Hi everyone, I have been researching SRS and am very confused between Dr. S and Dr. C. Both of them seem to be very good overall but like everyone else have a few negative reviews. It is difficult to make such a big decision based solely on the reviews so I thought I'd try to objectively compare their techniques and find out which one would be more appropriate for my needs. Please do not bash any surgeon - the idea is to understand the subtle differences between their techniques and not to put any of them down in any way. I must mention here that I am not very good with medical and technical terms so my interpretations to the information they provide on their websites may be incorrect. So, please feel free to correct me. And I cannot and do not expect everyone to reply to every point but even if there's one point you think you can give any input to,  it would be veryyyyyyyy  much appreciated.

1. Clitoris

"Dr. S - From glans penis with intact sensory nerves and vessels
Dr. C - This complex and specialized organ is made from the dorsal part of the gland penis with all sensory nerves and vessels preserved intact. The size, position and angle will be as that of a natal female."

I understand there is no difference in the technique used to make the clitoris. Please correct me if I am wrong.

2. Vestibule of Vagina between the Labia Minora

"Dr. S  - 'Secondary Sexual Sensated Organ' from glans penis with intact sensory nerves and vessels.
Dr. C- The additional sensory tissue from the gland penis which its attached sensory nerves is used on the particular area between the clitoral frenulum down to the part of the urethral tissue. This is normally a pink color in nature. The additional natural pink color urethral tissue is used to simulate the the lower part of the vulva vestibule"

It seems Dr. C uses urethral tissue in addition to glans to create vestibule. Does it have any significant advantages - better aesthetic results? lubrication?

3.   Labia Minora (Inner Surface)

"Dr. S - From prepuce of penile skin or penile skin with intact sensory nerves and vessels (originated by Dr Suporn). The labia minora which are anterior enough to cover the clitoris, urethra, and vaginal cavity (as in genetic women). Labia minora which can be stretched manually (as in genetic women). Pink or red color of the inner surface of labia minora (as in genetic women) No hair in the labia minora (as in genetic women) which have no suture lines (incision scars). The clitoris, clitoral hood, frenulum, labia minora and majora are all placed on different (3-dimensional) depth planes (as in genetic women)
Dr. C -The inner surface of labia minora is made from the originally pink colored tissue from the neurovasculized ventral prepuce flap"

If I am right, "neurovasculized" means with intact sensory nerves and vessels. So it seems both the doctors use foreskin to create the inner surface of labia minora. BUT, Dr. Chettawut doesn't mention any of the additional benefits except color on his website. These benefits include
(a) Coverage of clitoris, urethra and vaginal cavity
(b) Stretching
(c) No hair
(d) No incision scars
(e) 3-d work

Do these benefits not exist with Dr. C' s technique? Further, if one doesn't have a lot of tissue ( less than 5 of inches of length at the time of erection) but is uncircumcised, is the person likely to have less foreskin tissue to work with? In such a case, what material do Dr. C and Dr. S use ?

4. Labia Minora (Outer Surface)
"Dr. S  - From penile skin or scrotal skin with intact sensory nerves and vessels (originated by Dr Suporn)
Dr.C - The outer surface of labia minora is made from the penile skin flaps. The lip-like appearance, according to Doctor Chettawut's technique, is achievable with most patients."

I often see Dr. S patients raving about sensation. Does the "extra" sensation come from the sensate outer surface of labia minora? How much of a difference does it make during sexual intercourse? (Please refer to point 13 as well) Do you know why some patients cannot achieve lip like appearance? Is it because of less tissue? How much tissue is considered sufficient?

5.  Labia Majora

"Dr. S- From scrotal skin
Dr. C - natural-look labia majora is made from the scrotal skin. This will be done before the use of the remaining part of the scrotal skin to become the skin graft inside the vagina. Doctor Chettawut puts emphases on the different definition between the Labia majora and Labia minora."

I understand there is no difference in the technique used to make the labia majora. Please correct me if I am wrong.

6. Vaginal Wall

"Dr. S - From scrotal skin (and groin skin if necessary)
Dr. C -  The wall of vagina is made mainly from the scrotal skin graft. The entire surface of neovagina is hairless as because all of the hair follicles (hair roots) will be totally removed during the delicate process of the skin graft preparation."

Again, I see no difference in the technique from the description but from what I have read, it seems Dr. Suporn punctures the scrotal skin graft a lot more and hence achieves more depth. Is it true? If yes, how much of a difference does it make - 1 in, 2 inches? Does it lead to a very thin vaginal wall? Is it more prone to rupture or contraction? Are there any other long-term complications?

