Surgery by PAI's.

  • To create of a sensate, G spot and aesthetically acceptable vulva which include clitoris, labia minora, majora and vaginal introitus.
  • Orchiectomy & Penectomy.
  • 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.

Three techniques being performed at Preecha Aesthetic Institute for Sex Reassignment Surgery (SRS). All are orgasms provided the sensational glans clitoris, labiaplasty and vaginoplasty in one stage.

♥ Penile Skin Inversion (lubricate with organism)
♥ Penile Skin Inversion with Scrotal Skin Graft (lubricate with organism)
♥ Sigmoid Colon with Penile Skin Inversion (Sigmoid Colon) (self lubricate with organism)

Lubricate ⇔ Apply KY Gel before sexual intercourse.

Self lubricate ⇔ Lubricate during intercourse.


 

After sex change 4 years

After PSI (4 years)

MtF surgery post op with dilator

After surgery with 15 CM depth

IMG 4511

Objectives : Aesthetic, Depth, Sensation, Lubrication and Elastic

HEALTH CONCERN

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

  • CD4 must be 500 +
  • Viral load must undetectable
  • Good health condition

sample result

srs penile skin invertion mtf result l preecha aesthetic institute bangkok thailand

After 4 years surgery (Penile Skin Inversion)

SAMPLE RESULT

penile skin invertion mtf result l preecha aesthetic institute bangkok thailand

After 4 years surgery (Penile Skin Inversion).

SAMPLE RESULT

penile skin invertion srs mtf result l preecha aesthetic institute bangkok thailand

After 4 years surgery (Penile Skin Inversion).

SAMPLE sensational glans clitoris, labiaplasty and vaginoplasty combined in one stage.

After 4 years surgery Penile Skin Inversion anatomy mtf surgery l preecha aesthetic institute bangkok pioneer sex reassignment surgery

Sensational glans clitoris, labiaplasty and vaginoplasty combined in one stage.

SAMPLE RESULT

post op mtf surgery month psi techniquel preecha aesthetic institute

After 14 months and 20 months surgery (Penile Skin Inversion).

SAMPLE RESULT

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After one year surgery (MtF surgery penile skin inversion).

SAMPLE RESULT

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After eleven months surgery (MtF surgery penile skin inversion).

 

SAMPLE RESULT

srs mtf result after one week and two weeks and after one month l preecha aesthetic institute

one week, two weeks and four weeks after surgery (MtF surgery penile skin inversion).

sample result

post op male to female surgery six weeks l preecha aesthetic institute horz

After six weeks Penile Skin Inversion with some dissolve stitches (SRS).

sample result

post op surgery m2f surgery sex change

After 4 weeks surgery. Penile Skin Inversion (PSI).

sample result

male to female MtF surgery after six month l preecha aesthetic institute

After six months surgery. Penile Skin Inversion.

sample result

penile skin inversion male to female post op seven month dilator l preecha aesthetic institute

After 12 days and 7 months surgery. (Penile Skin Inversion).

sample result

male to female srs best place surgery bangkok thailand l preecha aesthetic institute

 

After 14 days surgery. (SRS Penile Skin Inversion).

Aesthetic, Introits, Neoclitoris,

clitoris size location hood column sex change post op l preecha aesthetic institute bangkok thailand

Objectives : Aesthetic, Depth, Sensation, Lubrication and Elastic

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

sample result

post op mtf surgery three months l preecha aesthetic institute leading sex reassignment surgery thailand

After 3 months surgery (Penile Skin Inversion).

 

sample result

male to female surgery post op one month best sex change surgeon bangkok thailand preecha aesthetic institute

After 1 month surgery. (Penile Skin Inversion).

 

sample result

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

After 7 day, 14 day and 21 day post op surgery. (Penile Skin Inversion).

 

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:

Personal stuffs bring from home

Sex Reassignment Surgery (MtF surgery)

  • 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

Surgery Schedule (Totals stay for Sex Reassignment Surgery are 18 days all together with 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)


 

Pre-Operative

(Penile Skin Inversion Instruction, MtF surgery)

  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 will be pay by cash (AUD, USD, JPY, EURO, CNY, THB, SGD, GBP, HKD, NZD). If credit cards (VISA and Master Card). An extra charge is 3%.

