Susan's Place Transgender Resources

Hi ladies!

It's finally time to make that final decision on a surgeon and I'm freaking out (to say the least!)

Initially I'd narrowed it down to Drs Chetawut, Saran, Preecha, and Suporn. I've heard some bad stories from girls over here about Chettawut so I've crossed him off. Dr Preecha is apparently great, but you probably won't actually get him to operate, he will supervise. Not thrilled about that so he's off the list too. So that leaves Saran and Suporn.

Pros for Dr Saran:
Shorter time under general (3 hours vs 6)
Shorter stay in hospital
Shorter recovery
Cheaper
Based in Bangkok, closer to airport and more to do.

Pros for Dr Suporn:
Better results (how much better?)
More depth (is it necessary?)
More sensation (true/false?)

I'm leaning toward Dr Saran, but I can't help but think that I might regret it, that Dr Suporn might have something that I'm just not seeing or realising? For those that have been to either, any suggestions?


I'm going crazy here trying to decide so any insight would be much appreciated :)

Suporn is a lot better at selling his services. Problem with any suggestions here is that it boils down to trusting the surgeon and aftercare provided. Both are experienced and should do the task well. Both are normal in the sense that there will always be the possibility of undesirable results but from the number of previous patients, that's not likely. Most of the Thai surgeons learned from Dr Preecha (which is why he isn't active as a surgeon: age).

Quote from: holly on May 25, 2013, 11:33:26 AM
Hi ladies!

It's finally time to make that final decision on a surgeon and I'm freaking out (to say the least!)

Initially I'd narrowed it down to Drs Chetawut, Saran, Preecha, and Suporn. I've heard some bad stories from girls over here about Chettawut so I've crossed him off. Dr Preecha is apparently great, but you probably won't actually get him to operate, he will supervise. Not thrilled about that so he's off the list too. So that leaves Saran and Suporn.

Pros for Dr Saran:
Shorter time under general (3 hours vs 6)
Shorter stay in hospital
Shorter recovery
Cheaper
Based in Bangkok, closer to airport and more to do.

Pros for Dr Suporn:
Better results (how much better?)
More depth (is it necessary?)
More sensation (true/false?)

I'm leaning toward Dr Saran, but I can't help but think that I might regret it, that Dr Suporn might have something that I'm just not seeing or realising? For those that have been to either, any suggestions?


I'm going crazy here trying to decide so any insight would be much appreciated :)

I had surgery with PAI. Dr Precha was present and did some work on my face whilst his current assistant Dr Burin did the work on the bottom. The standard of care whilst I was in Thailand was excellent and don't worry about who does the surgery as they all have to use the "unique" PAI technique which strangely is very similar to the unique Chettawutt technique or the unique Suporn technique. Don't misunderstand me, there are minor differences between all three but they are very minor. They all use a scrotal graft. They all use the entire glans tissue to form the clitoris, the floor of the vulva and the the area of inner labia at the clitoral hood. They all use the penile prepuce to form the inner surface of the labia minora and they all use penile skin to form the outside.  My results were good in terms of sensitivity and depth. I do have a little excess skin in the outer labia though and I lost the frenulum so the clitoris is no longer as attached to the wall of the inner labia as it once was (at least I think it was. The stitches were certainly there, through the inner labia wall and clitoris However I developed an abscess there after I returned home). Neither of the problems are a big deal and could be corrected very quickly on return to Thailand. The downside however is that PAI will charge for this process. I was quoted $3000 for this. However, you have to balance this against the original charge of $8600 when compared to Suporns current fee of almost $18000. Like you I had originally placed Dr Chet on my list and he was in fact originally my first choice. However, my gender specialist advised me against him as he told me that he had seen a number of serious complications in his patients.

Thanks for the feedback :)

Quote from: Flan on May 26, 2013, 04:04:51 AM
Suporn is a lot better at selling his services.