7. Clitoral frenulum

"Dr. S- The frenulum which extends below the clitoris and which is continued to both sides of the labia minora (as in genetic women)
Dr. C- This is the natural fold of the prepuce skin that joins the lower part of the clitoris with the inner surface of the labia Minor. This area also has sensation."

Dr. S doesn't mention what material he uses to create the frenulum.  Again, if someone doesn't have sufficient foreskin, does anyone know what material Dr. C uses to create the frenulum?  If you are a Dr. C patient, how sensate is the frenulum? How much does the frenulum sensation contribute to the overall sensation?

8. Mon Veneris

"Dr. C-  This the mound area above the clitoral hood which contains the natural fat (subcutaneous tissue)as well as the sensory nerve that carries the sensation to the clitoris."

No comments from Dr. S on his website on Mons Veneris but it doesn't seem something I would be concerned about.

9.Urethral Opening

"Dr. C - The urethral tract is shortened and the spongy tissue (Corpus Spongiosum) is totally and carefully removed. "

No comments from Dr. S on his website but I think almost everyone uses the same technique to create urethral opening.

10. Vaginal opening

"Dr. C : This area is made from the combination of the perineal and penile skin. Doctor Chettawut puts emphasis on the appropriate size (the diameter of the entrance) for use in sexual intercourse."

No comments from Dr. S on his website.  Does anyone know what material Dr. S usually use and if it makes much difference?

11.  Lubrication

None of the two doctors have commented on lubrication on their websites. Does anyone have any information? Does the urethral tissue Dr. C uses to create frenulum provide any lubrication? He makes no such claim on his website though!

12.  I often read Dr. S  provides MUCH better cosmetic results as compared to most patients of Dr. C. Why is this so? From the description, it seems apart from a possibly better inner surface of labia minora, Dr. S's technique gives no other aesthetic benefit that Dr. C's technique cannot give. (Please correct me if I am wrong).

13. Removal of erectile tissue

None of the two doctors mention on their websites if they remove erectile tissue or not.

I have read a few complaints from Dr. S patients that they can feel the "erection" at the time of arousal and this is uncomfortable. Moreover, I have read this can be painful and at times necessary to correct with additional surgery. Also, does this erectile tissue add to the " extra" sensation Dr. S patients rave about?

14. Dilation period

Can anyone tell me the number of hours (on average) Dr. S and Dr. C patients have to dilate 1 month AFTER surgery?

Also, is the dilation more painful and tiring for Dr. S patients?

15. Please mention any other differences you know of (including revisions, complications, after care, etc.) and any other comments you may have.

Thank you.

Thank you for posting this.

Hi and welcome to our group.

You have a lot of information and questions in your post, almost too much.  It might be easier if you pared it down to just a few at a time.  Its overwhelming trying to read something this indepth and respond.

We have many members who have been through surgery with good results and I'm sure they will be happy to share with you, but just remember each member only has experience with their own doctor, they can't give you first hand experiences with doctors they haven't used.  Its hard to compare results when you only have your results to answer about.

Stick around and get to know people, I'm sure you will get help over time.

Hi Sarah,

I agree there is a lot of information. I thought putting it all together would not only help me organize my thoughts, doubts and concerns better but also other people who are trying to make their final decision. Dr. Chettawut and Dr. Suporn are considered to be some of the best doctors in Thailand for SRS and many transgirls go through the dilemma of making a choice between them. Both of them have positive and negative reviews and so making a choice based solely on reviews may not always be the wisest thing to do. I remember reading a negative review about Dr. C on a personal blog. It got me curious and I contacted the person concerned. It turned out she struck Dr. C off her list simply because Dr. C's clinic seemed gloomy to her. Moreover, negative experiences are sometimes related to the technique and may be avoidable if one understands the difference between their techniques and takes into consideration the limitations of both the techniques, the amount and quality of tissue they have, and of course, their priorities (depth, aesthetics, shorter recovery period, etc.)

