Susan's Place Transgender Resources

hello, a girlfriend goes to Dr.Preecha!
who is better surgeon for SRS Dr.Chettawut or Dr.Preecha?
who has experience Dr.Preecha in pai Institute?
Thanks for the reply!
best regards from Germany

I've heard that Chettawut, Suporn etc. were trained by him (Preecha).(Someone correct me if i am wrong)
But they later changed their techniques(non Inversion) except Dr.Preecha. He offers the penile inversion method (with Skin grafts) or the sigmoid colon vaginoplasty.
Most of his patients are satisfied with the results. But honestly if she's traveling all the way from Germany to Thailand, why's she getting a penile inversion? ???
I mean if she really wants that method she should go to dr.bowers or dr.brassard (They always update their method!);)
Here some (old) results:  Chettawut: http://www.annelawrence.com/chettawut.html (http://www.annelawrence.com/chettawut.html)
                                     Preecha:  http://www.annelawrence.com/preecha.html (http://www.annelawrence.com/preecha.html)

By the way: (If shes from Germany). She should also consider Dr.Schaff in Munich. He developed his own method "the combined method". Almost the same as the chonburi flap but with longitudinally opened Urethra that he folds into the vagina. The Advantage of that is the Urethral Glands produce a secretion by arousal. You can read more of that here: http://community.transgender.at/showthread.php?tid=1773 (http://community.transgender.at/showthread.php?tid=1773) The only downside is his waiting list. I have to wait 3 years for my surgery :(

kisses from Germany :-*

Who is better.?  Well that is based on one's opinions and several girls here have been to both and have there  opinions.  When choosing a doctor for this type of surgery you should do your research (I. E. Using the search function)  than deciding on reviews and emailing both doctors and asking questions. I went to Chettawut and I have no complaints nor does my boyfriend or gynecologist. 

unfortunatel can hear currently much bad about dr chettawut

Preecha (or at least PAIs) SRS method is now virtually identical to Chets. Preecha calls it inversion with a scrotal graft, but then again he calls sigmoid colon vaginaplasty  "Penile inversion with a colon graft". The fact is that very little of the penile skin is used for inversion as most is used to form the outer structures. This is why Suporn, Chet, Kamol et al now describe their surgery as non inversion. There is also more to the Thai method that just the donor skin source for the neovagina though. the Thais also use all of the glans to construct the clitoris the inner lining of the labia minora and the floor of the vulva in a lotus flower like configuration. This provides a much greater area of sensitivity than any of the European methods that I am aware of. I don't know if this is also true for the US

Anne Lawrence's site is hopelessly out of date so there really isn't any point in looking there for present day techniques. In fact I understand that Suporn demanded that pictures of his earlier surgeries were removed for that reason.

Both Chet and Preecha's PAI clinic are at the top end of SRS surgery. Preecha's organisation is by far the biggest in Thailand whereas Chet runs a relatively small clinic. Both have the capacity to provide you with excellent cosmetic results with adequate depth and sensitivity. As for cost, Preecha is cheaper but will charge for cosmetic revisions. Chet is more money up front but cosmetic revisions (if you need them) are free. Calico's suggestion that you contact both and ask questions is very sensible. Remember though that they are unlikely to tell you about the surgeries that went wrong. You should also read between the lines when it comes to personal reviews on the internet. A lot of patients who complain had unrealistic expectations. Other post op girls hero worship their surgeons and conceal the problems that they have had. I have a friend who went to Suporn and had surgery that resulted in areas of necrosis, bleeding and pain from granulation tissue (treated here) and on her return to Thailand 12 month later it was discovered that she had a vaginal fistula. She still has problems dilating. However she wholeheartedly recommends Suporn to anybody who asks. I'm not implying that Suporn is anything but an excellent surgeon here, he clearly is. However based upon her own experience you would not expect the unequivocal endorsement that she provides.

So ur sayi g the non penile from chet is the same as pai..only its called the psi with scrotal graft?

Quote from: Susan T on April 04, 2014, 04:25:53 PM
Other post op girls hero worship their surgeons and conceal the problems that they have had. I have a friend who went to Suporn and had surgery that resulted in areas of necrosis, bleeding and pain from granulation tissue (treated here) and on her return to Thailand 12 month later it was discovered that she had a vaginal fistula. She still has problems dilating. However she wholeheartedly recommends Suporn to anybody who asks. I'm not implying that Suporn is anything but an excellent surgeon here, he clearly is. However based upon her own experience you would not expect the unequivocal endorsement that she provides.