 

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

preecha aesthetic institute cosmetic and reconstructive surgery center bangkok thailand Preecha Aesthetic Institute award sex change surgery

 


 

Surgical procedure and Sensations of Penile Skin Inversion Male to Female, Sex Reassignment Surgery by Preecha Aesthetic Institute (PAI)

  1. To create of a sensate, G spot and aesthetically acceptable vulva which include clitoris, labia minora, majora and vaginal introitus.
  2. Use a part penile skin.
  3. Orchiectomy & Penectomy, shortening of the urethra, with creation of a urethral opening that allows a downward urinary stream.
  4. To eliminate of erectile tissue completely (to avoid narrowing of introitus and protrusion of the urethral during sexual arousal.
  5. To achieve adequate vaginal depth.
  6. To preserve orgasmic capabilities.
  7. To minimize and hide scarring.
  8. To make neo vagina, appearance and overall realistic.

 

Summary procedure for Penile Skin Inversion - refinements consist of cavity by the penile flap, shaping of the clitoris complex from penis glans and neo-clitoral hood, the use of the urethral mucosa to line the anterior fourchette of the neo-vaginalabia majora, labia minora.


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  


 

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

 

Post-op recovery for Penile Skin Inversion.

  • After reassignment surgery PSI, 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 an instruction during follow up visits. 
  • 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 Penile Skin Inversion, Scrotal Skin Graft

  • Range from 25 mm, 28mm, 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. You may resume to work within a few days after arrive to your country but must avoid heavy lifting object over the head or fast movement during 8 to 12 weeks after SRS Penile Skin Inversion surgery date.

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


 

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 nurse on a daily basis throughout your stay with us in hospital and PAI's clinic.
  • Post-operative check-ups by PAI’s surgeon at least twice weekly and more frequently if necessary.
  • 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 Beta dine solution mixed with 1 L 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 (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.
  • No heavy exercise 8 to 12 weeks after surgery.
  • Continue dilation everyday at least twice a day, 15 minutes each time during eight to twelve months after surgery to maintain more depth. Dilate is highly recommend at least one a day after one year to maintain current and more depth vaginal canal. More information 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.

 

Treatment after surgery
during the first 7 days

Common normal after Male to Female surgery

Penile Skin Inversion.

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 responsibly, this can result in the shortening of depth and width of the newly made vagina because of the scar contracture. Failure to dilate properly can result in serious injury. You will be instructed to gently dilate into the right direction after the vaginal packing is removed.
  • Dilation can be painful for the first weeks, but is essential for developing maximum

 

dilator set penile skin inversion sex change surgery

surgery info:

Logo Preecha Aesthetic Institute
Penile Skin Inversion

is provided sensational glans clitoris, labiaplasty, vaginoplasty and overall realistic outcomes

services icon 1 150x150 1
TIME REQUIRED

4 hours+

services icon 2 150x150Anesthesia
ANESTHESIA

General Anesthesia

BACK TO WORK

3 weeks

services icon 4 150x150 Strenous Activity
STRENUOUS ACTIVITY

12 weeks

FADING SCARS

Several months to a year

Surgery Schedule

Question/Schedule Appointment Consultation / Surgery / Penile Skin Inversion at Preecha Aesthetic Institute.

Once you know your planning date for surgery

Sex Reassignment Surgery’s planning times Penile Skin Inversion 

Day 0 - Arrival Bangkok and Check in hotel.

Day 1 - Direct consultation and preparation medical health checks at Preecha Aesthetic Institute.

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)

Day 18 - Final checkup and prepare for letter fit to fly and issue for a new letter with gender name change
Day 18 - Safe to fly

  • Transportation during recovery period in Bangkok will be accompanied by PAI. This must be within 2 KM from Preecha Aesthetic Institute.
  • For HIV positive’s patient - CD4 must be > 500 +. Viral load must be undetectable. All are within good health conditions. An extra charge is 50% from total cost of surgery fee.

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 like to inquire about the services of SRS for my nephew who lives in China. He is 21 years old and he was diagnosed with gender identity disorder a few years ago. After that, he started taking hormone and his psychological reports that he is suitable for sex reassignment surgery. Now he wants to find a suitable hospital for the surgery because he is not confident in his language skills.

