Why no Suporn-style GCS outside of Thailand?

[Maria77]

I'm just wondering why no surgeons outside of Thailand (Suporn, Chet & Sanguan) perform the Chonguri flap style srs?  Is it North American/European/etc., reluctance in the face of a more malpractice oriented society?  I know Dr. Suporn did not do much training of other surgeons, so perhaps some of the specific procedures he does are unknown.  But Suporn was trained by Dr. Preecha and eventually arrived at his novel approach.   So maybe the Chonburi method is not understood by doctors outside of Thailand?  Anyone have any ideas?  Just curious. 

[echo7]

It's because of the cost.  Penile inversion is a 2-3 hour surgery with a 1 week post-op stay at the hospital/clinic.  The non-inversion method is a 6-7 hour surgery with a 3 week post-op stay at the hospital/clinic.  All those hours of surgery and weeks of recovery add up to higher hospital, operating room, surgeon, anesthesia, and nursing care costs, which are already very high in the western world.  There is no financial reason for US surgeons to do a longer surgery, and especially no reason for US health insurance companies to reimburse for a more costly procedure.

[warlockmaker]

Suporn does penile inversion and adds a few of his preferred features. e.g. He meshess the scrotal skin for  the vagina. Basically, all surgeons perform penile inversion in Thailand with their own twist of style learned from hundreds of procedures and then give it a marketing name. For example PAI has 2 srs surgeons, Dr Sutin and Dr Burin, they both have a different style. One observation is that Burin has stitches at the top of the labia majora, which kinda makes sense now as so many complain that the labia majora is too wide. This individual style results in the same surgeon required to correct or later aesthetic procedures.

Other than Sigmoid Colon, there is no other modern way. Its all about skin availibility and sensitivity for orgasms.

For the real aesthetic look, you need to have a secondary surgery a year later when dilating is not necessary daily. Mostly to  narrow  the labia majora, extend the labia minora to the vagina entrance and touchup on the clitoris and hood. Suporn patients and all the other surgeons have this secondary procedure which costs usd 4 to 5 thousand extra.

[Miss Clara]

Basically, all surgeons perform penile inversion in Thailand with their own twist of style learned from hundreds of procedures and then give it a marketing name.

The "penile inversion" method of creating a neo-vagina refers to the practice of creating most, if not all, of the lining of the vagina using penile skin.  This method is commonly practiced in the west.  The methods used by Suporn, Chetawutt, Sanguan, and others in Thailand use scrotal skin to create the vaginal lining, not skin from the penis.  Chetawutt refers to his method as the "non-penile inversion method" for this reason. If there isn't insufficient scrotal skin to create a functional vagina, the scrotal skin is meshed to increase its area (Suporn), or supplemented with skin taken from the groin area (Chetawutt).  Penile tissue is used exclusively to construct the vulva.

[warlockmaker]

Its called penile skin inversion and referred by that name in Thailand. The use of scrotal skin and penile skin for the vagina does not change the name of the procedure. Scrotal skin started being used when they discovered that scraping hair follicles permanently elimintated the hair growth. Nowadays, they used a manual machine to reduce the labour time to scrape the scrotal skin.

This procedure  is used by most surgeons globally. Using only the penile skin only for the vagina is no longer done unless you have a real big penis with lots of skin, its all about depth Please check with your surgeon.

[AnonyMs]

Suporn refers to it as "non-penile inversion technique" on the front page of his website.

If there isn't insufficient scrotal skin to create a functional vagina, the scrotal skin is meshed to increase its area (Suporn), or supplemented with skin taken from the groin area (Chetawutt). 

There's a recent interview published with Dr Suporn and it says

And regarding the purpose of meshing the scrotal skin, it's not to make it larger.

Dr Suporn	Not stretch. Because the skin is enough. The surface skin is enough for lining the whole vaginal wall. We just make the skin perforate to drain the serum and blood. Prevent the subdermal haematoma or subdermal serum collection because it may cause the skin graft not take.
Me	But everybody says it's for making it bigger?
Dr Suporn	Because they think about the skin graft on the burn wound.

Its part of a 204 page book on a women's SRS with Suporn. You can find it if you're interested by searching for: suporn pdf update

[warlockmaker]

Lovely marketing by Dr Suporn to his dominantly western clients. Develop part of the procedure in your unique style, call it by a derivative name and thus sounding very special, and you can charge considerably more, the old marketing ploy. SRS is not rocket science surgery and with lots of practice surgeons perfect their techniques. But it all semantics, there is much more to penile skin inversion, as a procedure, than the skin used in the vaginal canal.

[Miss Clara]

Its part of a 204 page book on a women's SRS with Suporn. You can find it if you're interested by searching for: suporn pdf update

I'm interested, but couldn't find it.  Can you provide a link to the book?

[AnonyMs]

I sent you a pm.

[Miss Clara]

Thanks, AnonyMs.  I found the 204 page pdf by Butterfly.  She writes on page 179:

The Scrotal Skin Mesh

Its "common knowledge" that Dr Suporn uses a machine to cut the scrotal skin into a mesh, allowing him to
stretch it to increase vaginal depth. The scrotal meshing machine used to cut the scrotal skin turns out to be
Dr Suporn himself.

Dr Suporn: By hand, hand and scissors, simple machine, I do it.

And regarding the purpose of meshing the scrotal skin, it's not to make it larger.