Have you any idea why this is? I can't understand it and it's one of the big things that it so hard to evaluate any surgeon.

Its hard to remember but I think I read a while ago that Suporn has had no fistula's, and it may have been reported by Suporn himself. I'll have to see I if can find it. It sounds like its out of date and or something has changed. I wonder he's been changing his technique.

hi there everyone.

I'm a Chet's patient and exactly today I am 7 weeks postop. I'd like to share my experience.

Dr. Chet is a nice enough guy who is keen on reaching perfection . while he is super busy and I only saw him twice postop it's clear he is results oriented and really does want his patients to have a great result.

the after care by the nursing team was pretty good.

however!!!!!  I Dr Chet's technique does not have a lot of tolerance for patient error because it's so... fine?

for myself I'd started out disadvantaged with dry and thin skin which reduced the margin of error.

in my immediate postop days I was not sleeping in the ideal position for recovery, with a calf under my over calf , because of a prior back injury which made laying perfectly straight very painful.

as a result I healed less than ideally and I had labia tears and necrosis even on unpacking day.

fortunately my vaj graft took and survived. dilation was not particularly difficult or painful.

when I had my review on Day 15, I was already totally disrobed and prepped for surgery (I could decline but why refuse free work lol? ) an hour and 8 painful local anesthesia injections later , Dr Chet had me sewn uptight and fixed beautifully . on a down note I got Recatheterised while conscious and sensate. not fun

I'd been taking vajfies daily for progress tracking so it looked so ideal ..if healing went as planned.

alas I picked up an infection from the revision work, probably when I tried taking a number 2 while catheter was in. the pelvic pressure made pee leak around the output tube and into my stitches.

I got very swollen and Siri had to pierce me to drain me..  without anesthesia. I bit a towel and screamed into it. I was prescribed (given?) strongest antibiotic at maximum dose. I flew home still infected but had the good sense to see my local trans friendly GP for followup )

my infection subsided after a hairy week and slowly i started to get better.

I am still satisfied with the results despite the hiccup in healing process and the loads of pain and stitching .

I would not hesitate to recommend anyone to Dr Chet except with the caveat to follow exactly the instructions given and the recovery process would be fine 

I'm sorry that you don't agree about the "lotus flower" style clitoral graft but unless Preecha changed his technique specially for me I can say quite categorically that he does.  I would also like to point out tat the Chonbri flap has never been as unique as Suporn claims http://www.pubfacts.com/detail/15509947/Corona-glans-clitoroplasty-and-urethropreputial-vestibuloplasty-in-male-to-female-transsexuals:-the (http://www.pubfacts.com/detail/15509947/Corona-glans-clitoroplasty-and-urethropreputial-vestibuloplasty-in-male-to-female-transsexuals:-the). This link is from a group of European surgeons who have been using a very similar technique since 1999.

I am not  critising Suporn in any way. He is a top class surgeon with an excellent marketing strategy. At his best his technique is world class, but like every other surgeon he also has his bad days. I have always found it strange that those who go to him and have problems still rate him so highly, even when they require later revisions. His lifetime guarantee is essential, a significant percentage have to use it, and you do pay for it. Only the payment is up front with the initial fee, which is considerably higher than anybody else charges.

As for Preecha, like Suporn he uses penile skin  to construct the inner labia. He does invert what is left but from the presentation that I was shown prior to surgery the vast majority of the vaginal lining is scrotal skin. So yes, you are right in saying that it isn't a true non inversion technique. However isn't the point of non inversion is to free up penile skin for use on the outer structures whilst at the same time having enough left over for an acceptable depth?
Once this has been done isn't the minor degree of inversion is a moot point?

The use of an isolated flap after all presents a higher risk of necrosis. It is because of this risk, (compounded by forming the scrotal skin into a mesh) that Suporn has to insist that his patients remain in Thailand for so long and in the initial sages at least is the reason for most of his revisions.

Preecha's fees are currently around $8600 for SRS, but if you need a cosmetic rather than a functional revision there is a charge.

Quote from: Susan T on February 28, 2015, 03:01:57 PM
I am not  critising Suporn in any way. He is a top class surgeon with an excellent marketing strategy.

