Phuket Health Tips Phuket Health & Travel Vaccination Exchange Rate Hotel Info	Select Other Programs - - - Plastic Surgery - - - Upper Eyelid Surgery Lower Eyelid Surgery Rhinoplasty Augmentation Chin Shaving Liposuction Breast Augmentation Breast Lift Brow Lift Abdominoplasty Sex Reassignment Surgery - - - Cosmetic Dentistry - - - Porcelain Laminate Veneers All-Ceramic Crown           Service Information Criteria - Patient must be at least age 18 years of age. Patients will require permission from parents if under 20 years old. - Patients must be diagnosed with at least one of the following disorders: gender identity disorder, gender dysphoria, or associated conditions (anxiety, depression). - Patients must have undergone at least one year of antiandrogens or/and hormones. - Patients are required to have lived full-time in the cross-gender role for at least 1 year (supported by Identification Documents). - Patients must have approval from a psychiatrist (MD), psychiatric social worker (Ph.D.), or clinical psychologist (Ph.D.). Surgical Procedure This procedure is a combination of a penile skin inversion and an immediate full thickness skin graft. The vaginal canal and opening is created beneath the urethral opening and prostate gland. Vaginal depth is of concern to most patients. The most important factor in creating this depth is the amount of penile shaft skin. Our technique lengthens the depth of the vagina by using the full thickness skin graft from the scrotal. Hair on the scrotum must be removed so that the skin graft is placed at the distal end of the penile skin flap. This technique can lengthen the depth at least 2 more inches. A portion of the glans (head of the penis), with its nerves and vessels, is converted into a clitoris. In so doing, the clitoris will be functional in sensation as well as in appearance. The excess erectile tissue around the urethra should be removed in order to avoid symptoms that stem from engorged erectile tissue during sexual arousal, that may result in the narrowing of the vaginal opening. Colon transposition is used for patients who need more depth (exceeding 8 inches). Duration of Operation Three to six hours Risks and Complications Infections, Infections are usually only minor and do not cause pulmonary or systemic infections. Short Vagina, Depth usually reaches six inches and will continue to extend after 6-12 months due to the maturation of scar tissue. In case of very short vagina, the second operation can be done after 6 months by using the sigmoid colon procedure. Rectovagina Fistula, A very serious complication of SRS, where a hole develops between the colon and the vagina. Other complications, such as urethra vaginal fistula, Pulmonary thromboembolism, extensive bleeding, and other serious infections are rare. Side Effects Wound disruptions, There will be strong tension in the area around the fourchet of the new vagina perineum. Wound care will be required, but will heal within one month. Unable to urinate. Urination difficulty sometimes occurs after the urine catheter is removed, due to the swollen stump at the opening of the shortened urethra. In such cases, the urine catheter should be retained for several more days. Eventually urination will return to normal. Bleeding, You may experience oozing blood around the gauze dressing after the first day after surgery due to bleeding through the stump of the urethral opening. This may require repacking or suturing. After Care Before being discharged from the hospital to the hotel, a nurse will teach you how to take care of your vagina and prescribe more medications. The stitches will be removed after seven to ten days. You will then be able to return home.     1 | 2 | 3 | 4 | 5
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