Dr Suporn: Not stretch. Because the skin is enough. The surface skin is enough for lining the whole vaginal
wall. We just make the skin perforate to drain the serum and blood. Prevent the subdermal
haematoma or subdermal serum collection because it may cause the skin graft not take.

Me:  But everybody says it's for making it bigger?

Dr Suporn:  Because they think about the skin graft on the burn wound.

Referring to this as meshing caused a fair bit of confusion when I was talking to Dr Suporn. Meshing is a
technical term with a very specific meaning to a plastic surgeon and it's not what he does. Regardless of what
it's called, these cuts are to drain the wound and prevent subdermal haematoma, and without it the skin graft
would not survive.

There are two basic grafting techniques used in this part of SRS

• The skin graft technique which Dr Suporn uses, where there's no blood vessels transferred with the
skin, and the blood vessels regenerate. This takes longer to heal than the skin flap technique.

• The skin flap technique is used in the standard penile-inversion and takes the skin with its blood vessels
intact, hence the recovery is quicker.

The cuts in the skin graft don't contribute much to the recovery time; it's mainly the skin graft itself.

Could it be that in this exchange Suporn was referring specifically to her (Butterfly's) surgery where she had enough scrotal tissue to build the vaginal lining so meshing wasn't needed? 

If machine meshing is not done by Suporn, what does he do if the amount of scrotal skin is not enough?

If hematoma/seroma is indeed a risk in doing the non-penile inversion method, does Dr. Chettawut also perforate the skin for the same reason?  I've not heard that he does.

[Nova_Noelle]

This is all really interesting.  Notes are being taken. 

With Love,
Noelle

[AnonyMs]

Thanks, AnonyMs.  I found the 204 page pdf by Butterfly.  She writes on page 179:

Could it be that in this exchange Suporn was referring specifically to her (Butterfly's) surgery where she had enough scrotal tissue to build the vaginal lining so meshing wasn't needed? 

If machine meshing is not done by Suporn, what does he do if the amount of scrotal skin is not enough?

If hematoma/seroma is indeed a risk in doing the non-penile inversion method, does Dr. Chettawut also perforate the skin for the same reason?  I've not heard that he does.

I quite certain from the way it's written and what Ive heard elsewhere that its describing the normal case. I've heard, once, of Suporn taking a graft "crotch fold where it joins the legs" where the skin is not enough, but the poster wasn't completely clear on how it was used. I believe that's not common. If you look at the women on page 191, she started blockers at 13 and didn't report needing a graft.

I've don't know what Chettawut does.

[Maria77]

I have read that Suporn's depth is consistantly over 6 inches.  Not sure about Chet, but Sanguan was getting a consistant 5 or under.   So there is some variation even among the Chonguri flap surgeons.

Echo7 probably hit the nail on the head with the increased cost being prohibitive in the West.  Still you would think at least on surgeon would offer it as an option.  The (alleged) greater depth is one benefit and I've noticed that Suporn also seems to more consistantly get the anatomical parts very close to Cis, by avoiding the two hole syndrome (i just made up that name).   . 

[reborn]

Of course there are doctors offering similar techniques. Dr Bowers and her students construct most of the vaginal lining from a scrotal graft while they use the penile skin for labia minora and the clitoral hood. The same goes for a German doctor called Dr Schaff or something. 

[AnonyMs]

I have read that Suporn's depth is consistantly over 6 inches.  Not sure about Chet, but Sanguan was getting a consistant 5 or under.   So there is some variation even among the Chonguri flap surgeons.

The minimum depth is 6", average 7", and maximum 8.5" according to his website. With micropenis he gets 5-6" according to the that pdf.

I believe this part of his technique is unusual, from his site

Maximum vaginal depth attained with the scrotal skin graft beyond the original position of the peritoneal reflection (Douglas Pouch)

http://www.supornclinic.com/restricted/srs/srstechnique.aspx

Of course there are doctors offering similar techniques. Dr Bowers and her students construct most of the vaginal lining from a scrotal graft while they use the penile skin for labia minora and the clitoral hood. The same goes for a German doctor called Dr Schaff or something.

I don't think Dr Bowers technique is similar based on the much shorter recover time and different aesthetics. No comment on Dr Schaff as I've never seen much info on him.

[PurplePelican]

I don't think Dr Bowers technique is similar based on the much shorter recover time and different aesthetics. No comment on Dr Schaff as I've never seen much info on him.

One of the differences is that Dr.Bowers doesn't mesh the graft like Suporn does. This is also one of the main reasons for the extended recovery needed for Suporn's procedure.

Now, I saw recently that Suporn was stating that he doesn't mesh the graft to enable it to cover more area, but his results speak for themselves.

But to think that Suporn is the only one to have developed their own tweaks and processes for the procedure is quite narrow minded. He, does, admittedly, have the biggest free PR mob in the world all selling for him.

[AnonyMs]

But to think that Suporn is the only one to have developed their own tweaks and processes for the procedure is quite narrow minded.

I didn't say others don't have their own techniques, only that I don't think they are similar to what Suporn does.

[warlockmaker]

I cant belive this thread. There is nothing propriety in GRS, there is no anti copying law and the surgery is really not complicated. If its now tweek that works well others follow. They all have their tweeks. Its not brain surgery. Great marketing to the Westerners, Asians dont use him.