SRS (Sigmoid Colon) Sex Change Surgery

SRS (Sigmoid Colon) Sex Change Surgery

SRS (Sigmoid Colon) Sex Change Surgery

SRS (Sigmoid colon) transposition is used for patients who need more depth (exceeding 8 inches).

Sex Reassignment Surgery  “Sigmoid Colon” (the sensational glans clitoris, labiaplasty, 7-8 inches depth and vaginoplasty).

Preecha Aesthetic Institute (PAI), the Pioneer for Sex Reassignment Surgery in Thailand.

Transsexual person is someone who was born into the wrong body. They have the body of one gender and the mind of the other.  Transsexuals may be a female trapped in a male’s body or a male trapped in a female’s body.

Preecha Aesthetic Institute has been provide information, help and supportive for Transsexuals, and Cross-Dressers of all ages, we are especially Reconstructive Center located in Bangkok ,Thailand for those who are in the final stages of “Sex Reassignment Surgery”. We have been performed SRS by PSI, SSG  and SCG > 4,800 + cases.


What is Sex Reassignment Surgery ?

Initialized as SRS; also known as genital reconstruction surgery, sex affirmation surgery, sex realignment surgery, gender change, gender reassignment, gender reassignment surgery, gender surgery or sex-change operation) is a term for the surgical procedures by which a person’s physical appearance and function of their existing sexual characteristics are altered to resemble that of the other sex.

It is part of a treatment for gender identity disorder/gender dysphoria in transsexual and transgender people.

Other terms for gender change operation include gender reassignment surgery, sex reconstruction surgery, genital reconstruction surgery, gender confirmation surgery, and more clinical terms, such as feminizing genitoplasty or penectomy, orchidectomy and Vaginoplasty are used medically for trans women



Sex Reassignment surgery by  Sigmoid Colon (lubricate with organism


SRS with Sigmoid Colon

- the sensational glans clitoris

- labiaplasty

- vaginal deeper canal

- vaginoplasty in one stage.


Selecting the method in Sex Reassignment Surgery 

Between Penile Skin Inversion or Sigmoid Colon

if you are:

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)


Best Candidate for Sex Reassignment Surgery:

Sex Reassignment Surgery male to female.

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

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

- Specific minimum requirements as prerequisites to HRT

- Much of the criticism surrounding the WPATH/HBIGDA

- Psychological evaluation letter

- Highly controversial and often maligned document among patients seeking medical intervention (Hormones)

- Real-Life experience

- Physically healthy and emotionally stable with realistic expectations

- Must be over 18 year old with good health condition with parent. Fully 20 year is able to come by yourself.


The package’s inclusive for male to female surgery Thailand :

- Accommodation for 5 days in hospital private room after surgery

- Operating Room Charges: OR Room Use, Recovery Room, Scrub & Circulate Nurse

- Regular menu food charges

- Laboratory Testing: necessary for the procedure as CBC, EKG, UA, Anti HIV, Chest X-Ray

(If age over 45 need to check Cardiology.  An extra charge 100 USD)

- Medical Equipments and Medical Supplies

- General Anesthesia – Pre Anesthetic Drugs, Anesthesia and Medical Gas (Oxygen, Nitrous Oxide)

- Medical Treatments

- Doctor fees

- Anesthesia fees

- Nursing services

- Take home medication and supplies

-  A pack of sanitary napkin ring

- PAI’s GRS dilator (1 size)

- Post op cares

- Transportation pick up


Service Accommodation: Non Medical

- Transportation pick up from airport –hotel-clinic-airport  as well as follow up period.

- Mobile service during recovery with local number.  People can get in touch with you.

- Hotel reservation at least 1 km from Preecha Aesthetic Institute

- Touring services

- Interpreter services  with any language


Type of Anesthesia: General Anesthesia

sex change pre-op

1) Inform us about any allergies, any serious medical condition(s), and all medications you are -

taking (both prescription and non-prescription).

2) Qualify letter from Psychiatrist doctor or Hormone Therapist

3) No Aspirin at least 2 weeks before surgery.

4) Stop vitamin E Oil 1 day before surgery.

5) Stop smoking 2 days and a month after surgery.

6) Stop Hormone, if taken 2 weeks before surgery date

7) Tell doctor if you have any serious medical condition(s).

8) Stop meal and water starting from midnight before surgery.

9) Plan to be in Thailand at least 14 days after or at least 15 days (Before and after) surgery.


Sex change procedure

1. Creation of vaginal space between urethra, prostate gland, bladder and rectum
2. Bilateral orchietomy
3. Degloved penis shaft
4. Separation of urethra from penis
5. Isolation glans penis with 2 dorsal nerves and vessels
6. Penile skin inversion to line vaginal cavity with or without scrotal skin graft or
sigmoid colon graft
7. Clitoroplasty (Sensate)
8. Urethropalsty
9. Labiaplasty, major and minor

A portion of the glans (head of the penis), with its nerves and vessels, is converted into
a clitoris. In so do, the clitoris will be functional in sensation as well as in appearance.