Why do you say he has excellent marketing strategy? He's got a good reputation, but he doesn't seem to do any marketing. I suspect its the long days in the hotel, due as you said to his technique, and the communities that form there that really help promote him. My theory is people get so much out of that that its makes them very outspoken about the entire thing, but if so its all a happy coincidence for him.

Or perhaps he's just good. I've no idea really but its a puzzle I'm kind of hooked on. Maybe I'll ask him one day myself.

By marketing strategy I mean that he claims a uniqueness that isn't really quite so unique anymore (and he does have a very good web site).  He is undoubtedly very good at what he does and without doubt he is one of the best in the world. However, there is a level of misinformation that seems to be taken as fact, as can be seen by the post that I responded to (from a Chet girl).

I would encourage anybody seeking SRS to do as much research as possible before deciding on a surgeon (there are half dozen or so first class surgeons in Thailand alone). Find out about the various techniques from the surgeons themselves and be skeptical about any claims of results that would fool a gynecologist, they don't exist. Talk to others who have been to those surgeons and and ask them about post op problems that they have had.  Above all don't rely solely on information on forums such as this one a most people will have views that are partisan because they are defending their own choice.

I went to Dr Chettawut for his skills in depth. I was initially 7 inches depth and after healing I'm still able to keep 6 inches of depth.. I had a very small penis from hormones shrinking them but he was able to grant me depth. Still healing but able to orgasm 7 times a week now lol. I'm 5 months post op.

I also went to Chettawut for his cost. With everything combine, from the hotel stay, surgery, skin graft, my two psychology visits in usa, my flight, my food orders, hygiene, breaat implants, and woman's needs, 5 blood work test, it all cost me. $18000

Quote from: jojo702 on March 06, 2015, 03:05:10 AM
I went to Dr Chettawut for his skills in depth. I was initially 7 inches depth and after healing I'm still able to keep 6 inches of depth.. I had a very small penis from hormones shrinking them but he was able to grant me depth. Still healing but able to orgasm 7 times a week now lol. I'm 5 months post op.

I also went to Chettawut for his cost. With everything combine, from the hotel stay, surgery, skin graft, my two psychology visits in usa, my flight, my food orders, hygiene, and woman's needs, 5 blood work test, it all cost me. $18000

This may be off-topic, but did you do any genital electrolysis beforehand for Chet? I know you don't have to but his website does have a picture and say it could be done before surgery. My date is in June and I'm thinking about doing some.Thanks!

Quote from: SarahSchilling on March 06, 2015, 03:11:44 AM
This may be off-topic, but did you do any genital electrolysis beforehand for Chet? I know you don't have to but his website does have a picture and say it could be done before surgery. My date is in June and I'm thinking about doing some.Thanks!

It was a choice for me to do electrolysis but he said I didn't need to and it wasn't required and it would be ok. At first they shaved down there before my surgery. At this present time I'm thinking of getting electro but it doesn't really worry me too much since I can shave down there if I have to but I am looking forward to doing electro now that everything has been finally healed up.

I visited Dr Suporn and Dr Preecha. Dr Suporn was a student of Dr Preecha and I understand that he does not personally perform SRS, he does a great FFS tho. Plus Dr Suporns choice of Hospital is 2nd class and he charges 2x as much and has a waiting list. Dr Preecha is the major stockholder of PIA and again he does not perform the SRS and he has a couple of surgeons that do this. His PIA is modern and the hospital they use in Bangkok is great. Personally,  I look for an SRS surgeon that does this surgery regularly, I believe practice makes perfect. I also look at the surgeon as an artist for the final outcome and I have grilled them on this. They claim that what I need aesthically will require a second surgery after dialiation. I'm paying and its my body and I really go over the whole process in great deatil and I believe anyone having SRS should have no reservations in asking any question they feel needs answering.

Quote from: jojo702 on March 06, 2015, 03:16:42 AM
It was a choice for me to do electrolysis but he said I didn't need to and it wasn't required and it would be ok. At first they shaved down there before my surgery. At this present time I'm thinking of getting electro but it doesn't really worry me too much since I can shave down there if I have to but I am looking forward to doing electro now that everything has been finally healed up.

