CarrieLiz's GRS With Dr. Chettawut, 8/9/16

[Dena]

I think this is your first surgery where as in my  case it ends up being just another one. The two surgeries that I could best determine how fast the body heals were my  nose and voice. As simple as voice surgery is, at 7 months I noticed a large improvement though at a year I still notice it's not fully normal. With my nose I could still feel swelling mid way in the surgical area after over a year. It wasn't very visible but I could feel it with my fingers when I rubbed my nose.

Swelling will be reduced over time and skin will tighten up. I can't guarantee what it will look like in the future but try to remember what was there before and be thankful for what you have.

[Jessika]

I was going to say before someone else mentioned it..

Ask the Surgeon Face to Face.

Hope it works out well.

[Carrie Liz]

Okay, I had my final consultation, and everything's fine. Internet rumors about Chett's aftercare got the best of me again. In real life, he was able to answer every single one of my questions/concerns directly, he was very specific, very straightforward, and there was no runaround or non-answers at all.


So, final exam day is the day when he checks how your healing is going, addresses any concerns you have, and he'll tell you directly if there were any unique problems with your surgery that might affect results.

Because my final consultation got moved up a day, I had another girl with me getting her exam at the same time. And this was something that was running around in the back of my anxious mind, "he just tells everyone that they're small so that he can get away with charging everyone for the skin graft and give everyone subpar results and divert blame from himself." Not true. With the girl I was with, her unique challenge that he said he had with her surgery was that she had very thin skin. After her consultation she said "I guess that explains why I was having a lot more pain than others, and couldn't sit or stand as long as you can even though I had surgery the very next day." (Her surgery was August 10th.) She was over the moon with her aesthetic results, saying that everything looked very natural.

Before I could even ask a question about the tight inner labia area, Dr. Chettawut told me "your surgery was difficult because your skin was very short." And I did ask him if things would loosen, if the inner labia area would become more defined, and if there was any sort of structural deficiency between my surgery and the surgery on his Youtube channel where he showcases the inner labia elasticity of a UK patient, and he said "no, the structure is very good, it is the same, it will just be a little tighter because you had not very much skin in the penile area."

I asked about the loose outer labia, and he said "it is within the normal range, and you can absolutely expect this to shrink as swelling goes down. It is a bit big, and I know no woman wants a very loose outer labia, but the structure is still correct. And there's not really a good way for us to pull and make it tighter right now. Wait 6-8 months to see how it heals, and then maybe you can correct it if it's still a problem."

Straight, honest, not diverting blame, no non-answers.

He then told me "there was a small lesion in the vagina area, so I just want to make sure that you use enough lube when you're dilating. Use a lot. Do not try to save money," and we both laughed. "And make sure that when you insert dilator, insert it slowly. Do not rush." (Which is actually what I did yesterday... I was trying to use less lube. Plus I rushed through my dilation because I was in a hurry, sliding the dilators in very quickly. And during my afternoon dilation, the phone rang from Chettawut's clinic to tell me about my new final exam date/time in the middle of it, so I had to abruptly take the dilator out to answer the phone. And when I was putting it back in, I figured "eh, it was already lubed up, I should be just fine sticking it right back in," and I didn't feel any discomfort at the time, but then there was a little blood during my evening dilation and I wasn't quite sure why. Now I know. Take it slow, and don't try to skimp on lube, just make sure you're not creating friction. [And I didn't tell him any of this, so this was all just his expertise from him having seen all of this thousands of times before.])


So, my concerns are eased, I REALLY need to learn to not let my mind and my emotions run away with me when I get scared of something, (and maybe not let myself freak out because of internet rumors about aftercare and them giving diverting non-answers to concerns,) and yeah, this is always a problem with me and anxiety, I freak out about things and the more I dwell on them the more I freak out about them because of panicking about the worst-case-scenario what-ifs.

Happy customer, so glad he was willing to take the time to address each of my concerns directly, and I have a lot more to say about the overall experience here, the social environment, and particularly the experiences of one of the girls I've been talking to at breakfast who just came from Dr. Suporn's clinic but was unable to go through with surgery there due to a personal issue, and her perspective was really enlightening to me on the differences between Suporn and Chettawut that so many people are interested in, particularly why Suporn is more expensive and why he has such untouchably-high reviews, but that's for another post.

