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Just like other cosmetic procedure, all cases are done under general anesthesia. Position is set in standard lithotomy. Silicon made cushion is used to support the weight bearing area just before the operation starts. The perineal skin flap is made in proper shape and size. It is joined with inverted penile flap for vaginal opening reconstruction.
The vaginal space and opening are created below the urinary tube or urethra and prostate gland. After passing the prostate capsule at about four inches depth, plane become loose and direction will be downward slant until to the recto-vescicle pouch. It will cause newly created space normally 6-7 inches or even more that depends on the anatomy of individuals.
Bilateral orchidectomy or removal of testes and spermatic cord can also be done as a sex change procedure. The inverted skin flap from the penis is used for the skin lining of neovagina. Scrotal skin graft will be routinely added for additional depth. Penis shaft is removed except some small parts of the gland and of course the sensory nerves and vessels should remain intact for constructing the sensate clitoris.
Sex Change in Thailand by Dr.Tanongsak
The Male to Female SRS is completed with one stage with result of
a. Sensate Glans- Clitoris
c. Vulva Floor
d. Labia major and minor
e. Neovagina of 5-6 inches
Sex Change Surgery Before & After Photos
by Dr. Tanongsak with Asia Cosmetic Hospital, Thailand