How does Dr. Chettawut deal with complications?

[Tiu]

I've been looking into mtf SRS surgeons until recently and I am now at the point where I am trying to make a decision on which one I am going to pick. I am drawn to Dr. Chettawut. He seems to be a good choice based on his surgical results, as far as I can tell. Usually good aesthetics, good sensation, good depth. However, I am a little concerned about some things, mainly how he deals with complications.

So there are stories out there which indicate that he might be reluctant to admit failure in which case he wouldn't fix issues or stop communicating with patients after a while. Or he'd try to blame them and would only help them for additional payment. I am talking about real problems here, like fistulas or stuff. Minor complications do not seem to be an issue in that regard.

On the other hand, I think I remember a contrary story as well, where he – in case of some tear or maybe fistula, I don't remember unfortunately – seems to have helped his patient immediately and very well.

First question: I find it difficult to judge this. To those, who went to him, from what you have experienced, do you consider him a safe choice? Will he be responsible and help his patients and willingly provide them with the care they need? Even in complicated and bad cases?



I am especially concerned about fistulas, they appear to be the one relatively popular, possibly major complication. I asked his clinic by email how they were going to address this issue if it were to happen. I quote how they claim they would fix it:

A fistula may close or heal by itself if it is very small (depending on the its size and location).

However, for some cases, a fistula needs to be closed surgically, then the vaginal canal lining will be replaced with the colon graft to patch the affected area.

Second question: Is this an appropriate treatment with colon vaginoplasty? It appears unusual to me.


They also said that none of their patients ever developed a fistula "during or right after the surgery". It may depend on how they define "right after", but is this believable? (Third question.)

Some rare stories oppose this, but I don't know how trustworthy they are. I've never been able to make contact with one of their authors, at least the ones I've came across.


Thank you for helping me. This is a hard time, having to make such an important decision. I feel as if every SRS surgeon has some downside to choosing him or her and maybe, this could be his.

[AnonyMs]

I don't know what Chettawut's rate of fistula is but I've seen some data from other surgeons. It seems to depend on the surgeon and averages around 1%, with some surgeons being far better and others anecdotally others are far worse.

Chettawut does have a number of reports of internal hair, so you might want to take care of that beforehand. For one of the other things I guess you're referring to the skin grafts and lack of depth being blamed on anal sex?

The good thing about Chett is that theere's lots of post-op photo's around and heaps of stories, so if you research it carefully you can be fairly certain of what you're getting.

[Brenda80]

There are good and bad versions about Chett. I guess that is always the case. Everyone has different expectations. Also no one can assure you of having the perfect surgery. I always believe experience and practise makes a difference. So that's how I judge. I mean Suporn and Chett have been doing this for so many years, there are bound to have different opinions about them, perhaps a good way is to judge and weight how many are positive and vice versa to give yourself a good comfort level.
I had no issue with skin tear with Chett. Hair grow in vagina none as well. But that is for my case.

I developed necrosis at the outer skin layer (that is due to my own fault for over exerting myself during the first week by walking around too much and not getting enough rest) which he done the revision a week before my schedule flight back. So far so good. I am 7.5months post nearly.

[AnonyMs]

I had no issue with skin tear with Chett. Hair grow in vagina none as well. But that is for my case.

I've heard of quite a few women having internal vaginal hair with Chett, so it may be worth having electrolysis beforehand.

[Tiu]

I am aware that fistulas are rare, bad ones even more so, I imagine (correct me if I am wrong). I am also aware of that hair problem and I am going to have hair removal beforehand.

I actually didn't think of hair at all when I created the initial post, rather actual medical problems. But, as we are already talking about hair removal now, what is the area one should cover with chett? Obviously scrotum and shaft and probably the perineum (the only area they somewhat recommend). How far should the clear area be expanded to the thigh creases though? What about the groin area where he harvests the transplant? I don't want to end up with no hair to the left and right of my vagina if I remove too much. I suppose there should be at least some. (Again, please correct me if I have a wrong view of natural female anatomy.)

AnonyMs, I was not referring to depth, but a few rare stories like this:

Regarding Chett.
It's nice to see so many happy people. I am not one of them. I think surgeons should be judged not by how they treat their successes but how they treat their failures.
Cosmetically, I am appalled by his work. Is this his fault? Yes and no. He can only work with what I had to give him. I understand making a cosmetically normal looking vulva is virtually impossible in a single step procedure. I knew that going in. I'm not upset about it because I expected it, and assumed I'd need revision. If you're happy with your single step vulva, that's great.  The nurses that have seen my vuvla have been noticably confused by it. It does not look natural at all. And I mean that, considering there is wide variation among natural vulvas. For a nurse to see it and not want to catheterise you, and go find a specialist to do it, means something isn't right in vulvatown.
Functionally, he peirced my bladder. I've had MRI's scans to confirm the damage, and a team of 5 urologists tell me they have no idea how I could have done this myself unless I dilate with a scalpel yet, Chet claims I did it to myself by having sex. I've not had sex because I can't have sex. He then claimed I did it to myself by dilating. My urologists assure me this isn't likely at all, and the the damage was caused during dissection during surgery. Chet knows this, he would have seen the issue when he did a my final examination before I left Thailand. He didn't say anything. I know for a fact the issue was present during this examination. The issue was present immediately after surgery. Beyond offering to perform a colon vaginoplasty (at the full price, of course). With a vesicovaginal fistula, a a colon vaginoplasty wouldn't even help. The issue is a hole cut in my bladder, a new vaginal lining wouldn't fix that, it would just cause the fluid to leak into my abdomin elsewhere. Chet has been combatative and dismissive from the outset and now doesnt even respond to emails.
I wouldn't trust him. I would not recommend him to anyone. Understand that a lot of the time thins go fine. When they don't go fine, it's how issues are dealt with that are important.
I wish I had gone to Suporn.
Would I go back to Chett for cosmetic revision? At this stage, absolutely not and I would implore anyone considering him as their surgeon to have a back up plan if something goes wrong, because Chett won't be there for you.

