Sex Reassignment Surgery

Male-to-female sex reassignment (MTF), also known as gender reassignment surgery or feminizing genitoplasty, is a complex surgical procedure that helps people transition from male to female. The surgery aims to create female external genitalia and may involve various techniques and procedures. Below is some information about MTF gender reassignment surgery:

Our surgeons perform sex reassignment surgery (SRS) or gender reassignment surgery (GRS) in a single step using the non-penile inversion technique.

The non-penile inversion technique produces gender reassignment surgical results that have the most correct anatomical appearance and physiological function.

In labiaplasty, our surgeon uses both the penile and foreskin (a hood covering the glans in non-circumcised patients, or part of the skin between the glans neck and the incision scar in circumcised patients) to form the well-defined inner lip (labia minora or inner labia).

The constructed labia minora are usually pink in color and extend to the bottom of the vulvar vestibule to form the posterior fourchette, which is similar to the appearance of the labia minora in biological women.

Our surgeon creates a natural shape of the vaginal opening in a vertical orientation for the most realistic appearance and optimal function. The vaginal opening can also widen appropriately to allow for comfortable intercourse and vaginal dilators of various sizes.

Even in SRS patients whose penis is small and short, an excellent vaginal depth of 6.5-7 inches can be expected.

Since the end of the penile skin is no longer inverted in the vagina, the vaginal liner is made only from a skin graft of the scrotum and/or groin, which is absolutely hairless due to the careful removal of all hair roots during the preparation of the skin graft.

Individual self-lubrication can also be expected due to the preservation of specific secretory glands around the urethral and vaginal opening.

The urethral opening is located above the vaginal opening in the correct anatomical position to allow female urine flow. All spongy muscles around the urethra are completely removed to prevent the tissue from compressing during sexual arousal, which can cause narrowing of the vaginal entrance or difficulty during intercourse.

The LBS surgical team is known for its ability to preserve certain sensory nerves to allow for excellent sensation and successful achievement of orgasm even within a short time after SRS.

It is important to note that the specific surgical technique used may depend on the individual surgeon's anatomy, preferences, and expertise.

The ultimate goal of MTF genital reconstructive surgery is to create a neovagina that is esthetically pleasing, allows for sexual intercourse, and provides a source of gender affirmation for transgender women.

Recovery from MTF genital reconstruction usually involves a hospital stay followed by postoperative care. Dilators are used to maintain the depth and width of the neovagina during the recovery process. Patients may also receive instructions on hygiene, wound care, pain management and follow-up visits.

For people considering genital reconstruction, it is important to consult with experienced gender reassignment surgeons who can provide individualized counseling, discuss available techniques and develop a comprehensive treatment plan based on their specific needs and goals.

Pre- and post-operative care for male-to-female sex reassignment surgery (MTF) includes several important steps to ensure a successful outcome and smooth recovery. Below are some details on pre- and post-operative care for candidates undergoing MTF SRS:

Pre-operative care:

1. Psychological assessment: candidates usually undergo a psychological assessment to determine if they are ready for surgery, if they understand the procedure, and if they feel psychologically comfortable.

Under current Thai regulations for SRS, you must provide two referral letters from qualified psychiatrists (each letter from a different psychiatrist). The letters should be sent directly to LBS's Surgeon Team. For more information about referral letters, please contact our medical coordinator team LBS.

2. Hormone Therapy: prior to surgery, individuals usually undergo hormone therapy under the guidance of a specialized healthcare provider. This promotes feminization of the body, including breast development and redistribution of body fat, which can improve overall SRS outcomes.

3. Real-life experience: Many surgeons require candidates to have a period of real life experience, i.e., living and performing as their identified gender, before being approved for surgery. This contributes to their decision to transition.

4. Medical clearance: candidates undergo a comprehensive medical examination to assess their overall health and to ensure they are suitable for surgery. This may include blood tests, imaging studies and consultations with various specialists.

Post-operative care:

1. Hospitalization: MTF SRS usually requires several days of hospitalization for monitoring and initial recovery. The exact length depends on the surgical technique used and individual circumstances.

2. Pain management: pain medications are administered to relieve postoperative discomfort. It is important that you follow the prescribed medication and inform the treatment team of any pain or concerns.

3. Wound care: Proper care of surgical incisions is critical for healing. This includes keeping the incisions clean and dry, changing dressings as directed, and avoiding activities that may stress the surgical site.

4. Dilation: Dilation is an important aspect of postoperative care. This includes the regular use of dilators to maintain the depth and width of the neovaginal canal, prevent the formation of scar tissue, and ensure optimal function and esthetics. The specific dilator schedule and technique will be communicated by the surgical team.

5. Follow-up visits: Regular follow-up visits with the surgical team are necessary to monitor healing, address any concerns or complications, and provide guidance on postoperative care, dilation, and other aspects of recovery. These visits may occur at intervals initially and become less frequent over time.

6. Emotional support: emotional support is critical throughout the recovery process. Candidates may seek counseling, support groups, or individual therapy to address psychological and emotional needs that arise during transition and recovery.

It is important to note that specific preoperative and postoperative care instructions may vary depending on the surgeon's preferences, the surgical technique chosen, and the patient's individual circumstances. Following the surgical team's instructions is essential for optimal outcomes and a smooth recovery.