I have raised the safest way on having these surgeries in the forum before and did receive a lot of advice. The main issue is to limit the number of inductions or have it in 3  or 2 inductions. I had a long consultation with Dr Preecha and he wants to do this all in one induction with two teams of surgeons. Dr Sutin and his team will perform the SRS, Dr Preecha and his team will do the FFS. The BA will be done by one of them. This limits the time under anesthesia to around 6 hours.

I am an older person but in excellent physical shape and health and discussed this with Dr Preecha and eviewed the following concerns:
1. My post op nausea. This will be addressed by the anesthetist who will be using drips before and after surgery and will use other non nausea induction drugs.
2. A BA would not restrict my dilation as the pain period for BA is in the first 5 days and there would be no dilation. As I will use a teardrop of 260cc which will be inserted under the muscle under the breast the main after a few days is in standing up as the muscles have been cut. Of course many have no pain.
As I will also have a nose reshaping I was concerned about breathing and nausea and was reassured that I would be able to breathe.the other FFS includes brow bossing and a rejuvenating face lift.
3. The induction time of 6 hours is reasonable and much less taxing on the system than multiple surgeries.

I hv a retirement visa for Thailand and can stay as long as I want thus I may take a longer recovery but it will be all done. Additional work can be done under a local later. So I have set the date for the 8th January 2016

If anaesthesia can be kept to the 6 hours, it should be OK.. Although with modern anaesthesia, the risks are a lot lower for multiple anaesthetics.

I've read more than one story of a trans person having multiple procedures and being under anaesthesia for up to 16 hours - this is way past the 6-8 hour guideline that most western surgeons follow.

I've done a bit of research on anaesthesia after I discovered the last one I had made a good attempt at killing me.

When I had my SRS with Dr Ch. there was one lady who had all 3 done. She had srs and ba and a few days later ffs. She did fine. The facial procedures you are having are not painful. BA is a very painful surgery for the first few days, and SRS in my experience was not that bad even though I have heard bad stories pain wise. If you think you can handle all that trauma at once than go for it. I wish you a successful surgery.

I really liked Dr Chettawut but I had concerns of having surgery in his clinic and i considered my age in case of a problem. He does all his surgery personally and thus the procedure takes longer. Thus he need 2 inductions if you do srs and FFS.

Hi Kelly, thanks for the additional info. I'm really concerned about the anesthesia and have made a real issue with each surgeon. Some behave like prima donna and I had one that actually after expressing my concerns stopped communication  with me. I will withhold the name.

Hello, my surgeon would only preform SRS and no other procedures at the same time.  If you think about it, the surgeons complete concentration and time on one critical operation is probably best.

Thank you,
Anne

I guess it seems like different people focus on different things which we feel are critical. For certain procedures range of motion and being able to shift the body is important with the upper body. I have had FFS and a BA not at the same time nor would I based on my recovery experience. SRS hopefully next  year. I have been under GA 6 times most not gender related. I would focus on best recovery scenarios however GA is a non event for me with my longest procedure over 10 hours.  It would be so cool to get it all done at once however the recovery could be much more than anticipated and post surgery depression can be quite intense and not easy to predict who gets it and why. Each to there own and good luck !!!

I brought this up in this forum as I need to hear your views and hopefully give me a better understanding. I did not expect it all to be done at one time. I have seen dr Preecha more than once on this matter and was lookong for his professional advice if I should do the SRS  of FFS first. It suprised me when he said all three at once.

To address the competence. There will be 2 top surgical teams. Dr Preecha will do the FFS.  He will have an assistant surgeon. This procedure will take 6 hours.  Simoustanely Dr Sutin and his assistant will do the SRS which takes around 3 hours.  The BA will be done by either Dr Sutin or Dr Preccha. I know Dr Suporn can do both which he says he personally handles. There is not much change in position for these surgeries.

I has a facelift before and the recovery is painless. I know that for most cases the SRS and BA can be very painful in recovery.

I have great issues regarding the GA. It's the narcotic that causes the depression. I raised this before and a sister on this forum expressed that a single induction is best.

I will also consult a close friend who is a top surgeon - not a srs or FFS one. Also I will be consulting my therapist. You have all raised the same initial concerns that I had.

Thank you and I will be reviewing this carefully and address each issue you have so kindly raised .

All three at the same time?? Very foolish. The list of complications as stunning. Not to mention anesthesia time. I would not go to any surgeon who would even entertain this. I have done O.R. rotations and none of the Surgeons I worked under would consider all three. Two, yes. Three no. It is your choice though.

I did SRS, BA, and butt implants all at the same time with Dr. Chet 5 weeks ago. It was 9 hours under.

It's doable. I had no major problems really... like others have said, the boobs hurt the worst, but only at first. The butt implants are still sore though!

SRS hasn't been very painful for me, just uncomfortable at times.

Good luck!!!!

HI Jessica , Hi Sara.

I have now spoken with an anesthestist and she has replied that one induction is much better than multiple. Surgery that last more than 7 hours has potential issues on recovey. It is most taxing on your system at each induction ad the fewer the better.

I spoke to a surgeon in the USA, who is my nephew. SRS, FFS and BA are NOTdeep tissue surgery and there is limited trauma. It is not rocket scientist surgery its what they refer to as vinilla surgery, and practice make perfect,There can be complications but based on the surgeons experience this is also limited.

Globally there are many SRS and FFS surgeons but MOST operate as individuals. Dr Chett, Dr Suporn, Dr Brssard for example. They would have to do both procedures themselves and this is tiring and not recommended. He was not aware that a clinic had two sets of surgeons that work together to complete the SRS and FFS. QUOTE " surgeons tend to be prima donnas and will want to do it themselves".

He also brought up the health of the individual. I do not drink, smoke and exercise daily and eat very healthy. I am of perfect weight of 35 pounds and 5ft 7in.

He would recommend all three at once rather than seperate, after reviewing their profiles.

I had gf do the BA with Preecha recently and she also said that the pain was minumal. depends on the size and I'm having a B cup with a 260 cc insert.

My last car salesman told me it was a great machine too. Runs great with no issue's. Just saying.

I've heard horror stories about FFS pain levels, and I do not even want to imagine what it would be like to be in severe pain from the face while recovering from GRS. (Sinus pain when I did it was bad enough!) Similarly, the one girl who did BA and GRS together said it was "hellish" for the first few days, and she was under 21 years old.

BTW, Brassard works with Belanger, and together they can do GRS in 2-2.5 hours with no general anesthesia used at all (they prefer epidural pain block with twilight sedation). They will also, as is obvious from my story, do BA at the same time. So you could get GRS and BA out of the way without general anesthesia and in about 3.5 hours total operating time...

I also get depression after GA. Talk to the doctor about that as mild antidepressants help. I think you can do all 3 at once. With the new techniques of cutting the muscle BA hurts less. I am just wondering why do you go for anatomic implants? They are known to rotate sometimes and most of the very well known boobs doctors even refuse to do them. High profile are just fine in my opinion, but talk to your doctor about it.

Great suggestions for the potential depression. I will most definitely ask about this. I did get the "doom n gloom" period about a week after surgery and saw my GP. He said it's caused by the chemical imbalance  in the brain caused by anesthesia. Took an over the counter med for a couple of days then it disappeared . Thank you so much.

Thank you for the very kind encouragement . It's all so helpful. xoxo