Dr. Preecha

[Raven_Wild]

Hi ladies.
My name is Raven I'm a 22yo Transgender female, I have recently been somewhat in contact with Preecha's assistants about SRS. I was wondering if anyone has been to him or had issues with communication coordinating the procedure. I have been given a date for the consultation, however they don't seem to be in a hurry to set up a payment plan.. is this common?

[jacintaandrews]

Hi Raven,

I went to PAI for my breast aug about 3 years ago and everything went well. communication was great, i think i paid like $300 aud and the rest when i got there.

I am booked again for my SRS in 2 weeks, same thing, paid about $300 and pay the rest when i get there.

email response is 24-72 hrs usually.

Hospital i stayed at was piyavate and i was so surprised at the care and just look of the place, i don't think I've been in a hospital that nice in australia!

[luckylady]

Hello I go on next week in the PAI Clinic!

[TinaVane]

do they take credit card payments in Thailand i wonder ... Think i am so much closer to getting my srs ... and i can't freaking wait hehe

[Raven_Wild]

Thanks ladies, I'm so excited to finally be done with my transition at age 22. I hope it all goes well. March 16, 16 is my surgery date.

[warlockmaker]

I have has my srs, ffs and ba with Preecha on Jan 20th I can only say they were absolutely wonderful and my surgeries turned put great. They are not so persistent about payments, alot more trusting than Suporn and Chett. I fully recommend them .

[jacintaandrews]

best of luck for your surgery in 2 days!

I am not 3.5 wks post op from PAI and had my first orgasm! wohoo! lol

have lots of show/movies downloaded or available, drink lots of water and relax.

See you on the other side hon xo

[Laura_7]

Hy Raven,

I have just had my first customer that I accompanied to Thailand for SRS with PAI (doula services for surgeries abroad)

It is common procedure for them to charge you when you get there, after you have your consultation - so credit card is an excellent option instead of bringing cash.
The reply about my question why they go about it that way is, that they have quite a number of patients who rely on short term surgery dates - since it seems like sometimes patients get money for the surgery (inheritance, sponsor etc.) on very short notice. This keeps PAI flexible for the demands and needs of their patients.

SO in short - YES - charging you when you get there is normal procedure for PAI.

And my customers result is first class for advanced PI technique - so I can also recommend PAI highly from personal experience - you can ask for post srs pictures via PM if you want to.

All the best

Mona

Could you tell who the surgeon was with PAI ?

And are the results similar to what they show on their website ?


*hugs*

[warlockmaker]

I have personally seen the results of Suporn, PAI and Chett girls. I have interviewed  Suporn and Chett 2 times. I have been very intrusion on discussing their techniques. Neither wanted to discuss in detail their procedures, other than in very vague terms . I have also had long discussions with Sutin at PAI. Sutin was most open and explained his procedure in detail . My assistant has been the ward head of Piyavate Hospital in the srs section, her nurse friend used to work for Suporn.

Just a quick layperson recap. Penile skin inversion uses penile skin for the vagina. Today, all top surgeons basically use the penile skin to create the labia minora and inner surface of the clitoris area.

All the surgeons use any excess penile skin for the vagina and use scrotal skin to supplement the depth and width. Skin grafts may be used  if there is insufficient skin.

Thus all of the 3 surgeons, that I know, use the same technique. Suporn also says he uses erectile tissue in the vagina. All surgeons that I have interviewed  uses some sort of meshing technique for the scrotal skin for depth and width.

So basically they all use the same techniques and have copied each others where they deem there is an advantage.

You can call their technique what you wish but the procedure is similar.  Yes, they all use an advanced penile skin inversion...or you can say that none use inversion technique anymore. But it's incorrect to state that one uses a penile skin inversion and not the other.

[michelle82]

I have personally seen the results of Suporn, PAI and Chett girls. I have interviewed  Suporn and Chett 2 times. I have been very intrusion on discussing their techniques. Neither wanted to discuss in detail their procedures, other than in very vague terms . I have also had long discussions with Sutin at PAI. Sutin was most open and explained his procedure in detail . My assistant has been the ward head of Piyavate Hospital in the srs section, her nurse friend used to work for Suporn.

