What is the price for SRS with Dr Suporn?

[Lagertha]

That's probably what his patients think when they choose him.

Many probably do. But truth is they use different techniques, with each having its pros and cons.

Some aspects of both techniques might be similar.. but many are very different. Therefore it cant be said you are getting same surgery for 50% discount. You are getting a different surgical technique for different price.   

[Laura_7]

Wow!  That 50% higher than Chettawut for basically the same surgery.

You could have a look here and the links there:
https://www.susans.org/forums/index.php/topic,185600.msg1762841.html#msg1762841

Revisions are free lifelong with Suporn, he charges upfront.


hugs

[roxie rudi]

Thankyou all so very much! You have been sooo encouraging because I am an Aussie and the airfares etc. aren't such a problem from the antipodes. Thanks, thanks and thanks girls!

[Miss Clara]

It's not really the same surgery...

Please explain the difference if you would.  As I understand it, both use scrotal skin tissue grafts, scraped of hair follicles to fashion the vagina (non-penile inversion method)  The tissues of the penis are used to create the clitoris, clitoral hood, labia minora, etc. 

[Miss Clara]

That's probably what his patients think when they choose him.
And he performs all surgeries himself, while Dr. Chettawut does not.

My goodness, where did you hear that?  I will attest to the fact that Dr. Chettawut does ALL of his GRS, BA, and FFS surgeries. 

[Laura_7]

Please explain the difference if you would.  As I understand it, both use scrotal skin tissue grafts, scraped of hair follicles to fashion the vagina (non-penile inversion method)  The tissues of the penis are used to create the clitoris, clitoral hood, labia minora, etc.

Supon uses a special technique to mesh the tissue and stretch it so a great depth might be achieved. Note its not guaranteed.

This is from another posting:
https://www.susans.org/forums/index.php/topic,96561.msg706793.html#msg706793

Re: what is the downside of Dr. Suporn's technique
« Reply #13 on: April 09, 2011, 10:14:29 pm »
As I perceive it - as an almost outsider to this community, because I was done so long ago that I hardly count now

The plus side of suporn is that when it goes well it looks good and gives maximum depth.

The down side is that the recovery is a fair bit longer, there are about ten times more stitches involved, and when it goes wrong boy oh boy does it go wrong!

In essence it's like a high performance car. Fantastic when it works, but where as other surgeons go for reliability, suporn has gone for the absolute maximum possible performance, which means that you must be prepared for more discomfort in the healing phase and to be really careful to follow his postoperative care instructions to the letter.

I hope that is a fair and balanced summary.

[Miss Clara]

Supon uses a special technique to mesh the tissue and stretch it so a great depth might be achieved. Note its not guaranteed.

This is from another posting:
https://www.susans.org/forums/index.php/topic,96561.msg706793.html#msg706793

The maximum depth that can be achieved is limited my the patient's anatomy.  The vaginal space in created between the rectum and the bladder/prostate extending only as far as the peritoneal reflex.  Both Drs. Suporn and Chettawut use groin skin grafts to achieve the desired vaginal depth if scrotal skin is insufficient.  There is no substantial difference in their techniques. 

[Laura_7]

The maximum depth that can be achieved is limited my the patient's anatomy.  The vaginal space in created between the rectum and the bladder/prostate extending only as far as the peritoneal reflex.  Both Drs. Suporn and Chettawut use groin skin grafts to achieve the desired vaginal depth if scrotal skin is insufficient.  There is no substantial difference in their techniques.

Suporn uses a machine to mesh the tissue so it becomes more stretchable. There are videos of this.
This is also a reason why the healing process takes longer.

Some patients of suporn report results in excess of 7 in which seem to be rare with other docs.


hugs

[Lagertha]

Please explain the difference if you would.  As I understand it, both use scrotal skin tissue grafts, scraped of hair follicles to fashion the vagina (non-penile inversion method)  The tissues of the penis are used to create the clitoris, clitoral hood, labia minora, etc.

Like Laura already said, Suporn uses meshed scrotal skin graft... Its not really special technique, it is commonly used to treat patients with severe burn injuries where it is used as full-thickness skin graft transplant. Skin graft is meshed and perforated with a special device, which increases the surface by quite a bit, and perforated skin allows for better adhesion with the underlying tissue, and better chance for survival of graft. This also comes (in SRS use) with quite harder and longer recovery (expected tissue contraction from 3nd to 6th month) which requires a special dilation technique (called dynamic dilation).

Meshed scrotal skin graft is far more likely to turn into mucosal tissue (after a year or two), which gives more than adequate self lubrication (from vaginal wall) and around 80% of patients report no need of using any additional lubrication during sexual activities or dilation.   

Chettawut removes as most of corpora cavernosa as he can. Suporn keeps ALL corpora cavernosa (only testicles get discarded) and incorporates erectile tissue exactly as it is in biological females.. Chettawut and most other surgeons in the world avoid doing this because it is supposedly extremly hard to do it right, and its therefore far less riskier to just remove and discard complete corpora cavernosa.

