Many questions about GRS.

[Michelle3]

Hello all .
I would like to ask a lot of questions about GRS and also orchiectomy. First i would like to explain why I am asking that so early. The reason for this are laws in my country. If you do GRS or better to say that you have changed gender, you will loose all your achieved education to the point of legal change of gender. Right now I am studying Masters degree and have to interrupt study, if I want to have any title or diploma. So from now on I have like 2 and half years to do everything, including GRS. Gonna start HRT next month or in 2. And I just want to be sure in future as much as possible.

1. If I will perform orchiectomy first, in which time should I go for GRS to not have a lot of shrinkage? Maybe there is a possibility I will not earn enough money for GRS or another complication will come and I will need to go for orchiectomy, if I would like to have at least something from my 15 years of studying.

2. How much could keloid scaring affect the result of orchiectomy? Which type you would prefer to do, or there is not a choice? I have keloid scaring by genes and I am afraid that if I will perform orchiectomy first, that scars will make GRS impossible.

3. Which method will work best after orchiectomy? Will be there additional pricing? I have heard that some methods, for example Chettawut is ok also with orchiectomy, but I am not sure about it.

4. Would you perform orchiectomy before GRS or is it better to wait for one major surgery? I know that orchiectomy has a lot of positive effects for feminizing and you will not need AA drugs. Of course if it makes sense to do orchiectomy first.

5. Which method of GRS right now available would you consider as the best one? I am pretty young (21) now and GRS will be for the rest of my life, so if it will be possible for me to get the best method I will go for it. Is it one performed by Chett or Supporn? I am also interested in depth and lubrication.

6. Which method should be best if I have keloid scaring issue? I am sure that inverted penile technique would be worst for me, if it would go wrong, so this is actually no available method for me. I have heard that Chett is performing his GRS with minimal scaring, or which method will be best?

7. Which method do you prefer and why? This question is bounded with the last two, but answers here can be different.

8. Does GRS have any influence on the length of life? I am just curious.

9. Is revision often needed after GRS? I read a lot of stories here about revisions needed after GRS, after 1 year or so to finish the job.

10. There is said that Supporn and Chett from Thai have similar methods. Why is Supporn almost 2 times that price of Chett? More times, a lot of more times on this forum is Chettawut mentioned more often, and sometimes opinions are for him instead of Supporn. But I like Supporn is free of charge for revisions. Would like to know comparison.

11. There is one german surgeon, but I cannot recall the name of him who was doing interesting method with speciality on self lubricating. Do you know his name? Germany is much closer to me and it is better if any complications will occur. Actually the pricing as far as i know is too high.

12. I have heard about method of taking steam cells from inner side of cheeks and growing them in laboratory. Is this method available now or this is future?


So these are my questions and probably will ask more when answers will come. As from the questions above, my opinion is for Chettawut right now, but from your opinions and answers it can change. Thank you for all future answers.

Michelle

[SorchaC]

Hi Michelle

I cannot answer all your questions but I'll have a go at those that I can.

I had an Orchidectomy and while there was some shrinkage it wasn't so bad as to make SRS impossible. You will need to wait 6 months after for SRS surgery to allow scar healing.

If I'm not mistaken it is possible to perform an orchie with an incision in the groin area rather than the scrotum meaning any keloids would be away from the SRS surgery site. This may be an option for you.

Dr Chett did my SRS and I'd also been circumcised meaning even less skin. I cannot comment on other surgeons but I know Chett isn't the only one who will do it. I'm told Suporn will also

I only had an orchie because the surgeon at the time wanted to reduce my hormone intake because we both felt Estrogen was causing excessive weight gain which in turn was making me unsuitable for SRS. My advice for many reasons would be to do just one surgery if you can.

Surgical outcomes vary by the person. I think it's unfair to say one way is better than the other without trying them which I obviously cannot. You have to decide based on your own expectations what will work for you. Research now will help you to a successful outcome post op.