Just a quick layperson recap. Penile skin inversion uses penile skin for the vagina. Today, all top surgeons basically use the penile skin to create the labia minora and inner surface of the clitoris area.

All the surgeons use any excess penile skin for the vagina and use scrotal skin to supplement the depth and width. Skin grafts may be used  if there is insufficient skin.

Thus all of the 3 surgeons, that I know, use the same technique. Suporn also says he uses erectile tissue in the vagina. All surgeons that I have interviewed  uses some sort of meshing technique for the scrotal skin for depth and width.

So basically they all use the same techniques and have copied each others where they deem there is an advantage.

You can call their technique what you wish but the procedure is similar.  Yes, they all use an advanced penile skin inversion...or you can say that none use inversion technique anymore. But it's incorrect to state that one uses a penile skin inversion and not the other.

I think the problem that I've noticed with most of the US surgeons as well doing the penile inversion, is that the labia minora never entirely frames the vulva, and sort of stops short and recedes inwards right around the top of the vulva. This gives the appearance of almost "two" different vaginal openings. Is this also a drawback with the PAI method?

PAI does not have any really great photos on their website or in the presentation slideshow, showing their aesthetic so its really hard to make an educated and informed decision. I know this is a bit intrusive but would you mind sharing photos privately of your surgery results?

[warlockmaker]

I'm going to post my results at a site. I am very good friends with 2 Chettawut girls.and we have  examined each other only recently.  One of the girls also had a look at Dr. Ives results of another friend.  We have all been pretty open about looking carefully at each others...no inhibitions. I am really trying to get some physical comparisons for the forum . We all have 6 inches depth or more ....especially one of the Chett test girls who has 7 inches. I believe I could have achieved greater depth except for my stupidity in the fist few days of dilation which caused tearing at the entrance. This made dilating very painful so I guess I did not try to great a depth.

Thete is an artistic difference in aesthetics ....but I'm not so sure as the other ladies has more weight than me, which may have affected the aesthics.
Maybe I can persuade my Suporn and Chett girls show pics on an anonymous basis..

[RubyAliza]

Warlockmaker,

Please note there is a big difference between a penile inversion and a full graft!

You make it sound like it isn't but it is.

A full graft is - as the name implies - a neovagina that is made completely out of scrotal skin that is free and in no way attached to the body.
That is why the incision lines for SRS with full graft are completely different, and the surgeon is free to create and build.

Penile inversion is a flap graft - which means that the graft is still attached to the body at one point with nerve and blood vessels intact - and then this graft gets an add-on of scrotal skin to achieve adequate neovagina depth. Due to the concept of one end being still attached, the surgeon is bound and limited in the use of the available skin and the way it can be adapted and used to build structures.

That is why a penile inversion can't have labia minor all the way to the vaginal entrance - also the amount of available penile skin to create the labia, the clitoral frenulum and the clitoral hooding is limited compared to the full graft surgeon who can use all valuable penile skin to build those structures.

   I respectfully agree and disagree with you, although you sound very nice and well informed Perhaps it's a matter of semantics (or not). When you say that the full graft means the surgeon is free to "create and build," I don't think that's true, all plastic surgery is bound by the previous anatomy. Both techniques are still bound in very much the same way. The difference is that penile skin "tube" is never severed and split to create a more realistic, generous labia minora. The reason the labia extend further down around the vaginal introitus is because Suporn can use the full length of the penis for labia minora, whereas "penile inversion" uses part of the penile skin tube for the first few inches of the introitus. In both techniques the penile skin tube is never cut off. It's still bound pretty much exactly the same.

   I agree with you though that the Suporn techique makes absolutely beautiful vaginas, it's true.  However cisgendered vaginas have so much variation that it's hard to say that Suporn's look more like some kind of platonistic ideal version of a cisgender vagina. Some vaginas have more labia minor, some less. Suporn vaginas have more labia minor.