[Carrie Liz]

I also did get a consultation for facial feminization surgery.

(Most people's concerns with FFS consultations are probably that the doctor is going to tell them that they need more surgery than they really do to try and squeeze more money out of them, and hopefully this will demonstrate that Dr. Chett is not one of those people.)

What he told me I needed most was the traditional FFS trifecta of forehead/browlift/nose. I asked him about my hairline, as that's one of my biggest concerns, whether there was any way to correct that at the same time as the forehead, and he said "no, actually, the scalp advancement, which is often done at the same time as forehead reconstruction, that would actually make your hairline worse, because it would pull down the middle, but not fill in on the sides. So it would actually make the sides look even thinner." He was straight-forward honest with me "to fill in the hair recession, you would need implants." (Something that his clinic does not do.)

When I asked him what the second most-important thing would be for me, he said "Jaw. You have a very square jaw. And we would also work with the chin, because when you round the jaw, you need a different chin shape to compensate. And that is your other big feminizing procedure, because it would take away some of the harshness of your face, you have very strong facial features. But that's the only other thing. You have very feminine cheeks and lips, so you do not need lip lift or lip augmentation or cheek shaping."

I am VERY happy with that analysis, because it's seriously EXACTLY the same conclusions I'd come to on my own analysis of my own face's masculine features. Chett basically agreed with me 100%. (And I didn't tell him. This was him completely going off of his own analysis.)

My FFS quote came in two parts... part 1, which probably need to be done together, forehead/browlift was 320,000 baht, rhinoplasty was 178,000 baht. 498,000 baht total, or about $15,500 for "part 1." For chin/jaw contouring it was another 280,000 baht. ($8500.) Grand total for both parts, what would be considered "full FFS," about $24,000.



I'm not sure that I want to come back to Chett for FFS, though. It was great that I was able to get a price quote from him, and get his honest opinion on what procedures I could benefit from, this was my first FFS consultation so now I have a baseline, (And I really do think that one of the best aspects of Chett as a surgeon is his honesty and trustworthiness. After two Q&A sessions and two consultations with him, I've come to really trust his word and his judgment.) But I'm still on the fence in regards to which surgeon I'm going to seek FFS from. I've personally seen two people who got FFS from Chett, and both turned out well, specifically how flat and feminine their foreheads were afterward, which is why I was seriously considering him in the first place. But they also didn't either have major nose work done, and there's a girl here freaking out right now who just had nose work. And one of my other Chett-SRS friends is saying "you might be better off going to Facial Team," so I don't know. One of the big factors in that would be that Chett does FFS using the traditional hairline-incision method, and I don't have a very thick hairline so I'm scared that I couldn't hide it very well, whereas Facial Team does it using a much-more-invisible incision behind the hairline, plus they do hair transplants at the same time as forehead work, and FFS is their main area of expertise while SRS is Chett's main area of expertise with FFS secondary, so I might be leaning back toward them, but I'm not sure, I still need to get a consultation and a price quote from more FFS surgeons before making a final decision.

[stephaniec]

thanks for posting

[Carrie Liz]

A wise friend once told me, "going through SRS is like going through transition all over again."

I understand what she meant now. And it really is like that.

In transition, you get the elation of experiencing amazing new things that you've wished you could experience for your entire life. And this really does feel like that all over again... it's just like the elation of experiencing estrogen in my body for the first time, the elation of wearing feminine things for the first time, the elation of looking in the mirror and feeling feminine, feeling beautiful, for the first time... the elation of people calling you by a female name for the first time. SRS is just like that. It's the first time in a very long time that I've had that same kind of feeling of elation.

But just like transition itself, because of that elation and how it artificially inflates your emotions, you can be prone to emotional crashes too, like what I had a couple of days ago. When the elation of "I look like a GIRL!" faded during transition, I was confronted with the reality that I wasn't there yet, that I still only really looked kinda female-ish, that I still had a long way to go with my hair and face and developing a feminine shape. And because of that abrupt transition from an elation where everything is perfect because it's new and validating and exciting to reality, that reality hits a little bit harder and you can be prone to breakdowns where the exact same face, the exact same body that you were looking at in the mirror and squeeing with joy only the day before now suddenly makes you cry and have breakdowns.