A: We have interpreter for many languages such as Chinese, Italian, Japanese, Spanish, Russian, Turkish, and Iranian and on request. All staff and doctors here are fluent in English.

Q: If I have orchiectomy, Could I do SRS surgery

A: Yes.

Q: I am from the Philippines. I plan to have SRS soon and I want to ask how much is the total cost of the procedure in your clinic?

A: As medical law for cosmetic and reconstruction surgery 18+, we can’t provide surgery fees on line website as respectfully. Please kindly write questions direct email and we will answers all questions and schedule everything.

Q: I’m interested in receiving the MtF PSI SRS. I am a transgender woman, and have known about it since I was a little kid. Due to some societal pressure I was not able to go through the puberty I was supposed to have, but friends have been addressing me with the proper name since I was 9-10 years old. I came out in my 20s (am 29 now) and living openly and proud as myself in all areas of life. My current equipment has caused me a great deal of dysphoria throughout the years, and even though I have tried to come to terms with it there is no way that I can ever be okay with what I have now. I have been on hormones 4 years and I have spent a great deal of time considering if having the surgery is worth the risk. Ultimately I decided that I can’t go through life like this, even though HRT has been kind to me I feel like there is a part still missing. The dysphoria is present every single day, in ways like when I pee, how I get dressed, how I walk, how my body feels. I would like to be able to be sexually active after the surgery, but the most important part is being able to move through life without having that specific part of me tearing my mental health down. I do recognize that surgery is not a “fix-all”, but it will alleviate a lot of physical dysphoria for me.

A: Base on your personal information, this seems to be ready for transition srs penile skin inversion. So please kindly prepare your hormone therapist letter, fill out your medical form and then processes will be contact via email.

Q: I'm a transgender woman living in France I'm 37, 1m86 and 80kg I'm doing research since 2 years to choose the surgeon to do my vaginoplasty penile skin inversion. I would like to know the process, the cost estimate and the delay to be operated by doctor there. I would be pleased to give you all the information you need. Thank you very much for your help

A: In general, your Body Mass Index (BMI) is 23.12, which is in good bodyweight. So please remain your bodyweight at 23.12 or below 24.99 just on surgery date (this is just to avoid an extra charge on general anesthesia) For the process (pre-screening), we can exchange all information via email such as fill out a medical form, tentative surgery date and so on. All questions and answers are direct to each request doctors (Dr.Burin or Dr.Sutin).

Q: Hello. I’m curious to the cost of the srs program for mtf vaginoplasty for a girl coming from the United States ? California to be exact.

A: For MtF vaginoplasty , you should also provide us aging, bodyweight, height as well as your personal history such as how long you have been living as female, psychiatrist, hormone treatments, health conditions and fill out medical form. The doctor needs firstly to review and all questions with answers will be response by doctors via email.

Q: I have few questions about laser hair removal , I just start it on my genitals. How many sessions do you recommend and how much time before the surgery should I stop it ?

A: Laser hair removal is just an optional before coming to surgery. It’s not necessary because doctor will also scrape the root of hair from penile and scrotal skin during surgical times (hair follicle scraping). However, if you still consider before coming surgery. This can consider around two sections and all should be finished at least two weeks before arriving Bangkok.

Q: Is the surgery performed with the expectation that there will be a cosmetic revision in the future, as part of a two-step process? Or is it performed with the intention that this one surgery will result in a cosmetically satisfactory outcome (just one surgery rather than two). (Obviously this is regarding the intention of surgery, and the actual outcomes vary by individual)

A: Expectation should not come back for revision unless, you have had much sexual intercourse, which may need to come back for labia repairs. This is just normal to all.

Q: What if I haven't yet chosen the technique for which I want to perform the operation (PSI or PSI with scrotal graft? Can it be solved on the spot, in your clinic?

A: Yes. You and the doctor need to finalize here direct consultation. Everything needs to finalize here together during direct consultation here in clinic PAI.

Q: Can the patient have a companion? And how many companions can the patient have? And how much is the cost for the companion per night?

A: Companion is allowing in hospital for one person. The hospital will provide pillow, blankets and able to sleep on sofa bed (free of charge). If more than one adult person, we are recommend to stay in hotel and able to use a taxi to come to see her while in hospital. The cost of a taxi meter from hotel to hospital is less than $5.

