Curious as I am at times, it would be ever so interesting to know HOW Dr. Suporn finds the extra skin required to achieve this sort of depth...(7") that OTHER surgeons can not find, -  other then switching to colon-section.

I have heard he perforates the scrotal skin like e.g. "stretch metal" (lattice) is created, and thereby is able to produce 2.5" or more? from 1" (just an example).

It might also explain the added pain involved as there be a lot more scar-tissue/healing - though all internal to the vj-cannel...

Sorry, just curious about it as I'm mostly not into "miracles"

It be furthermore of interest about the inquiry of preferring Dr. Suporn vs Dr. Bassard, and of course all depending on one's own 'donor situation'.

Axélle

Hi Axelle,
No problem, it's all good. The simplest question to answer of why Suporn and not Brassard was simply that I live in Hong Kong, and Suporn is only a short 3 hour flight. So yeah, right off the bat I didn't consider US surgeons, but not because of anything skill related. My options were either to have it done for free in Hong Kong through the Hospital Authority, or to go to Thailand. Given my situation and the evaluations I had already received, I chose what I considered to be the best possible option. It certainly wasn't the cheapest, and that has been an enormous sacrifice for me as I'm currently studying and supporting my partner.

As far as why I chose Suporn and not another Thai surgeon, well, Suporn presented what I considered to be the best surgical option, the best results, and the best post-surgical care. As it turns out, I was lucky in that I haven't had any complications, but there was no way of knowing that this would be the case, so I wanted to err on the side of safety.

As for the skin graft issue. As far as I'm aware, he Suporn doesn't perforate the skin. It's possible that he takes extra skin from the crease in the groin. I can certainly say that area has been quite tight, but then, it's hard to tell with swelling etc.

I can appreciate what you're saying about miracles, and I tend to be the same. Perhaps though, this is not so much a 'miracle' as just a surgeon who has found a far more efficient way of using material. Suporn has done a lot of work with intersex people, and apparently his technique was specifically developed with this situation in mind. Again, I'm not one of those people who wants to rubbish other surgeons, but I will say that just because one way is established and 'normal' doesn't mean that it can't be done better. If that were the case, we would have stopped developing cars with the Model T.

I have to reiterate though, Suporn's procedure may not be for everyone. It really hurts; and from what I'm told, it hurts WAY more than others. It also takes longer to recover. I made the choice knowing this, but after weighing it up, felt that the sacrifice of pain and recovery time was worth it if I had a higher probability of getting the result I wanted. As it turns out, I was right.

Thanks again Sophie for sharing all this detail.

I'm quite sure it be of much interest also to some of our 'lookers-on',
and now... have a great day - of what's left

Axélle

Axelle,
After your last message, I was talking to my friend who had her surgery a few days after me. Together we took a look at the photos Dr Suporn took during my operation. It would appear that he does perforate the skin after all. I'm not sure if this is the sole reason he gets that much depth though. From the photos, although you can see rows of small incisions, it is not what I would consider a 'lattice' effect. If anything, it would appear that the incisions are more likely to give the graft more 'grip' as it bonds to the inside of the new vaginal cavity.

I would suggest that perhaps it has something to do with the properties of the scrotal skin as it is. I know that pre-surgery, I could stretch that skin quite significantly, to a much larger area than usual. Once it is detached from the body and stretched over the plastic tube thing, he then removes the plastic tube and sews the open end to the body again, while the skin tube itself remains inside out. it appeared from the photos to be limp and, well, much more 'expansive'. He then uses the plastic tube to push it inside. It would seem then, that in this state, and with the perforations giving it more purchase, the skin sticks to the inner wall of the cavity to the greater depth he is able to achieve. I suspect therefore, as it seems logical, that this explains why Suporn's dilation schedule is so much more demanding and why recovery is longer. It may also explain why he requires his patients to stay in hospital longer than most other surgeons...in order to give the skin more time to form a strong enough bond. In effect, the skin has been 'forced' to remain stretched, and so post-op, it has two forces trying to reduce the vaginal canal...one, the natural healing tendency, and two, the pre-existing elasticity of the skin returning as the nerves reconnect.

So these are my ideas. I'm not saying I'm absolutely right, as I don't have hard evidence of that other than the photos; it just seems to make sense as a possible explanation.

Thanks again Sophie, for such a diligent follow-up. Much appreciated it is.

Interesting to note, that Dr. Kunaporn uses a similar protocol with a few differences.

One stays also 2 weeks -minimum- at the clinic, and has 3 ops.

One 1st main op (~ 7.5 hrs) to create the vulva and vj-canal, 'unlined' at this at stage, and only filled with loads of packing and a suction set-up to ensure no major blood vessels are damaged/leaking.

After ~ 3 days a 2nd very short op, only replacing the packing, about 20min gen. anaesthetic.

After 7 - 8 days, the scrotal skin that has been saved in a fridge in the meantime, is also pulled over a stent, all hair follicles removed and --- ------  then I was gone/under, could not see anymore what else was going on

This "item" is then attached to the inner vj-introitus and becomes the vj-canal lining.

NOW... here is the difference... it is the formation of the vj-canal that ends at the peritoneal reflection (part of the pelvic bone).

Only if entering the peritoneal cavity (abdominal cavity), by-passing the peritoneal reflection, can more depth such a 6" - 7" come about.
The peritoneal reflection (part of pelvic bone) allows for max. 4.5" - 5" as mentioned earlier, this also being the case with biological-females.

I hope this makes reasonable sense, as did your own well presented explanation.

Thank you again and best of luck
Axélle

PS: The above will be mostly to also give some idea to our "on-lookers"...