Neo-clitoris.... Edit: apparently I was wrong and Chettawut also creates similar secondary sensate organ.

Chonburi flap (skin flaps for formation of inner-outer labia minora, hooding and labia majora) is more than a little different in some details to flap that Chettawut uses, which can be observed in different incision-scar placements. Due to preservation of corpora cavernosa labia minora keeps most of nerve connection and is reportedly far more sensate in comparison to labia minora with techniques which discard corpora cavernosa.

Suporn uses groin skin graft very rarely (patients with 10 or 20  or more years of HRT or previously done orchiectomy), while Chettawut reports using groin or abdominal graft far more often.. Not all patients have enough scrotal skin material available to achieve 5-6 inch depth with normal full-thickness graft, where Suporn guarantees minumum 6 inch depth for uncircumsized patients without previous orchiectomy and not more than few years of HRT. 17.8 cm is average final depth (no additional grafts needed in patients who fit uncircumsized-no orchie-no more than few years HRT criteria).

[Miss Clara]

Thank you for that explanation.

A few clarifications, however, from his website:

Doctor Chettawut no longer uses the abdominal skin graft to avoid any additional scar on the tummy.

All spongiosum (spongy) muscles around urethra are completely removed to prevent tissue engorgement during sexual arousal which can narrow the vaginal opening or cause difficulty during sexual intercourse.

The neo-clitoris made from the dorsal part of glans penis is considered the primary sensate organ innervated by branches of pudendal nerve.  The part of vulva vestibule made from the ventral part of glans penis is considered the secondary sensate organ innervated by branches of pudendal nerve.  Not only pudendal nerve, Dr. Chettawut can preserve 3 more specific nerves which innervate the created sensate genital structures as follows:

- Clitoral hood and clitoral frenulum
- Inner labia and its frenulum (posterior fourchette)
- Vaginal wall adjacent to the intact prostate (G-spot area compared to biological female anatomy)

The sex reassignment surgery lasts around 6 hours to complete all delicate processes and Dr. Chettawut is the only surgeon who performs the surgery from the start to the end.

From Dr, Suporn's website:

Full-thickness scrotal and groin skin grafts construct the neovaginal wall without penile skin inversion.

I couldn't find any mention of the scrotal mesh technique that you claim Dr. Suporn uses.  Also, there's no mention of using spongiosum tissue in the construction of the vulva/vagina.

Do you have a reference that backs up these claims?

[Laura_7]

I couldn't find any mention of the scrotal mesh technique that you claim Dr. Suporn uses.  Also, there's no mention of using spongiosum tissue in the construction of the vulva/vagina.

Do you have a reference that backs up these claims?

I have seen a video of an srs, performed by him.
There was a machine meshing the tissue.
Afterwards it was sewn and spread over a large transparent tube before being inserted.

The technique used by him is quite unique. there are even surgeons who complain there are no written explanations.


hugs

[AnonyMs]

I was not aware Dr Supon has ever produced a video. Do you have a link?

I'm somewhat curious about all of this. There's a lot of "facts" about these two surgeons, but it would be very interesting to trace them back to primary sources. I doubt its possible in many cases.

I have the impression someone will say something and others will repeat it and so on until it becomes accepted truth.

[Lagertha]

I couldn't find any mention of the scrotal mesh technique that you claim Dr. Suporn uses.  Also, there's no mention of using spongiosum tissue in the construction of the vulva/vagina.

Do you have a reference that backs up these claims?

If you email their administration (Sophie) you can get first hand information about technique that dr. Suporn uses and as many technical details as you have concerns. Their website really isnt much informative... and it hasnt been updated in like 10 years.


Full-thickness scrotal and groin skin grafts construct the neovaginal wall without penile skin inversion.

"Meshed" graft can be made from full-thickness and split-thickness skin grafts, depending on the area of use and severity of burn damage. In SRS use for neo-vaginal wall he uses full-thickness skin grafts.

[Lagertha]

... but it would be very interesting to trace them back to primary sources. I doubt its possible in many cases.

Why not? If you have questions or doubts you ask primary source (-> the administration) directly... they are there to answer the questions of clients and potential clients.

[Laura_7]

I was not aware he has ever produced a video. Do you have a link?

I'm somewhat curious about all of this. There's a lot of "facts" about these two surgeons, but it would be very interesting to trace them back to primary sources. I doubt its possible in many cases.

I have the impression someone will say something and others will repeat it and so on until it becomes accepted truth.

I'm still looking... it was not by him but by a person being present and filming an operation...

there was a machine... like a drum... tissue was inserted and like dotted with small rectangles... and it was very stretchy afterwards...

well not finding it at the moment... if I find it I'll post the link...