   This whole debate is oversimplified. The so-called "penile inversion" techniques, which has advanced greatly even in the last few years, shouldn't even really be called that. Pretty much always nowadays surgeons who do the "penile inversion" technique use scrotal skin grafts for a significant portion of the vaginal wall. One nice thing though is that the vaginal introitus is made from skin never severed, whereas the introitus of Suporn's technique is made competely out of meshed scrotal skin. Maybe Suporn vaginas have less sensitivity in the first few inches? One thing though for sure is that his vaginas seem to be pretty deep, deeper in fact than the average natal vagina. Who cares? I don't.

   Is anyone else tired of non-penile inversion vs penile inversion? They all look great. And for those of us who have insurance that doesn't pay for thailand, we have to stay here. We don't choose. I'm too poor. I'm a teacher for Godsakes

   So I respectfully disagree and agree. Neither of us are experts or surgeons so take all this for face value.
- Ruby

[michelle82]

 If you look at most cis female vaginas compared to vaginas created by all of the US surgeons, PAI, and elsewhere who aren't doing the Suporn method, the results for the most part are anatomically incorrect when you consider the labia minor and how it frames the vulva. It ends up giving an appearance of two vagina holes, which looks extremely odd in my opinion.  The only surgeon that seems to have tried addressing this issue is Dr. Bowers, and even in her latest photos, its not quite there yet.  I do agree that the person's anatomy is going to dictate the end result to some extent. But you can look at all of the photos on Bowers, Mcginn's, websites, etc and they all have a similiar outcome which as Mona pointed out is not quite as realistic as what Suporn does, considering he uses more tissue and has "more" to work with.

   I respectfully agree and disagree with you, although you sound very nice and well informed Perhaps it's a matter of semantics (or not). When you say that the full graft means the surgeon is free to "create and build," I don't think that's true, all plastic surgery is bound by the previous anatomy. Both techniques are still bound in very much the same way. The difference is that penile skin "tube" is never severed and split to create a more realistic, generous labia minora. The reason the labia extend further down around the vaginal introitus is because Suporn can use the full length of the penis for labia minora, whereas "penile inversion" uses part of the penile skin tube for the first few inches of the introitus. In both techniques the penile skin tube is never cut off. It's still bound pretty much exactly the same.

   I agree with you though that the Suporn techique makes absolutely beautiful vaginas, it's true.  However cisgendered vaginas have so much variation that it's hard to say that Suporn's look more like some kind of platonistic ideal version of a cisgender vagina. Some vaginas have more labia minor, some less. Suporn vaginas have more labia minor.

   This whole debate is oversimplified. The so-called "penile inversion" techniques, which has advanced greatly even in the last few years, shouldn't even really be called that. Pretty much always nowadays surgeons who do the "penile inversion" technique use scrotal skin grafts for a significant portion of the vaginal wall. One nice thing though is that the vaginal introitus is made from skin never severed, whereas the introitus of Suporn's technique is made competely out of meshed scrotal skin. Maybe Suporn vaginas have less sensitivity in the first few inches? One thing though for sure is that his vaginas seem to be pretty deep, deeper in fact than the average natal vagina. Who cares? I don't.

   Is anyone else tired of non-penile inversion vs penile inversion? They all look great. And for those of us who have insurance that doesn't pay for thailand, we have to stay here. We don't choose. I'm too poor. I'm a teacher for Godsakes

   So I respectfully disagree and agree. Neither of us are experts or surgeons so take all this for face value.
- Ruby

[RubyAliza]

If you look at most cis female vaginas compared to vaginas created by all of the US surgeons, PAI, and elsewhere who aren't doing the Suporn method, the results for the most part are anatomically incorrect when you consider the labia minor and how it frames the vulva. It ends up giving an appearance of two vagina holes, which looks extremely odd in my opinion.  The only surgeon that seems to have tried addressing this issue is Dr. Bowers, and even in her latest photos, its not quite there yet.  I do agree that the person's anatomy is going to dictate the end result to some extent. But you can look at all of the photos on Bowers, Mcginn's, websites, etc and they all have a similiar outcome which as Mona pointed out is not quite as realistic as what Suporn does, considering he uses more tissue and has "more" to work with.