Thanks! One less thing to worry about! :)

Quote from: warlockmaker on March 06, 2015, 03:30:30 AM
I visited Dr Suporn and Dr Preecha. Dr Suporn was a student of Dr Preecha and I understand that he does not personally perform SRS, he does a great FFS tho. Plus Dr Suporns choice of Hospital is 2nd class and he charges 2x as much and has a waiting list. Dr Preecha is the major stockholder of PIA and again he does not perform the SRS and he has a couple of surgeons that do this. His PIA is modern and the hospital they use in Bangkok is great. Personally,  I look for an SRS surgeon that does this surgery regularly, I believe practice makes perfect. I also look at the surgeon as an artist for the final outcome and I have grilled them on this. They claim that what I need aesthically will require a second surgery after dialiation. I'm paying and its my body and I really go over the whole process in great deatil and I believe anyone having SRS should have no reservations in asking any question they feel needs answering.

I couldn't agree with you more. My surgery in 2010 was done by both Preecha and Burin, working on both ends of me at the same time. Burin was the surgeon that actually carried out the SRS. The clinic and hospital were better than anything that I have experienced here in the UK. I presume that you want the posterior commissure closed. I don't think that any Thai surgeon does that in their one stage operation. I believe that it has something to do with the blood supply and damage during initial dilation I think that PAI charge around $2500 dollars for the second stage operation which is still a lot cheaper that going to Suporn but as I have said before Suporn seems to charge for his revisions up front. I think that Chet still gives a lifetime guarantee on his work and will do aesthetic revisions without charge.

Is at Dr.Preecha PAI always 2. Operation for correction necessary?

Quote from: warlockmaker on March 06, 2015, 03:30:30 AM
I look for an SRS surgeon that does this surgery regularly, I believe practice makes perfect.

I agree about practice makes perfect, it does, but there's another side to that. People have a tendency to get stuck in their ways as they get older, and having perfected their knowledge and position in society, there's no need or even ability to change. That's when younger people come in with something new, perfect it, and repeat the process. I've no idea about Dr Preecha, but I'm kind of wondering if that's happening to Dr Suporn.

Quote from: warlockmaker on March 06, 2015, 03:30:30 AM
I visited Dr Suporn and Dr Preecha. Dr Suporn was a student of Dr Preecha and I understand that he does not personally perform SRS

That reads as if Dr Suporn does not personally perform SRS, but I guess you mean the other way around?

When I chose, I wanted a surgeon who did the surgery himself.  I didn't want to go somewhere meet a Dr,  than not have him perform the work. Also I chose based on the way I read emails,  I was actually going to go to phukett, however 6 months before the scheduled date I changed Dr's. I like my result and the Dr I went to, bu
T that is just me and many others likes their Dr too.  It's a personal decision who "you" have to choose, and no one else. And you have to make that choice based on your email correspondence, pictures and we'll.....  I don't think it should be on other people's reviews or opinions,  because let's face it lady's most people aren't going to be objectionable, and are honestly going to be biased,  it's a shame we can't meet the Dr's ahead (well some can)  and get a good feel(vibe, etc) for the Dr's they are looking at. Just another opinion from yours truly ;)

Quote from: luckylady on March 06, 2015, 05:53:40 PM
Is at Dr.Preecha PAI always 2. Operation for correction necessary?

No, he does a one stage operation. You will need a second stage operation with any surgeon if you require the posterior commissure to be closed. They will of course tidy up anything else at the same time. I have a little too much skin on the outer labia (Probably due to post op swelling), that could do with removal if I was going to be picky. It troubled me at first, but you know what, 5 years on its so minor that really can't be bothered.

Quote from: calico on March 07, 2015, 02:26:56 AM
When I chose, I wanted a surgeon who did the surgery himself.  I didn't want to go somewhere meet a Dr,  than not have him perform the work.

You do meet the PAI surgeon before surgery and the method he uses will be exactly the same as all of the other PAI surgeons. PIA have developed their own claimed "unique" method that say they have been using since 2009. They are probably the most experienced clinic in Thailand, they are certainly the biggest. The scale of their operation knocks anybody else out of the ball park. I'm not saying that they are the best. However,  I am saying that they are one of the top clinics in the world and that the difference in outcome between any of the top clinics\ surgeons are often quite subtle.  You have to consider whether those subtle differences are important enough to you to pay the premium. Do you actually need more than 6 inches of depth?
Is scrotal skin better than penile skin to line the neo-vagina  if there is sufficient penile skin to form the outer structures. Do you need electrolysis before surgery or is the donor skin scraped and cauterised. Is the cosmetic result good (none are undetectable if you look hard enough).  Finally do they maximise the use of sensitive material. Do your research and balance all of the factors in order to reach your decision.