Q: If they (the patient and companion) are going to stay in hospital, are they served with food? If yes, how much must be paid for serving food?

A: While in hospital private room, patient meals are included within a package surgery fee. But companion can order room services or just walk to 1st floor hospital. There are many international foods, local foods there. Restaurants, cafeterias are charge as a standard cost. They won’t double charge.

Q: Are there hospital, hotel or clinic free internet WIFI?

A: Yes. All places.

Q: Must the cost be paid in dollars or another currency? (It is very important)

A: Surgery fee can be pay by cash CNY, HKD, SGD, AUD, USD, EURO, and YEN, GBP or credit cards (VISA and Master card). But credit card is an extra charge 3% from surgery fee. Hotel, living expenses can use credit cards without an extra charge. Most of them prefer VISA or Master card.

Q: I am also considering a zero depth SRS. I thought we had discussed this in past emails but cannot find them. Please could you tell me if you carry out zero depth SRS and can I have the price too, thank you.

A: Yes. But you must provide clarify letter from your psychiatrist or hormone therapist that you are just request a zero depth SRS or minimal depth for SRS.

Q: As said in my previous email i have already undergone a chest x-ray and extensive blood test in preparation for surgery. Do you require any other tests?

A: You still have to do medical health exams here with us. But within a package surgery fee. No need to pay extra. But if there’s any indicate sign need to recheck some specific, an extra charge maybe applied.

Q: Could you please tell me if you require psychiatrist (Thai psychiatrist) to undergo surgery at PAI?

A: Yes. This is a requirement because we are follow WPATH, Asia PATH and medical law Thailand. All Gender affirming surgery are required Thai’s psychiatrist. We will refer to hospital. This is 1,800 THB. It’s requirement for international patient. Your local psychiatrist or hormone therapist's letter is also best supportive.

Q: I hope it's okay for me to ask, but what is the absolute cheapest hotel near PAI that you would recommend?

A: The best budget hotel nearby PAI is 1,800 THB/net include breakfast (studio room).

Q: Can I just request Sex Reassignment Surgery for Male to Female, especially for No-depth and PSI because I do not really care much on the depth of vagina?

A: Yes, you can. But you must provide proof of psychiatrist or hormone therapist to qualified SRS and in the letter, your psychiatrist or therapist must written the patient is request zero depth or minimum depth for surgery in English.

Q: I have had trouble with my gender since 2017 because I cannot accept my current biological sex. I've always felt strongly that my gender should be a woman. When I was in 2022, I told my family about my troubles and started hormone therapy. At the beginning of 2023, I went to a psychiatric hospital in China, where the doctors endorsed my thoughts. I think undergoing gender reassignment surgery may be my last resort! So, I chose to go to Thailand for gender reassignment surgery. I don't do surgery in China because the pre-surgery preparation process in China is very troublesome. The operation process in Thailand is relatively qualified, and has rich surgical experience. I am 19 years old. Please tell be the general process for patient who want to go for SRS under 20 years old.

A: For patient who under 20 years old. But must be fully 18 years old. 1. Psychiatrist evaluation written in English. This can be one letter. 2. Endocrinologist to explain and how long you have been taking hormone. 3. Parent must come with you to sign a permission (consent form) allowing surgery. This can be father or mother. 4. Must be in good health. Pre-screen labs and questions will be communicate via email.

Q: IS THERE ANY PROBLEM FOR SRS (MtF) ? If I have done voice surgery a long ago.

A: It is importance to double check with your voice surgeon or written in the letter. Please inform your voice surgeon that we (PAI), general anesthesia will using tube size 6.5-7 or a little bigger. No smaller size. Is there any side effect ? If not, sex reassignment surgery can be perform.

Q: Can you compare PPV and PSI's technique in general ?

A: The standard technique is Penile Skin Inversion (PSI). By PSI, this is most qualified long researchers (in house researchers and international public researchers) reliable accepted technique - compare with Penile Peritoneal Vaginoplasty (PPV) technique.

Q: How will the whole process work, like on day one when we arrive do we rest in hotel for one day than have a consultation the next day or how does the whole plan work ?

