Our Services

Female to Male surgery

Dr.Kamol offers the operative procedures for FTM-GIDs as follows:
Operative technique

1. Breast gland removal
2. Hystero-salpingo-oophorectomy
3. FtM genital Reconstruction

1. Breast gland removal procedures

a. Periareolar scar for small size breast
b. Circumferential scar for medium size breast
c. Vertical scar for large size breast

The procedures for breast gland removal are performed under general anesthesia. After surgery, patient is required to spend two nights in the hospital and at least 10-14 days recovery time in Thailand.

Picture of the Surgery
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2. Hystero-salpingo-oophorectomy

a) Laparoscopic technique

b) Conventional opened technique

The above procedures are performed under general anesthesia. After surgery, patient is required to spend 2-4 nights in the hospital and 10-14 days recovery time in Thailand.

3. FtM genital Reconstruction

a) Metoidioplasty

1. A good candidate for metoidioplasty should have a large clitoris from adequate hormonal therapy. The average length of clitoris should be at least 6 cm to achieve good function.
2. The new urethra is performed by the vaginal mucosa and the vagina is collapsed in one operation.
3. The catheter is required for 10-14 days after surgery.
4. Patient is required to stay in Thailand during a 2-3 week recovery period.
5. Patient can expect an average length of his new penis to be two inches.
6. The surgery is performed under general anesthesia.

Advantage:
One-stage surgery
Less complication than Phalloplasty
Preserved erogenous sensation

Disadvantages:
Size Limitation (average 3-10 cm. length)
Unable for sexual penetration

Picture of the Surgery
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b) Phalloplasty

The goal of phalloplasty are;

• Creation of a sensate and aesthetically acceptable penis with sufficient length and bulk take viable for penetrative sexual intercourse
(With the aid of a prosthetic erectile device)
• Extension of the urethra to the tip of the penis to allow voiding while standing
• Preservation of orgasmic capability
• Minimal scarring, disfigurement and functional loss in the donor area

Phalloplasty is a long and complex microsurgical procedure that requires free tissue transfer to create the neophallus. The flap is usually harvested from the forearm, the fibula, dorsalis pedis, tensor fasciae latae, groin, deltoid, anterolateral thigh and lateral arm and abdominal tissue.

Dr. Kamol ‘s technique provides two procedures by the following ;

1. Radial forearm microsurgery technique (two stage – technique)

a. The procedure is suitable for one who has forearm circumference more than 26 cm.
b. The first procedure involved urethral construction with silicone tube stent at the non-dominant forearm. For the first two weeks after the initial procedure, the stent is required to be in place. After that, six months prior to second stage surgery, the stent is required to be in place only at night while you sleep.
For the 1st stage the patient may need approximately 3-4 weeks for recovering
c. The second stage involved phallus construction by microsurgery technique. The donor site is covered by skin graft from inner thigh. The new urethra is joined to the original urethra.
d. The urine catheter is on for 2-3 weeks after surgery
e. The patient needs to stay in Thailand for 4-6 weeks after surgery for the recovering.
* Please be advised that some patients require longer recovery time.


Advantages:
Average sizes of neophallus like adult
Preservation of orgasmic capability
Possible to undergo penile implantation

Disadvantage:
Higher rate of complication and donor site morbidity
Permanent large scar on forearm

2. Abdominal flap technique:

a. The procedure is a multi-stage technique.
b. First stage involves pre-phallus and urethral construction with skin wrapping stent at the lower abdomen. This stage needs six months for complete healing and good flap circulation. The patient may need approximately 3-4 weeks for recovering.
c. Second stage involves phallus construction by moving the pre-phallus to join the original urethra. The new urethra is connected.
d. The catheter is required for two weeks post operatively. This 2nd stage may needs approximately 3-4 weeks for the recovering.
e. Third stage may be necessary for touching up the new glans penis and testicle implantation. Approximately 4-6 weeks may need for recovering.
* Please be advised that some patients require longer recovery time.

Advantages:
Not require micro surgery

Disadvantage:
Limitation for some patients who has a big belly
Limitation for the sensation

The specific risks and complications:

1. Urethral leakage or fistula is the most common complication of phalloplasty. Multi-stage procedures are lower risk (5-10%), whereas a single stage procedure increases risk (20-25%) of urethral fistula.
2. Wound infection and suture dehiscing are the most common complications of phalloplasty, resulting in a urethral fistula. Incidence of infection and/or wound dehiscing is 5-10%.
3. Incidence of urethral stricture is 3-5%.
4. Hypertrophic scarring

For more details, please contact us