The excess erectile tissue around the urethra should be removed in order to avoid
symptoms that stem from engorged erectile tissue during sexual arousal, that may
result in the narrowing of the vaginal opening.

Post-op  recovery: sex change recovery time

After reassignment surgery, pain that is easily controlled by medication usually will subside in a few days.  Dressings have been applied.  we will be 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 fee.  To permit proper healing, you should avoid over activity and refrain from overhead lifting.

Treatment after surgery for sex reassignment surgery

After release from hospital you will recover with the aid of liaison at the hotel.

During recovery in the hotel, you must follow instructions including:

1. Dilating is the most important thing you can do to ensure the success of your surgery. If you do not dilate responsibly, this can result in the shortening of depth and width of the newly made vagina because of the scar contracture.

2. 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.

3. Dilation can be painful for the first weeks, but is essential for developing maximum

4 Depth and ensuring post operative functioning of the neovagina. More instructions will be given after surgery

During the recovery period and after each dilation session:

- 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 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 Beta dine 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 knapkins (tampons) should be changed several times per day due to normal vaginal bleeding during recovery.

- After one month of SRS operation you will be required to start applying Premarin cream to your neo-vagina. Apply two times a day to soften your neo-vagina. This would generally take around six months.

- You can return to female hormones as before surgery or after two weeks. You should consult your endocrinologist to re-adjust the dosage. A sudden change in hormone levels, for some individuals, may result in the fluctuation of emotion.

- For SRS patients – a full post-operative care kit necessary for dilation, including a -piece dilator set specially manufactured for GRS as design by Preecha Aesthetic Institute.

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 you are here.


Surgery Time required: 2 hours

Anesthesia : General Anesthesia

Recovery Sex Reassignment Surgery: Required to be in Thailand 15 days (Totals)

Back to work: after 20 days more

Strenuous activity: 4-8 weeks

Fading of scars: several months to a year


Sex Reassignment Surgery’s  schedule (require 14 days after surgery in Thailand)

Day 1 – Consultation and Prepare for Laboratory Testing

Day 2-6 – Surgery and 5 days in hospital private room after surgery

Day 6 – Discharge from Hospital
Day 6 to 13 – Stay in hotel for recovery period and follow up on doctor appointment

Day 7-10 – Stitches removal

Day 13 – Final check up and prepare for letter fit to fly and  issue for a new letter with gender name change
Day  14 – Safe to fly

All transportation during recovery period in Bangkok will be sponsor by PAI.


Schedule an appointment or question in Sex Reassignment Surgery MtF .

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

2. Via email

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.

3.1   Consultation with us via email for details and procedure

3.2   Plan your available date to be surgery and departure from Bangkok

3.3    We will confirm you for surgery date

3.4    You may start to book your airline ticket

3.5    We will confirm you all detail and hotel booking, if require

3.6    For transportation to be pick up from the airport, we can do for you as optional


PAI (Preecha Aesthetic Institute)

898/1 Sukumvit 55

Wattana, Bangkok 10110 Thailand

Tel: (662) 715-0111


Meeting Point (Airport)

We collect you and any accompanying travellers from Bangkok Suvarnabhumi International airport – irrespective of day or time of arrival of your flight. We return you to the airport at the end of your stay.

Our driver will wait for you or any accompany travellers at door number 4 (Meeting Point), after exit from customs.  Travellers will see a sign of PAI’s logo under your name.



Hotel partner are special rate offer for PAI.

Prior to admission to , and discharge from hospital, patients stay in local hotel accommodation. We arrange your Hotel accommodation as co-operate rate and low rate (located from 20-100 meters  from Preecha Aesthetic Institute).


Approval hotels by Preecha Aesthetic Institute (PAI).

Full access to the Clinic facility within walking access of local shops and facilities, which is very much a patient’s recreational facility and “home” while she is with us. This includes:

- Free internet via broadband with a wireless network and wired network.

- Lounge facility

- Full air condition

- House keeper

- TV with DVD movies

- Laundry

- Restaurant / Cooking facilities

- Recreational trips to areas of local interest

- Room, bed, floor clean and hygiene



- Thai, Italian, Spanish and English

- Other Language upon request



1. The payment can be prepared in Cash by US dollars, Euro Dollar, Japanese Yen, HKD, SGD, AUD or pay by Traveler‘s Cheques.

2. Bank’s Transfer.

3. If using credit cards, 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 30% from total cost.


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


Passport and VISA:

Preecha Aesthetic Institute can issue the letter to clarify with your local Embassy or Passport.


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.


Air Travel Tips for Transgender People

Nothing on this webpage is meant, or should be interpreted to mean, that transgender people or anyone else should attempt to circumvent security or deceive security personnel in any way. It is meant only to provide tips to transgender people who may otherwise be subjected to unfair or embarrassing selective scrutiny or treatment.


Who You Are: Identification Issues

All passengers 18 years of age or older are required to provide proof of identity at check-in and at the security checkpoint.

- The name you use for your airline reservation must match the name on your identification.

- If your current name does not match your passport, we recommend that you consider getting an updated ID if possible.

- For an international flight, you will need to present a valid passport, visa, or any other required documentation. Passengers without proper ID may be denied boarding.