I only have 2 scars from my SRS and they are fading well. My partner Bernadette is prone to Keloids and Chett was fairly confident he could do SRS for her with a low risk of them. This is not to say it won't happen but he felt confident in his outcome. I have not seen discussions about Keloids as when Bernadette was talking to Chett I was recovering downstairs from my SRS

If I answer 9 and 10 together then it may help. I do need a revision which Chett is doing on October 8th. The cause wasn't really Chetts fault because when I had got rid of the swelling my skin was not elastic enough to go tight again. Being 49 and previously really overweight I had stretched my skin to the limit already so post surgery swelling was a bit too much for it. Chett  agreed at 4 months post op to perform the revision for free so my only cost is a flight and 16 nights in a hotel. which to me is an excuse for a holiday. I am sure there are a few of us who need revisions for various reasons but that is the same for many cosmetic surgeries and so I am thinking the % of trans patients needing a revision is no higher than say people having Rhinoplasty.

I think the German surgeons name is Dr Schaff in Munich. I will let his patients comment on his results.

I hope you get many answers and whoever you choose you have a wonderful outcome

Hugs

Sorcha 

[Michelle3]

Thank you Sorcha for the answers . I know some of my questions are more opinion based and hardly you can say this is the best, but I want as many opinions as possible . This will be a huge step and I want to have that step with minimal possible risk and best outcome to that risk . I will be doing a lot of research on this. Thanks for the opinions, advices and help . Will be waiting for more answers .

[SorchaC]

Thank you Sorcha for the answers . I know some of my questions are more opinion based and hardly you can say this is the best, but I want as many opinions as possible . This will be a huge step and I want to have that step with minimal possible risk and best outcome to that risk . I will be doing a lot of research on this. Thanks for the opinions, advices and help . Will be waiting for more answers .

I hope others answer You are right to do as much research as you can because this is a huge step. You need to work out which surgeon is the best fit for you. My only other advice would be to try if you can to not base your choice on either surgeons location or price. You'll only do this once and if it takes a year more to be able to afford a better surgeon then that's time well spent

Hugs

Sorcha 

[Michelle3]

Maybe I asked too many questions, sry for that I am very curios at all. I will ask few more now and will specify them to one surgeon - Dr. Chettawut.

A. What is the waiting time for Dr. Chettawut?
B. Colon graft vs. skin graft? Should I avoid colon graft when I have keloid scarring? Would it be worth it?
C. What are the reviews on his rhinoplasty? I have a big ball on the end of my nose and I am pretty sure that I would like to get rid of it.
D. Is it good to combine SRS + Tracheal Shave + Rhinoplasty?
E. Does his techinque requiring much more dilation than the other ones? Do you still need to dilate daily after 2-5 years?

[Jenna Marie]

Sorry about that; I usually try to answer questions in this section because traffic is relatively low (longer-term post-op women tend to wander away, I guess), but I don't have any experience with Thai surgeons or orchi or keloid scarring.

All I can really say is that I had penile inversion and the results were excellent for me, including self-lubrication. But since you've ruled out that technique, I doubt most of my experience will be helpful for you.

[Joi]

Michelle3:  I am pre-op and have chosen Dr. Chett.  I will try to answer some of your ?'s.

Waiting time:  I started my communications (via) email with Dr. Chett's office in late May.  At that time, I told them that I wanted to have  GRS surgery early in 2016 (preferably in Jan.)  After they reviewed the initial info that submitted, they gave me a "tentative" date of Jan. 21st.  Since that time,  I have been fulfilling all of the pre-surgical requirements that they require.  As I will be 68 when I have my surgery, the requirements are quite a bit more stringent than they would be if I was 30. He is very thorough in his process for approval.  This is good!  I expect to receive my approval within the next 10 days.  My surgery date will be firm when they receive the "down-payment." 

Grafts:  My understanding is that if a graft is required (this is dependent on each individual) it will come from the thigh.  certainly not from the colon.

