People have asked, how did I hear about Dr. Suporn? He’s probably the best surgeon in the world for this particular surgery, with the most advanced technique (which he personally pioneered). Especially in earlier years, there simply weren’t a lot of surgeons who do the procedure, so on forums where trans women talk to each other it’s not that hard to find out what surgeons are out there, and what their results are like.
There are some very skilled surgeons in the States — and thankfully, there’s more and more surgeons who are doing the procedure — but they generally use a technique that I don’t think is as good as the Thai surgeons, and Dr. Suporn in particular. And if I was gonna have the furniture re-arranged I wanted to to be some the best surgeon I could find.
In the “penile inversion” method — which is the one commonly used in the States, they do in fact use the penile skin to line the neo-vagina. The procedure is pretty much what it sounds like, in effect they remove the internal erectile tissue and turn the penis inside out.
Dr. Suporn’s technique is radically different. He’s essentially trying to match the analogous tissue between the male and female genitalia — since it all started out as the same tissue in the womb before differentiating later on during fetal development. For example, the tissue of the foreskin and glans of the penis is extremely similar to that of the inner labia. So Dr. Suporn’s insight and innovation was to match similar tissue as much as he can. So the penile tissue is used to create the labia, and he uses the scrotal tissue to line the neo-vagina.
However, to prevent hair from growing inside the neo-vagina, he first essentially planes down the scrotal skin to get rid of the layer of dermis that contains the follicles. Needless to say this does mean the remaining skin is extremely thin and delicate — and more importantly lacks an attached blood supply. The blood vessels will regrow into the grafted tissue, but that’s one reason the recovery is more physically demanding with Dr. Suporn’s technique.
OTOH, one major advantage of this is there’s no need to do genital electrolysis, as is needed with some older forms of the penile inversion method. My facial electrolysis has been painful AF — and I’ve got an extremely high pain tolerance — so I can’t even imagine doing electrolysis to the penile shaft. 😱😱😱
Didn’t hurt that with the Thai exchange rate it’s also considerably less expensive than in the States, since trans-related procedures are generally not covered by insurance — in fact the fine print of my insurance policy specifically prohibits coverage of a long list of trans-related surgeries.
Consequently, I’ve spent more than $100,000 (and counting) all told — including facial feminization surgery, breast augmentation, three rounds of hair transplants and hundreds of hours of facial electrolysis (still in progress) — and I’m extremely privileged to had have the financial ability to pay for all that. Most of my peers don’t.
FWIW, the same was true with the “facial feminization surgery” I had — there’s literally only half a dozen surgeon worldwide who are truly expert at doing the brow reduction procedure I needed, so again it was short list, and I ended up going to a surgeon in Buenos Aries, who I personally think is one of the best of that small group.
Ironically, I had a far harder time deciding on a surgeon for my breast augmentation because it’s such a common procedure, and the trans forums had less info about particular surgeons.