1- clitoris

i don't know about chett, but suporn keeps most of the original glans, as " secondary sensate organ" and creates a clitoris from the top of it (like a mushroom popping from it :p )

2-about vestibule, i think i have heard that suporn also uses oretra but not sure

3- labia minora : 100% same

4- labia minora external: both same, made from penis skin,
in suporn's case, sensation of outer labia minora is just like penis skin sensation, nothing too amazing, the "good" sentation comes from the inner side mostly, and the foreskin-tip part wich ends near the vagina


5- labia majora : scrotum skin to fill the gaps, looks same on both

6- vaginal wall : 100% same, both use scrotal skin grafts with hair removal
not sure about the length difference between suporn and chett, as every patient is different anyway .... in my case there wasn't any issue of width or strength with suporn



7- frenulum
in my case, with suporn it does NOT start from the lower part of the clitoris as in genetic women, it starts OVER the clitoris and just goes around it,
so his descripion is false in my case...


8- mons veneris/pubis
well there's nothing you can do about that, so irrelevant comparaison element



10- vaginal opening
in the case of suporn, it is slightly obstructed by the erectile corpora-cavernosa passing by the upper part, otherwise i assume both are identical, this detail apart.


12- i don't think suporn produces better appearance, also comments are purely subjective, we would need a gallery to compare,
as a suporn patient, i don't think his results are so amazing, mine was a total mess anyway :p


13- removal of erectile tissue
suporn simply doesn't do that, or partly, it seems common that suporn parients keep around 8cm of erectile tissue burried inside,  some don't notice it at all, other have severe discomfort

not sure of wich are annoyed, is it a direct matter of penis size? or something else? as far as i know it's a random occurence...


14- dilation
with suporn, it's advised to dilate 2 times a day for 15 minutes each time, it has to be painful (unless you do it wrong) as you must go as far as you can bear, so it's tiring indeed




then about after care:
forget it with suporn, unless you have VERY SUPERFICIAL problems, serious ones will be ignored, and perhaps mocked, OR wou will be asked to pay again a considerable amount of money (this is also worth for FFS and so on, as i have been told first hand by someone who got suporn's work corrected by.... chettawut !  )


i don't advise anyone to see suporn right now, some years ago, he had time to talk and meet patients, now the clinic works like a factory where wou will be chain-operated, and chain-checked, the secretary sees you like money bags, you're just rich meat there now...
chettawut reached this stage recently, but did something against it, he has his own block and he now is doing less surgeries and is much more available , i also think his staff is made of doctors instead of hostesses, wich may be a plus...

also you can think of what's around the clinics,


Suporn: chonburi isn't a really interesting city, you will mostly stay in a 2 star hotel wich was really good years ago but now more and more run down year after year, your main distraction will be the small Mall in front of the clinic and the pizza place , chonburi has that thai "je ne sais quoi" that is always pretty cool and poetic, but basically, it's just some town on the border of some highway ...

Chettawutt: you will be in BANGKOK, so basically, everything is at your hand, there is a gigantic mall just steps away from the clinic, as well as a racetrack and well, all the city of bangkok wich you can enjoy visiting while you're there, going every day to a different place!
Chettawut has Bungalows for patients, but they don't seem very nice, i've been told by my chett friends that you get a better deal staying at the hotel they work with


i'll also go to chettawut's place with a preop friend this year, and i'll compare everything

Hi I am a Dr Chettawut Girl I had my GRS & trachea shave a year ago this week, I at one stage was going to go to Suporn, But there was so much Hype on the Internet about this Guy & I had read a lot of Girls had one problem after another, So I researched Dr Chettawut. Now In my view you cannot compare Directly Because It really depends what material the Surgeon has to work with For Example because I had been on Hormones for 16 years I did not have much material & also your stature plays a big part Until the Surgeon Opens you up He really does not know how much Depth you will have, I myself has only 3 inches Because he found a scar on my Colon & could not go any further, Having said all that I am sensate Orgasms are really great & the  rest looks Aesthetically correct well i tell you I am very happy In the end It also comes down to money & I saved £6000.0 by going to Dr Chettawut & the area & hotel we stayed at was 4star plus good places to eat &  2 masive Mall's to shop In as well as the rest of Bangkok Hi Clinic Is small but ver very well organised & the After care was second to none. When I was there their was 21 other people In the 2 months I stayed That was my choice as I am a lot older than most & not one of us has problem we have all stayed in touch. I had an experience of a life time & gained 21 sisters who I am really happy to know. Welcome to Susans you will learn a lot on hear from people that have been through a lot. Life deals you with a set of cards & you have to deal with It In your way with Support from people on places like Susans. It can take up to 2 years to completely Heal whichever Surgeon you go to Some people heal sooner rather than Later It's called Neuropathic Pain & can last up to 2 years.