   I think you're right about the surgeons here not being there yet here in North America. I think the problem is consistency or something because sometimes the results end of with the appearance of two vaginas like you said (which could probably be fixed with a revision). Oftentime though Bowers, Brassard, Satterwhite's results look great, as good as Suporn's - see results H2,I, M http://brownsteincrane.com/vaginoplasty-photos/. However the consistency is just not there. They're behind Suporn in that sense though. I'd go to Suporn too if my insurance would let me and if I had "more" tissue to with as well lol since I'm circumsized. The fact that he takes twice the time in the OR is a testament to his dedication and level of detail. He's great although I think the secondary organ thing where he uses the glans corona could use some work - maybe they should be inside, kinda like the wishbone shape of a natal clitoris? Sometimes he makes them very visible between the labia minor, and in my opinion it looks weird - different than any cis vagina I've ever seen. Let's hope that the other surgeons can learn something from him I think the surgeons here though would probably be comparable if they considered revisions, which I hear Suporn does often (smartly and fairly).

- Ruby

[Laura_7]

Here is therad about results from Brassard, where people say they had similar results years later, though no guarantees:

https://www.susans.org/forums/index.php/topic,82218.msg578043.html#msg578043

If you look at most cis female vaginas compared to vaginas created by all of the US surgeons, PAI, and elsewhere who aren't doing the Suporn method, the results for the most part are anatomically incorrect when you consider the labia minor and how it frames the vulva. It ends up giving an appearance of two vagina holes, which looks extremely odd in my opinion.  The only surgeon that seems to have tried addressing this issue is Dr. Bowers, and even in her latest photos, its not quite there yet.  I do agree that the person's anatomy is going to dictate the end result to some extent. But you can look at all of the photos on Bowers, Mcginn's, websites, etc and they all have a similiar outcome which as Mona pointed out is not quite as realistic as what Suporn does, considering he uses more tissue and has "more" to work with.

You could look up wall of vaginas.

There are cis vaginas who have this kind of appearance, especially in the asian population.
Inner labia not being pronounced around the vagina are common in cis people, there is a huge variance in vaginas.


*hugs*

[Richenda]

I've also been doing quite a bit of research into this and live in Thailand. The alleged differences between Dr Chettawut's technique and that of PAI seem to be largely semantics. PAI uses a mostly non inversion technique very similar to Dr Chet's. I don't think the semantics should be a deciding factor in who people decide to choose.

[mmmmm]

I've also been doing quite a bit of research into this and live in Thailand. The alleged differences between Dr Chettawut's technique and that of PAI seem to be largely semantics. PAI uses a mostly non inversion technique very similar to Dr Chet's. I don't think the semantics should be a deciding factor in who people decide to choose.

Surgeons at PAI do updated penile-inversion, very much the same technique as most surgeons in Europe and North America do nowadays. Its penile-inversion with added scrotal graft for better depth.

[warlockmaker]

I don't understand the squabble over who is the better. Anyone who has surgery with their surgeon and it goes well will advocate  that their surgeon is the best ....more so with Dr Suporn....well you pay the most by quite a margin and I guess you thus stand up more strongly. I've  seen their work personally and it's all about the same.

[RubyAliza]

I don't understand the squabble over who is the better. Anyone who has surgery with their surgeon and it goes well will advocate  that their surgeon is the best ....more so with Dr Suporn....well you pay the most by quite a margin and I guess you thus stand up more strongly. I've  seen their work personally and it's all about the same.

This is exactly what my electrologist said and she's done hair removal on post op patients from practically every major surgeon from Thailand and North America. The only surgeon who uses the old penile inversion technique is probably Dr. Meltzer. It's not about non-inversion vs inversion anymore - they all look pretty darn good. (speaking of looking good - cute new avatar pic Warlockmaker my dad lives in Thailand, been thinking of visiting for fun).

- Ruby

[Richenda]

My understanding too. They're virtually identical now: certainly the ones in Thailand.

It's down to other factors for people to choose, not the technique.