Here's an update.   I had labiaplasty surgery done a month ago to remove excess skin from my labia majora.  I chose to have the surgery done locally (Chicago) instead of going back to Dr. Chettawut in Bangkok.  This despite he agreeing to do the revision free of charge.  Since I'd be responsible for travel and lodging expenses, the cost penalty of having the surgery locally was minimal. 

My surgeon's clientele are primarily natal women who seek mammoplasty/labiaplasty/abdominoplasty (tummy tuck), etc.  At my initial consultation, I found him to be very transgender friendly, as well.  He examined the GRS work that Dr. Chettawut did for me, remarking that aside from the faint scars that remain, and the excess skin in the outer labia, the appearance of my vulva looks very natural.  He expressed considerable surprise that GRS surgery techniques in Thailand were able to achieve such excellent results, having seen the results of MTF GRS surgery results of surgeons here in the U.S.  His comments made my day, of course.

He said I was an excellent candidate for labiaplasty, and although most natal women seek labiaplasty for the labia minora, surgery on my labia majora would be no different than for a natal woman.  I had the surgery done at the same time as he did a tummy tuck, which together took 2-1/2 hours under general anesthesia.  I stayed over night at the surgery center under the watchful supervision of a night shift RN.  If I only had the labia surgery, it would have been done with sedation and a local anesthetic, and I could have returned home the same day.

The labiaplasty incisions were closed with dissolvable sutures, and have already healed nicely.  Post-op discomfort has minimal.  I could sit, stand, and even walk the next day.  I had some minor blood spotting for a couple of days, but that was to be expected.  I still have some swelling, however, but from what I can see today, I'm expecting a very satisfactory end result.   

Probably my final posting on this thread.  It's been two years since my GRS with Dr. Chettawut in Bangkok, Thailand.  The revision labiaplasty that I had earlier this year here in Chicago to remove excess skin in the labia majora has healed up nicely.  Urination flow is normal now, and I'm very happy with the appearance of my vulva. 

I've lost 1/2" of depth, although it's possible to regain it if I take the time to dilate with downward pressure for a couple of hours, but I'm okay with 5-1/2 inches.  I still dilate once a week, but skipping a session doesn't seem to have any negative consequence.  I actually like taking the time to do it.  The few hairs I had at the posterior entry to my vagina seem to have gone away.  I thought I might need some cleanup electrolysis, but it's no longer a concern. 

I masturbate every week or so for fun, and it's becoming easier to reach orgasm as my brain adapts to the new anatomy.  I don't develop that sexual tension build up that testosterone causes.  I think I could do without sex altogether, but I'd rather have it be a small part of my life.  Use it or lose it seems to apply. 

I don't have any odor problems, nor do I find it necessary to douche.  I think the weekly dilation keeps things clean and healthy.  I've had some problems contracting bladder infections, so I take a daily dose of cranberry concentrate to acidify my urine.  It seems to be working. 

Psychologically I'm fine.  It's been four years since I started my transition and I've settled into a comfortable routine.  I find it hard to recall what life used to be like, and I can't imagine wanting to ever go back.  I'm really the happiest I've ever been in my life. 

I finally found my female voice to where I don't have to think about it anymore.  I'm convinced that next to eliminating facial hair, voice quality and speech characteristics are keys to passability.  I live non-disclosure know enjoying all the benefits and dealing with the disadvantages that women face as women.

Transition is hard, there can be no doubt about that, but it can be done with determination and hard work, even at my age.  It's the hardest, but best thing I've ever set out to do. 

To all my sisters:  Good luck wherever your path takes you.

Thank you so much Clara for sharing you whole experience about your SRS with Dr. Chettawut. It has been very useful to me and I'm sure that it has been also to a lot of other girls on Susan's. I wish you well for your life as a woman.

Happy to hear that things worked out fine for you Clara! I'm in a similar boat as you, went for SRS with Chett around the same time but had the same issue of excess tissue. Chett's agreed to revise it and I'm currently back at the Bangkok Rama for a consultation before I decide on any further action. Your story gives me hope that my problems can be solved too. Glad that you're happy and I wish you all the best.