Rhinoplasty:  I am not considering this. In regard to combining surgeries.  I thought about the same  (brow bossing). Dr. Chett. did not recommend that it be done simultaneously. His position was that any procedures that could cause discomfort and swelling (especially to the face) would likely interfere with one's recovery from the GRS. Later maybe after appropriate recovery from the GRS, but certainly not at the same time.

Dilation:  He has recommended durations, but everyones body is different and recovery is dependent on many factors (too many to list here).  You will have to dilate.  Better to know this in advance and prepare yourself mentally for this.  IMO: It's all about how you use your new vagina after the healing and swelling is resolved.

Hope this helps! 

[SorchaC]

Hi Michelle,

Dr Chett asks you to schedule 3-4 months in advance but I guess if you have a specific date in mind it would be better to schedule as much in advance as you can. When I scheduled mine about this time last year I could have had my SRS in November but as that was right when my partner gets all busy with work I concluded to wait 4 months longer as having her with me was more important than having my surgery a few months earlier.

Dr Chett does his skin grafts by taking the skin from the inner thigh so when he does his stitching you cannot see where the graft came from. All I am left with is a U shaped scar with the bottom of the U being my vagina. I had to specifically ask where he took the skin from it was so good. If you had the colon surgery you are increasing the risk of Keloids as there will be further incisions in an area of the body where the risk of Keloids is highest so unless you have a specific need for it I'd avoid colon surgery.

I am not sure if he will perform all 3 surgeries at once. He will for sure do 2 but the length of time you're under the anesthetic will obviously increase with 3 surgeries and only Chett will know if that is possible. As Joi said facial surgery is best done at a later date but he will do Trach Shave and SRS as my friend had that done

Dilation is like housekeeping, The more you do the better the result. Most people will have to dilate for life the only thing that changes is the frequency. I am about 5 months now and still do it 3 times a day because I have the time for it. I've gain half an inch over the last month and it is pretty easy now. If you are going to have regular sex with a man then once you have properly established your vagina I suppose the sex will take care of dilation and act as a warning if you start losing depth and need to dilate more but others will know that better than me as I've not had any sex

Hope that helps

Hugs

Sorcha 

[Isabelle]

I scheduled with him about 4 weeks before the actual date. As long as you can pay the fee and get to thailand, waiting lists don't seem to be an issue 

[AnonyMs]

I'll have a go at 10, "Why is Supporn almost 2 times that price of Chett?"

Firstly, my answer is a bit biased as I've studied Dr Suporn in great depth, and the other surgeons relatively superficially. I'm a bit of a Suporn fan.

I believe its either because he can or because he has more expenses. Dr Suporn operates out of a hospital, while Dr Chet has his own operating theatre. I know Dr Suporn has a very high standard of aftercare, but I get the impression that Dr Chettawut does as well.

Dr Suporn's waiting list is around a year, so he has no shortage of business and can charge whatever he wants. A good questions might be why doesn't he charge more?

http://www.supornclinic.com/clients/calendar.htm

I don't know why there more people here talking about Dr Chettawut. Presumably they are doing a similar number of surgeries each year, and if so I think that means the demographic of people on this forums is biased or Chettawut people talk about it more than Suporn. Not sure why either of those might be. The only thing I can think of is that there's a couple of private groups elsewhere that are dedicated to Dr Suporn, and perhaps they are sucking people away from this site. I don't know of any for Dr Chet.

I got this far, may as well keep going..

1. If I will perform orchiectomy first, in which time should I go for GRS to not have a lot of shrinkage?
Dr Suporn will refuse to do SRS if you've done an orchiectomy in a way he doesn't like. Its stated on his website. I've seen a drawing of what he requires, and I guess you can email him to get it. Personally I'd not risk it as I really like Suporn and don't trust another surgeon not to screw it up (the orchiectomy). I've heard people say not to bother with an orchi unless its going to be many years before you can get SRS.