:Posted with best of Intentions

Babz

This thread is so great...I am learning quiet a bit...Could anybody comment about the SRS procedure conducted by the rest of the world.

Hi all
(this is my first post here!)

Thanks SRSresearch for posting those questions - about sums up a lot of what I'd like to know.  I'm planning on having my SRS in about 12 months' time and am currently thinking of going with Chet although Suporn is on my list.

I sent Dr Chet an email a couple of days ago asking about booking surgery and describing my circumstances.  I also asked him about aesthetics - I am particularly interested in having a fourchett (spelling?) which many images I've seen of neo-vaginas seem to lack and asking for clarification about the need - or not - for follow up labiaplasty to achieve this.  I'm yet to hear back...

I am very keen to read responses to this thread from those who have gone before me!

Cheers
Sarah

Quote from: SarahAdcock on February 18, 2013, 09:00:49 PM
I sent Dr Chet an email a couple of days ago asking about booking surgery and describing my circumstances.  I also asked him about aesthetics - I am particularly interested in having a fourchett (spelling?) which many images I've seen of neo-vaginas seem to lack and asking for clarification about the need - or not - for follow up labiaplasty to achieve this.  I'm yet to hear back...

The fourchette/posterior commissure/frenulum labiorum pudendi (a mouth full for sure) is generally not done in first step surgery because of the amount of physical stress placed there during dilation. Its too much risk that something goes wrong there so the general consensus (medically) is wait until secondary surgery to define that and clitoral hooding.

Quote from: Flan on February 19, 2013, 12:26:04 AM
The fourchette/posterior commissure/frenulum labiorum pudendi (a mouth full for sure) is generally not done in first step surgery because of the amount of physical stress placed there during dilation. Its too much risk that something goes wrong there so the general consensus (medically) is wait until secondary surgery to define that and clitoral hooding.

Is that concensus in America, Canada?, Europe, Thai? all of the above? What type of SRS is performed in China? Japan?  Here is some work for you Dr. Flan... Thx!

Quote from: peky on February 19, 2013, 08:49:03 AM

Quote from: Flan on February 19, 2013, 12:26:04 AM
The fourchette/posterior commissure/frenulum labiorum pudendi (a mouth full for sure) is generally not done in first step surgery because of the amount of physical stress placed there during dilation. Its too much risk that something goes wrong there so the general consensus (medically) is wait until secondary surgery to define that and clitoral hooding.

Is that concensus in America, Canada?, Europe, Thai? all of the above? What type of SRS is performed in China? Japan?  Here is some work for you Dr. Flan... Thx!

Just the surgeons I know that offer it. There are surgeons in Japan that have novel use of (the patient's) materials (see pdf) but I only know it from journal articles and not what might have been posted publicly. China is a black hole information wise, same as Iran; very hard to tell what they do because of lack of good information.

Quote from: Flan on February 19, 2013, 06:41:47 PM
Is that concensus in America, Canada?, Europe, Thai? all of the above? What type of SRS is performed in China? Japan?  Here is some work for you Dr. Flan... Thx!

Just the surgeons I know that offer it. There are surgeons in Japan that have novel use of (the patient's) materials (see pdf) but I only know it from journal articles and not what might have been posted publicly. China is a black hole information wise, same as Iran; very hard to tell what they do because of lack of good information.

B&W pictures? What is with the Japanese, they could not afford to pay for the color pictures..LOL..Not seriously, sometimes the journals will charge thousands of dollars for color plates.

The argument for the M flap is a sound one..

I have Dr. Reed's SRS technique as a PDF but I do not know how to insert it. How do you about attaching a pdf file?

Quote from: peky on February 19, 2013, 08:33:22 PM
I have Dr. Reed's SRS technique as a PDF but I do not know how to insert it. How do you about attaching a pdf file?

in attachments and other options under the message window (expand it).
a mod or admin will have to approve the attachment before it is publicly available.

Quote from: Flan on February 19, 2013, 09:02:29 PM
in attachments and other options under the message window (expand it).
a mod or admin will have to approve the attachment before it is publicly available.

Notify me of replies.
Return to this topic.
Don't use smileys.

This ^^^ is all I see after expanding the "attachments and other options"

Quote from: peky on February 19, 2013, 09:08:20 PM

Quote from: Flan on February 19, 2013, 09:02:29 PM
in attachments and other options under the message window (expand it).
a mod or admin will have to approve the attachment before it is publicly available.