In reality, things are good. You're happy with how you're progressing, and you're happy that you've become more like the person you've always wished. But because you have such a high emotional stake in what's happening, and therefore can tend to exaggerate the highs because they give you a taste of that perfection, it's hard to be realistic. You have to mitigate that line between "this is exactly what I've always wanted" and "OMG it's not 100% perfect, that means I'm a failure and I'll never be what I've always wanted to be." It's a vulnerable emotional time where you can be prone to complete 100% elation followed by crying breakdowns where it feels like the world is ending.

That's what you saw play out in this blog over the last couple of days. I was super-elated when I first woke up because I was experiencing not having erections for the first time, and being able to lay in bed with no floppy bits for the first time, and even just seeing myself with a vagina for the first time. But inevitably that "newness" elation faded. And I realized that there were a few things that weren't 100% exactly like my hypothetical ideal vagina, and so because of that "coming down from elation" state of mind, I had a breakdown because I started panicking.

In reality, I am VERY happy with my results. My weeks straight of elation are a testament to that. And today I'm back to being very content, and just relaxing and enjoying the ride as everything heals.

Ultimately, though, sometimes there's no way to stop it, this elation/breakdown cycle is just how my brain works a lot of the time. It's the same cycle that frustrated a lot of people back when I was writing my transition blog, that I'd teeter back and forth between "OMG everything is perfect I feel so good" and "OMG I'm a hideous freak" over and over and over again.

So, yeah, sorry about that. Like I said, SRS really is like transition all over again. Just like transition as a whole, it will pull every single hope, dream, and fear right out of you.

[Carrie Liz]

Also, just a quick FYI, I'm really starting to feel my strength returning now. I went out for dinner to a local yakiniku restaurant last night, then to Tesco with Mom, and I had plenty of energy left this morning to shower, go to breakfast, and we're about to go on a tour of the Dusit Palace.

Going out every day for multiple hours is becoming possible again, and I don't feel completely wiped out the day afterward like I did the first couple of times we went out to Seacon Square.

People have asked what a good time frame is for when you can conceivably travel comfortably back home after surgery... I REALLY recommend going the full 3-3.5 weeks. I can't imagine taking a 15-hour flight back to America in the state I was in last week. Now I'm finally starting to feel strong enough and recovered enough for it.

[Tess2016]

That means I should be about right.. I will have my SRS second day then home in 3 weeks...  Although its been fascinating reading your journey, in some ways I am more scared but in other ways you have enlightened me into what to expect.. I just want it over and done with.. It all seems to be a bit of a dream.. The realisation I am soon to have my own SRS is brain numbing..

Tess..

[Carrie Liz]

And here we are, at my final day in Thailand.

Now begins quite possibly one of the hardest parts of this entire process... the flight back.

I've had a couple of friends who came for surgery in Thailand, and every single one of them said "I'm not going to sugar-coat it, the flight back is hell. Make sure you sit on the aisle and make sure you get up and walk around as much as you can, because you're going to be in a lot of pain for a long time."

We've sectioned the flight off to try and reduce our air time as much as possible, so we have a 3-hour flight from Bangkok to Taipei, a nice long layover so that I can relax, and then our big flight is a 13-hour flight from Taipei to LA. And then we've actually planned in an overnight stay at a hotel in LA, to give me a chance to rest, dilate, and catch my breath before we do the final 5-hour leg from LA to Tampa. Hopefully we've planned this well enough, hopefully I'll be able to get some sleep on the plane, and hopefully I won't be in too much pain by the time we land. (Chett gave me some extra painkillers in case I need them.)

I'm able to sit fairly comfortably recently, I actually just had a pedicure last night (first one ever, by the way,) where I was sitting with no doughnut cushion on a seat for over an hour and a half. And although the swelling was a bit uncomfortable, and I kept my weight on my arms as much as possible, it wasn't unmanageable. Sitting for a couple of hours, switching back and forth between sitting on the donut cushion and sitting on one of my feet, seems to be a viable strategy for reducing sitting pain as much as possible and going long-term.

We'll see.

Not looking forward to this. But on the plus side, once we land in Tampa, I can FINALLY be back on my hormones! Hooray!

Off we go! I'll miss Bangkok a lot... I love it here. I really wish we'd had more time to explore than just 2 days before surgery and the past few days.