- “For e-tickets, you will need to show your photo identification and e-ticket receipt to receive your boarding pass.”

- If you do not currently look like the picture on your picture ID, we recommend that you consider getting an updated ID with a new picture if possible. If you cannot or if you are still concerned about ID issues, consider carrying an explanatory note from a physician or therapist explaining why you may not look like the picture on your ID.


Hospital’s guest

You may also have guests stay in your private room at sofa bed (no charge).


Flight Bookings

We do not provide a flight booking service for journeys to Thailand. But recommend there are many local agency base, which low cost booking.  You may also search a booking flight via website.

Surgeon’s team

At PAI, we are only one center and biggest group of qualify plastic surgeon in Thailand for multidisciplinary in aesthetic and reconstructive surgery.  Because we believe no one can work best in all kinds.  Therefore, at PAI, Dr.Preecha Tiewtranon, MD’s  highly selective qualify doctor who match for each type of procedure, FFS, SRS, body contouring as well as anaesthesiologist and team of operating theatre nurses.



We are confident you will find the overall service we offer for these surgeries to be more comprehensive than is available from any other surgery, anywhere.




FAQs (Sex Reassignment 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 was truly ready to get it done.

Q: How did you feel after surgery?

A: 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: 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 you make labia major and minor ?

A: The labia majors and minors are created.

Q:  Do we have orgasm in this surgery technique?

A:   We cannot guarantee,because even natural female do not all have orgasm. But70-80% of our patients reported orgasm.

Q:  What does vagina looks like after surgery? Will it be natural as women’s vagina? Do any one 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:  Many partners and gynecologists cannot tell.

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 read some of information.  Can Colonvaginoplasty lead to a large number of unpleasant complications including colon fistula, and faecal incontinence.

A: It is possibly.  Within our experiences 30 years, we have done 700++ cases for Colon (SRS).  Non of them’ve experienced with unpleasant.  We have to make sure that they are safe to fly.

Q:  What is requirement for SRS (Sigmoid Colon)?

For Sigmoid Colon,  your body weight should no more than 90 KG. (Lbs 190), No previous abdominal surgery and Good health.

For SRS by Sigmoid Colon with Preecha Aesthetic Institute, Thailand,  your Body Mass Index (BMI) must less than 24.99.

 Q: I read that in order to get SRS (sigmoid colon surgery) no previous abdominal surgery must be done. I had the normal SRS procedure done 4 yrs ago. Does that I mean I cant have the sigmoid colon done after all?

No, it does not.  Base on your information, you had normal SRS four years ago.  If you are not happy with the depth of vagina canal or looking to gain more depth.  The new method is called Secondary Sigmoid Colon, which can be done after normal SRS.

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.

There is no age limit for surgery, if you are healthy and passed the lab tests or medical check up 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 Wife is concerned about the final out come of the SRS .  Is it sensitive ( with feeling ) ? Is she going to be able to have Orgasms?

The goal of SRS (MtF surgery) here at Preecha Aesthetic Institute (PAI), all patients must receive sensate, G spot, aesthetically acceptable vulva which include clitoris, labia minora, majora and vaginal introitus.  Shortening of the urethra, with 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.  To achieve adequate vaginal depth. To preserve orgasmic capabilities.  Minimize and hide scarring. To make neo vagina, appearance and overall realistic.

Q: I would like to inquire about your methods of SRS Sigmoid Colon Surgery I presently am a male with desires to become female I would like to ask about the SRS mentioned in your site. Will I able to get 12 inches of Colon (MtF) to make a neo Vagina.  I presently date a man that possess over 10 inches of penis and I don’t want to have him leave part of himself outside during intercourse . Could you please advise on the best methods to handle this concerns. I am now 9 inches, while erect.

Base on your personal information, if SRS Male to Female by Penile Skin Inversion, the result should be reach 9 -9.5 inches maximum depth vagina canal.  But again not able be satisfy with your partner, if he is over 10 inches. Since your boyfriend is bigger than 10 inches length.  SRS by Sigmoid Colon technique is the best answer for you because much more longer depth of vagina canal, lubricate (no apply gel) and able to get 12 inches of colon male to female surgery.

Q:  Can I do Facial Feminzation Surgery together with SRS surgery?. 

Yes.  Facial Feminzation Surgery (FFS) can be perform together with SRS and Breast Augmentation at the same time.

Preecha Aesthetic Institute doctors Dr.Sirachai Jindarak MD, Dr.Prayuth Chokrungvaranont MD, Dr.Sattha Siritantikorn, MD, Dr.Apichai Angspatt, MD, Dr. Preecha Tiewtranon MD, Dr.Sutin Khobunsongserm, , Dr.Burin Wangjiraniran MD. FRCS    

.Sattha Siritantikorn, MD, Dr.Apichai Angspatt, MD, Dr. Preecha Tiewtranon MD, Dr.Sutin Khobunsongserm, , Dr.Burin Wangjiraniran MD. FRCS    


All surgery carries risks – But can minimize by closely following your surgeon’s advice on follow up care during the healing process.


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