Notify me of replies.
Return to this topic.
Don't use smileys.

This ^^^ is all I see after expanding the "attachments and other options"

hmm
might have been removed for users. I've attached it since I found it on pubmed

Quote from: Flan on February 19, 2013, 09:13:54 PM
Notify me of replies.
Return to this topic.
Don't use smileys.

This ^^^ is all I see after expanding the "attachments and other options"

hmm
might have been removed for users. I've attached it since I found it on pubmed

Despite the bum rap he has gotten in this forum, his paper is well written and sound. I still feel that the M-flap of the Japanese is more advantageous

     I received 7 replies from other former patients of Dr., Chettawut in the first day after posting my information on GenderTrender. Dr. Chettawut damage my mouth and left cheek (nerve damage) and his SRS is nothing more than a mutilation. I have tried to convey this information to those who are even considering giving their hard earned money to this Monster. My attempts have been halted and the information deleted. I have been told that getting this information out was an "agenda." I am also a Trans person and I am not telling people to not have any surgeries that they want; I am telling people to cross this hack called Dr. Chettawut off your list. And if you have been a victim to make contact with me; that we may seek legal action en masse.

Gregory

1) https://www.facebook.com/dr.chettawut.warning

2)New comment on chettawutwarning. Dr. Chettawut Tulayaphanich Thailand ruined my face after FFS (facial feminization surgery).

in response to AnneUK:

Can you please explain what happened! What did they have to take out? I had FFS in May 2012. Eleven months later I am still itching. I could stratch my skin off on my forehead. Please tell me what they found.

If you are also a victim or dr.chettawut or have friends who been victims than visit our website facebook and put a like on it

3) Briar Fredericksen commented on Dr. Chettawut Tulayaphanich Thailand ruined my face after FFS (facial feminization surgery).

in response to Vicky vick:

3) I cried so much when I found this page.. I am transgendered and went to dr chettawut for jaw slimming surgery and rhinoplasty. He shaved the whole bridge of my nose.. I have a Flat crooked nose and. I cannot feel my jaw and the skin around my jaw is saggy! I wasted so much [...]

hi vicky can u pls tell me where u were looking at for ffs in australia? was just going thru with dr chet when stumbled on this site. many thanks,
\briar xx

4) Aaliyahbell66@yahoo.com commented on Dr. Chettawut Tulayaphanich Thailand ruined my face after FFS (facial feminization surgery).

in response to karina müller:

i had forehead surgery with chettawut and my forehead got inflammatation. The hospital must took it out from my forehead.

What was taking out of your forehead I'm suppose to have surgery with him as we'll July 25th

5) Jhuly commented on Dr. Chettawut Tulayaphanich Thailand ruined my face after FFS (facial feminization surgery).

in response to chettawut2013:

Dr. Chettawut ruined my face specially my lip. I have problems to speak,drink and eat. He made me abnormal!! Dr. Chettawut damaged my face after ffs more infos also at www.facebook.com/dr.chettawut.warning I let 4 doctors checking my face and all they said that this results comes from dr.chettawut surgery. The nerves are damaged and also my [...]

I live in Brazil and I really want to operate the tests complete with Dr. Chet. But after reports got really scared. Mean that the website photos of him are false? Who have photos of unsuccessful results and can send me I will be very grateful.
jhulyglow@hotmail.com

6)  chettawut2013 commented on Dr. Chettawut Tulayaphanich Thailand ruined my face after FFS (facial feminization surgery).

in response to nadia:

Hi, I had feminizing rhinoplasty done with Dr Chettawut on 29th June, 2012. My nose is deformed now. I look like a handicapped person. Both the septum and columella are deviated. One nostril is higher than the other. Dr Chettawut agreed to do revision surgery but under local anesthesia. He said if I want to [...]

Dear gregory,

Your comment is very cheap and not well-documented. This is slander! You must give more evidence than just citing some unhappy patients with unclear stories.

This unacceptable!

I'm going to start by ssaying I'm non-op, so I have no agenda, but I do like to keep my ear open about the various surgoens for those times I get asked about them by other trans women.. And I have a comment to make abut Suporn. From my researching, it seems that complaints about his leaving most/all erectile tissue seem to have increased in the last 3 or 4 years. Which also seems to conincide with him becoming more factory-like..

Whether the increase in complaints is due to an actualy increase in the number of complaints, or due to the internet making complaints easier to be heard, I really don't know, but it is something to consider.