But oh well. One last delicious hotel breakfast, one last chat with the 4/5 other Chett girls all staying at this hotel who I've bonded with over the last few days, (more on that later,) and then off we go.

[kittenpower]

Yeah, the flight back was rough; I flew coach, but on the way to Thailand there was no one sitting next to me so I had a lot of extra room, plus I was excited about the trip and having my surgery, but on the way home, I had to sit with an annoying guy on the flight to Tokyo, and then another annoying guy on the flight to L.A., plus the added pain from my surgery (I didn't have SRS, but I still had a lot of gnawing pain from my BA and Lipo, and I was wearing a compression girdle), and the desire to be back home with my family, made it seem like I was traveling for a week!!! Try to get to Bangkok airport as early as possible, because it takes a couple of hours to get through customs. Have a safe trip. 😊

[mac1]

Carrie have a good flight back girl.

I have a question which I may ask you in a PM or email (if I still have it) later.

[Carrie Liz]

First leg of the trip is over, I made it from Bangkok to LAX.

The pain honestly wasn't that bad. Basically, I asked Dr. Chett if I could keep a few of the tramadol pills (strong painkiller) I had left over from the early stages of recovery for the sake of making the flight a bit less painful, and he was more than happy to give me a few more. So because I was taking a strong painkiller pill every 6 hours or so, I was able to manage the flight pretty well without much pain from the surgical site.

I had a bit of swelling, and dilation was really difficult tonight after having not done it in 18 hours, it was VERY tight going in and I couldn't get to the full 6" depth, I only made it to about 5 1/2", but in terms of sheer pain, the highest it got was about a 4/10. So after what I'd endured already during recovery, this was very manageable. The butt doughnut cushion kept me nice and comfy, I got a wheelchair ride through the Bangkok, Taipei, and LAX airports so I never really felt overexerted, and honestly I was expecting the flight to be way worse than it was.

With that said, I did have one super-miserable moment during the flight. Don't drink the water in the Bangkok airport. Seriously, don't. I thought "oh, hey, a water fountain," and took pills with water from that water fountain while I was waiting for the flight to leave for Taipei. Big mistake. About halfway through the Taipei flight, I started getting a headache and started feeling nauseous. And then after taking off from Taipei, I started feeling downright sick. My headache progressed to a "my head is splitting and every single word that the people around me speak feels like a jackhammer in my ears" headache, and the nausea progressed and progressed. Finally about 2 hours into the flight I threw up. And thankfully after that both the headache and the nausea were gone, so I don't think there's much doubt that it was the Bangkok water fountain that did it.

That was the only miserable part of the flight, though. Once I was done with my digestive pyrotechnics, the rest of the flight was only a bit more painful than the flight there in the first place. Mom and I got really lucky and ended up in a row with an empty seat, so I had all the leg room I wanted, made sure that I got up and walked a bit every couple of hours, took lots of bathroom breaks and took my time in the bathroom, washed my face, changed pads, etc, because I do agree that that's the best way to give your tired bottom a break after hours of sitting on the doughnut cushion, and I made sure to keep up with my pill schedule, and everything was fine. I got a bit swollen, but wasn't ever in much pain.



Anyway, stage 1 complete, final leg of the trip is tomorrow afternoon, a final 5-hour flight from LAX to Tampa. And then YIPPEE!!! I finally get my estrogen back!!! Oh, sweet little blue pills, I've missed you so much!

[islandgirl]

Good to see that you are on the last leg of your journey! Thanks for sharing your story with us. It really helps those of us who are looking forward to GRS in the near future.

[Carrie Liz]

And, there we go, I'm back home. (Well, at my mom's home at least. I won't be going back to Ohio for another month still.)

Thankfully I was able to get my dilators back to their full 6" depth this morning, so no harm no foul on going so long without dilating during the flights back, it didn't take any time at all for everything to snap back to normal. I still feel really swollen, and it will probably take a few days to go back down to where it was when we left Bangkok, but it's to be expected.

Final leg of the trip was easy. Southwest Airlines thankfully honored Dr. Chettawut's letter for me to get wheelchair assistance, so I was able to speed through security, plus take advantage of pre-boarding so I didn't have to wait in line to board either, plus got an aisle seat right at the front of the plane with easy bathroom access.

