I think most good plastic or urological surgeons would be able to perform cookie cutter variants of SRS in both directions, if they fully understand the procedure, even if they rarely do so. Yes, they're complicated, but they're not that complicated.
That said, the more a surgeon does a procedure, the better they get, and the fewer complications they experience (percentage-wise, obviously). As a heart surgeon I know says, even though some surgeons don't want to admit it, this is a law without exception. Of course, a surgeon could be so incredibly skilled that they'd get better results even if they do a procedure rarely, compared to an unskilled surgeon who does the same procedure daily, but the incredibly skilled surgeon would be even more skilled if they did the specific procedure more often, and the clumsy surgeon would be even less skilled if they did fewer. So in my case, while I might be able to get SRS done in my own country in a few years, they use regular plastic surgeons who don't specialize in trans surgery, and often only do around five MtF procedures a year, so I've chosen to get it done overseas since I'd rather pay myself and know that I got "the best" rather than end up with a suboptimal result because the surgeon spends most of their year doing other stuff.
Of course, this might be wasted money, since my result "at home" could've been just as good. Or I might be one of the very few unlucky who get a suboptimal result where I'm going. But either way, I'll know the money was in reality well spent - I pay to get a statistically higher chance of a good result, even though the particular outcome could be different. And of course it'll never be possible to compare the two results, since I can obviously only go through SRS once.