That's what I'm struggling with. I'm so sure that Saran is better for me, yet I keep coming back to Suporn, and I'm not convinced that its all just spin and marketing. His girls think he's the best, but that's true of most of the top surgeons.

Quote from: Susan T on May 26, 2013, 02:49:52 PM
... the "unique" PAI technique which strangely is very similar to the unique Chettawutt technique or the unique Suporn technique.

Finally someone has said it! In my mind, these drs trained under Preecha, and the descriptions seem to be much the same so surely if I go to one of the top surgeons I will be happy. Suporn seems to just be more aggressive, hence the longer recovery time.

Basically the Chonburi organ (the way that the glans tissue is used) has been adopted by many of the Thai surgeons. It really does work in terms of sensitivity but it hasn't been unique to Suporn for many years. In fact it was never unique to Suporn as a trawl through the internet will show that a group of surgeons in Spain have been using the technique since 1999 http://www.ncbi.nlm.nih.gov/pubmed/15509947 (http://www.ncbi.nlm.nih.gov/pubmed/15509947).

The big difference with Suporn is the way that he achieves depth. All of the other surgeons use a full thickness scrotal flap graft that has has the hair follicles and fat scraped away. Thay will therefore offer you and average depth of between 5 and 7 inches  Suporn goes further and runs the scrotal graft through a machine that cuts hundred of slits into it, enabling the skin to be pulled out to form a mesh. This allows him to get an extra couple of inches of depth but it increases the chance of tissue necrosis. That's why his patients have to stay in Thailand for so long after surgery. Many have minor revisions during the recovery period.

I only stayed in Thailand for 2 weeks after surgery and to be honest that wasn't long enough and to be honest that and my tendency to visit all of the tourist spots around the country during my recovery period was probably at least partly the cause of the minor cosmetic issues that I have. As I have said PAI will cover this work for $3000 if I was to return. This would cost include a full second stage procedure though, including the closure of the posterior commissure  under G.A. with an overnight stay in hospital, not the quick snip and stitch in the clinic offered free by Suporn.

Suporn is an excellent surgeon when everything goes to plan and his cosmetic results can be outstanding. The truth is though that most people find themselves going back to him for revisions in order to achieve those results and even if they don't they have paid for several revisions up front within his inflated fees.

I don't know what Saran's work is like. He worked with Preecha in the same role that Dr Burin now occupies so it is highly likely that his technique is the same. You need to check that out though. I know that he still uses PAI's facilities at the Piyavate hospital (Preecha has a large clinic and 2 upper floors of the hospital for his patients as well as a very large up market clinic in central Bangcock). Above all remember that although the major Thai clinics are at the cutting edge of SRS, when you get home apart from getting advice via email you are on your own. Realistically, it would probably be sensible to factor in the cost of a future return for a cosmetic tidy up after a year or so.

Quote from: Susan T on May 26, 2013, 02:49:52 PM
However, my gender specialist advised me against him as he told me that he had seen a number of serious complications in his patients.

I believe you may have seen the same gender specialist I am seeing for the purpose of deciding on an SRS surgeon. He has advised me against going to any surgeon that uses the scrotal technique because of complications and extended healing. Who is PAI (acronym?) and how did your specialist feel about PAI's work?

PAI = Preecha Aesthetic Institute

It is more like a "school" of technique(s) used by several student of Dr. Preecha.

Quote from: Jamie D on May 27, 2013, 03:27:24 AM
PAI = Preecha Aesthetic Institute

It is more like a "school" of technique(s) used by several student of Dr. Preecha.

Not Quite, PAI is the name of the clinic run by Dr Preecha. It is by far the largest and most respected plastic surgery organisation wthin Thailand. It's clientèle is not restricted to transgendered patients and the doctors who work within the organisation have to be at the top of their profession. They probably carry out more SRS operations than anybody else in the country and so all of the surgeons have a lot of experience. Strangely they don't seem to market themselves as aggressively in the west as some of the other Thai surgeons.