Take advantage of the wheelchair. Trust me, you won't regret it. I can't even imagine what it would have been like to try and push/carry my bags all the way through the airport, stand in the many lines, and do it FOUR times with all of the transfers. The wheelchair and assistance took something that would have been horrifying and turned it into something that was really easy.

I am so happy that the flight wasn't as bad as I feared it would be. So many people had told me that the flight back was going to be hell, I was terrified.

(And, well, maybe that's why everything has felt so easy for me... because I was preparing for the absolute worst, preparing for a hellish recovery of blood and pain and a flight of constant 6-7/10 pain, so it was a REALLY pleasant surprise when the pain mostly stayed down in the 3/10 manageable range. Yes, it was constant pain, and it wasn't exactly fun, but it was very much manageable.)



So, well, there we go, my trip is officially over.

It was truly amazing. I took a lot of pictures and videos, because this is definitely a trip that I'm never going to forget. And honestly, I am SO glad I went to Bangkok for surgery, because Bangkok is a tourist destination in addition to a surgery destination. Some of the things I saw (specifically Dusit Palace and the Wat Phra Kaew) are among the most amazing things I've ever seen in my entire life, easily rivaling or surpassing the palaces and churches of Europe. And the culture of Bangkok is so vibrant and alive, where there's a street market or a vendor on almost every single corner, and I seriously didn't have enough time to truly experience it. Bangkok is a place you simply have to visit.

(I bawled my eyes out when we left, by the way... I was so sad thinking that I'm probably not going to see that place again. [Also, my T levels have definitely dropped way further than they were pre-surgery, because I've never cried like that before. Every single little emotion was making me feel like crying, which never happened to me before on just HRT.])

[jujubes1986]

I enjoyed your journey... It has prepared me to what is going to be...

[Rachel]

Thank you Carrie,

You helped a lot of us who will be having GCS. This is an awesome thread. Good luck in healing and lease keep going with the thread.

[Carrie Liz]

So tired... goodness...

That trip apparently took more out of me than I was expecting. I slept for 10 hours last night, was still exhausted when I woke up, went back to sleep for an afternoon nap, and was still exhausted even after that. I'm not sure if it's just exhaustion from all of the physical exertion of the flight, or residual drowziness from two days' worth of taking tramadol, but yeah, I am really wiped out. Today is definitely a day for laying in bed and resting and recovering my strength.

[islandgirl]

I think that this is inevitable given the last few weeks. The body will tell us when it needs to lay low and rest. Think of it as time to refill the tank, as it were, and enjoy the down time.

[Carrie Liz]

Welp, bit of a setback just now.

According to my official schedule, I was supposed to move up to the #2 dilator yesterday. Obviously that wasn't possible given that I'd just gotten back from Thailand after 2 days of flying, and I was feeling really swollen, so I decided to play it safe and just dilate with #0 and #1 like I'd been doing for the past week and a half.

Tonight I finally did try to dilate using the #2 dilator (the instructions say 10 minutes with #0, 20 minutes with #1, then 10 minutes with #2, so that's what I was attempting,) and, well, no go. I couldn't even get it in. When I first started using the #1 dilator it was a bit tight but would still go in, albeit with some pain and bleeding. This wouldn't even go in in the first place. No matter how much I pushed, it wouldn't go in.

So, looks like I'm going to need some more time to recover, and I might be a bit behind on my dilation schedule for a while. What I'm going to do is go ahead and do my 2 dilation sessions with #0 and #1 tomorrow, then during my final dilation of the night try the #2 again. If it goes in, great. If it doesn't, I try again the next day. If it still doesn't go in the next day, I might contact Dr. Chett and ask what to do about it.

To be fair, of all the dilators, #2 visually looks like the biggest difference percentage-wise. #1 and #0 look really close to each-other, but #2 looks like it's WAY bigger than #1. So this is probably the hardest step out of all of them. But it's still a bit worrisome that I can't get it in at all, not even a little bit.

[Dena]

You haven't mentioned it so I figured I should suggest it. When you dilate do you use a mirror to make sure you are properly placing the dilator in the entrance of the vagina? When starting a larger dilator it's easy  to get off center a little bit and it just doesn't want to go in. I am currently using a makeup mirror and that gives me a good view of my underside. Before that I used a hand mirror which works as well.