5. Which method of GRS right now available would you consider as the best one?
Not sure how to answer this without staring a pointless argument. Many people go to each, and reading their posts you can be sure that at least some of them have spent a considerable amount of time and effort researching it. I know I did. Do you have enough money to choose?

8. Does GRS have any influence on the length of life?
I expect it does. How long are you going to last if you don't transition? I wasn't doing so well. So yes, lots of extra years.

9. Is revision often needed after GRS?
Some surgeons do a two stage process. Dr Suporn does a one stage, and offers free revisions. Some people take him up on that to either fix problems or get cosmetic improvements. His initial surgery is very good though so many don't bother or can't afford the time/money. I spoke to one women doing that and she was happy with the result before the revision, and super happy afterwards. The 1 year is because it takes that long for the swelling and healing from the initial surgery complete, but also because you can't dilate for quite a while after the revision, and up to a year you need to dilate every day. Dilation would damage the revision. This is therefore not equivalent to the second stage offered by surgeons who do a 2 stage SRS with the stages separated by a days. Dr Suporn also has a lot of revisions during the 30 days patient stay in Thailand, and I believe that's due to his technique. I don't think its a big deal, and I'd rather stay the extra time to make sure its all just right before going home.

Another thing you might want to consider, is that Dr Suporn's recovery time is double that of penile inversion. I believe its stated somewhere on his website. Anyway, that might mean more time off work, and a bit more suffering I suppose. However I spoke to a post-op lady who was down to dilating only twice a year, some years afterwards. Sounds good to me.

There's quite a few pictures you can find on Suporn SRS results if you look hard enough. I didn't manage to find nearly so many from other surgeons. I don't know why.

So much for a short answer...

[Michelle3]

Thank you all for the answers . Every answer and experience is very valuable for me. And it is changing my view on several things, and can make more wiser decisions .

@Jenna Marie I am afraid more of the penile inversion, because of the much more skin inside a vagina and keloids. And also that other techniques seems more interesting for me, considering final outcome. But Penile inversion can still be very successful and satisfying .

@Joi I would like to get SRS ASAP, so 3 - 6 months from the first communication would be nice ..... I do not want on rhinoplasty to be done anything with the bone, only to the tip of the nose where is from my genetics ball, i would call that, and place the tip in more feminine angle. Anyway will be considering doing this apart from SRS and tracheal shave and will see after consultation in future. .... I am sure I will be taking as much care as possible but was curious if it will be long dilations during the rest of the life for every day, but after more information i found it can be reduced then.

@SorchaC Thanks again for the answers . It looks like that skin graft is much wiser option than colon graft for me and also less risky with less complications.

@Isabelle This is great . I hope nothing should be problem for me.

@AnonyMs Thank you for a lot of information about Dr. Supporn..... I was thinking about orchi because of better feminising effect, but would like to have best outcome, so rather will go for SRS without orchiectomy..... Is possible I will be able to choose maybe between Supporn or Chettawut. Their techniques are pretty similar as there was one post on the forum comparing them, but maybe one year waiting time for my situation is not the best. But still have Supporn as option for me in my head, future will decide  ..... Love the answer on question 8 . ...... If I would choose any surgeon I will stay in hospital or nearby hotel for 4 weeks as I know that this period would be the most critical..... 2 times per year is very nice results

Thanks again for the answers. I will be probably asking more and more when time will be closer and closer. Because I am very curious as I said and would like to be best informed as I can .

[Isabelle]

I talked to my surgeon about it. He said it wouldn't really make much difference. He said the testicles shrink from hrt over time, which makes the sack shrink a bit. This is important cause that's what forms the lining of the vagina canal. I don't have enough so, I need a skin graft. So even if what you have is small, it's not a big deal.

[Michelle3]

Hello again .

My parents started to discuss the price and want to help me. But it will be great to know what price it will approximately be. So the question is. How much it will cost for GRS + Trachea Shave + 30 days staying in Bangkok for 2 people? Chettawut I know that the fly would cost around 1600-1800€ for 2 people there and back.