I realise 99% of people that take the time to read my post will dismis is as one unhappy person out of thousands. That is correct, he has done a lot of great work and helped a lot of people. So, the only reason I am posting this is as warning to people considering him.
He doesn't guarantee his work
He doesn't accept the medical opinions of specialists
If you have a problem, he will ignore you.

And this is pretty much what worries me. I'd like to know if there are more or contrary stories out there to clarify what Chett's behavior is like when things don't turn out as they should.

Brenda, was the necrosis revision for free?

[Brenda80]

Brenda, was the necrosis revision for free?

Yes, it was done during my recovery stay.

[AnonyMs]

I actually didn't think of hair at all when I created the initial post, rather actual medical problems. But, as we are already talking about hair removal now, what is the area one should cover with chett?

If its bad enough it can turn into a serious medical problem due to infection. There used to be a post here where that happened.

There's a drawing on Chett's website showing the area to remove hair. Do a search for "Dr.Chettawut's recommendation of genital hair removal". If you search for "TransSurgeriesWiki" you'll find a bunch of info on Chett and other surgeons.

[Tiu]

How bad was the necrosis, Brenda?

Thank you, AnonyMs. Unfortunately, I've already gone through all English links by HiddenStill regarding Chett and I ended up having the questions I posted here.

The area of hair removal he reccomends isn't enough though, is it? At least if you want to be a 100% sure.

[AnonyMs]

Regarding the hair, I'd guess Chett's diagram is correct, but not everyone does hair removal and that many of those who do it don't do it properly. Laser is risky for hair removal as it's not guaranteed to get everything, and even electrolysis is going to take a 1.5 years plus to get through all the hair cycles. Most women get away with it because its only a minority of cases that get hair even without removal.

Just curious, but what made you interested in Chettawut over anyone else?

[Tiu]

To be honest, he is the best I've come across so far, despite not being perfect. Every surgeon has downsides I guess, with him at least the results are outstanding (usually). He and his team seem to be friendly and to know what they are doing. He seems to be a relatively solid choice, worth the risk.

I am looking into Suporn again, I am scpetical of his technique and his results, but maybe, overall, he could be a better option. Who knows. I really don't. In the end, one probably has to choose one, jump and hope for the best.

[PurplePelican]

To be honest, he is the best I've come across so far, despite not being perfect. Every surgeon has downsides I guess, with him at least the results are outstanding (usually). He and his team seem to be friendly and to know what they are doing. He seems to be a relatively solid choice, worth the risk.

Given accusations from others on here in the past, I'll make only these comments:

Thoroughly investigate the doctors registration and board certifications.

Investigate what hospitals he can/will transfer you to in the event of an emergency and whether he has the privileges to practice there.

I am looking into Suporn again, I am scpetical of his technique and his results, but maybe, overall, he could be a better option. Who knows. I really don't. In the end, one probably has to choose one, jump and hope for the best.

Given his pending retirement, I'd give him a miss, he skimps on the guarantee. As it turns out. his much lauded "guarantee" is just hot air for many - who no longer tell of their experiences due to being silenced by the surgeons fan club.

[Miss Clara]

I'm convinced that the outcome differences that have been reported from surgeries performed by Dr. Chettawut are due to the differences in individual patients.  The amount of tissue available to work with, individual healing ability, bleeding tendency, immune system efficiency, genetics...  There are so many variables that impact outcomes.  Trying to decide on a surgeon based on the anecdotal experiences of others is no guarantee of achieving a satisfactory outcome.  Dr. Chet is a very experienced surgeon.  I believe that he's conscientious about doing the best possible work for each patient.  He's willing to do certain corrections and to treat complications for no extra fee.  My sense is that he is rather conservative in his surgical practice so as to minimize the chance of complications like the occurrence of fistulas.  His prices are held in check by low overhead expenses, so don't expect luxury accommodations at his clinic.  If you have a history of or concern about complications after surgery, you might consider staying closer to home.  Having to travel long distances for follow-up work is expensive and inconvenient.  Many surgeon routinely refuse to treat surgical complications arising from the work of other surgeons.

[warlockmaker]

All surgeons make mistakes and can do corrections, but who pays is the issue and  their reputation on quality of their correctiom. I had considered Dr Chett ater a consultation, he was initially very responsive to my email questions and I really liked him.  Then I did some research on problem he had.and I wrote to him and asked if he could please explain these very serious issues or confirm that it was not true. HE NEVER RESPONDED after that.

Just as well and I swithched to PAI. its been the best decision and 3 years after GRS I am completely satisified.

[Brenda80]

How bad was the necrosis, Brenda?

One side of the stitches seem not to be healing and eventually turned black due to lack of blood supply.
The reason was mainly due to me still smoking and not resting and I overexerted myself by walking quite a fair bit after my discharge. After the revision, learnt my lesson cut down on smoking and rested in bed most of the time till I headed to the airport. Thankfully all is fine now.

[AnonyMs]

Suporn's retiring, but there's a few photos of Dr Bank's work around now and so far it looks like Suporn at his best.

[Emily.coates]

I had surgery with Chett about 7 months ago. I'm not happy with everything but I'm still confident in my choice being the correct one.

I have contacted him more than once since I got home and his assistant Som has been responsive.

I have an issue with bleeding at the moment (my own fault from lazy dilation) and it is quite difficult to take photos which are good enough for him to be able to figure out what is going on.

As far as hair removal goes, he recommends that you wait until post surgery to avoid tightening of the skin from electrolysis.




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