A: That’s right. Start on arrival date at the airport: - (Day 0) PAI’s driver will pick you up at the airport anytime. - (Day 0) Check in hotel for rest. - (Day 1) In the next morning, PAI’s driver will pick you up from hotel to PAI’s clinic. Direct consultation is set in the morning and then medical health exams. - (Day 2) Other preparation before surgery (labs, if need) - (Day 3) Surgery date (check out hotel, if need) - (Day 3 to Day 8) Stay in hospital for recovery. - (Day 8) Discharge from hospital after doctor visit. This is normally discharge at noon. - (Day 8) Check in hotel. - (Day 8 to Day 17) Stay in hotel for recovery period and come to PAI’s clinic by appointments. PAI’s driver will pick you up from hotel to PAI’s clinic. - (Day 18) Check out hotel in the afternoon. - (Day 18) You are able to fly home after day 18 or plan to be in Bangkok with us at least eighteen days all together for SRS (Penile Skin Inversion)

Q: Also what is the bowel prep for penile inversion vaginoplasty because in UK it’s normal eating and they just do enema before the surgery and are you admitted on the day of surgery. Also after surgery what is the diet when can you eat and what about bowel movements after surgery how is that dealt with ?

A: Bowel prep for penile skin inversion (SRS), this will be preparation after direct consultation here in Bangkok. About after surgery, you can eat normal meals well cooked. But avoid any spices and alcohol at least 2 weeks, after surgery date.

Q: I would also like to know if I need to have any consultation session(s) beforehand. If yes, can it be done via email or online meeting?

A: Yes. You can consult with doctor beforehand via email and then finalize can be choose during direct consultation.

Q: Does my friend who will accompany me need to book a room in a hotel for the 5 days I am in the hospital, or can he stay with me there?

A: Your friend is welcome with you and able to stay with you in hospital too. The hospital will provide pillow and blankets with sofa bed for your friend. There are many local and international restaurants inside hospital. Your friend will enjoys. But for you, we have meals included with surgery fee while in hospital. Otherwise, your friend can wait in hotel to see you after discharge from hospital. If prefer to wait at the hotel and he is able to take a taxi to visit you in hospital too. A taxi meter from hotel to hospital is around 6 USD/trip.

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.

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 (SRS) 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: 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: Whether Bulbourethral glands will manage to be kept?

A: Bulbourethral glands, these are keep.

Q: Do I have any routine check after finished my gender affirmation surgery (when back to my country) ?

A: No you don't. However, we encourage you to follow up with any primary physician care such as gynecologist in your home town.

Q: Does PAI provide identification letter after SRS ?

A: Yes. We will issue the letter after gender reassignment surgery. You may consider updating your name and identification in your country.

Q: Appointment and Reservation: What is the procedure for scheduling an appointment for gender confirmation surgery?

A: If you live oversea. We can forward all information on line (email) and able to arrange everything include pre-screen ahead of time.

Q: Duration of Stay: How many days is it typically recommended for transgender women to stay in Thailand post-surgery?

A: Mostly, we are recommend transgender women to stay in Bangkok at least fourteen days (14 days) for post surgery.

Q: When would it be feasible for me to return to my home country after the surgery?

A: You should be in Bangkok at least 14 days after surgery date or 18 days included before and after surgery.

Q: Are there specific documents or materials I need to prepare before the surgery? Is a consultation with a psychological professional required in advance of the surgery, and if so, how can I schedule this?

A: Yes. Specific documents such as fill out a medical form and referral letter (psychiatrist or hormone therapist) written in English. Psychological consultation can also refer after direct consultation at Preecha Aesthetic Institute (PAI). We will refer to consult with Thai’s psychiatrists. All speak in English. This is a part of WPATH/AsiaPATH as well as follow Thailand Medical Law for transition surgery.

Q: Postoperative Recovery: After the surgery, what is the estimated recovery time before I can safely get out of bed and resume normal activities?

A: Let’s say able to walk slowly in hospital) after 3 nights surgery. To resume normal activities, this is require at least eighteen days (18 days) after surgery date. But avoid heavy lifting for 3 months after surgery date.

Q: Assistance and Translation: Is it necessary to have a local intermediary accompany me during the process? Will translation assistance be provided during consultations and throughout the postoperative care?

A: We speak English. Mostly, our patients (90%) are traveling alone for transition surgery. But able to bring anyone to accompany. This is free of charge.

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