Someone asked whether, after returning home, I go back to check-ups. And the answer is, no you don’t, due to the distance involved, but you can send the clinic photos and status reports as needed.
Dr. Suporn actually doesn’t want other doctors looking at things because his technique is so different that even doctors in the States who do genital reassignment surgery don’t necessarily understand his technique and how it heals. (Obviously if there’s a medical emergency, they will have you see your local doctors.)
I’ve heard a horror story about a patient who was in an auto accident, and when she was taken to the ER the doctors there attempted to “fix” what they thought where problems down there — and completely ruined her GRS. 😱
After a year, you can return to Thailand for revisions. The revisions themselves are free, but you need to pay for your flight and hotel.
Typically revisions are things like correctly asymmetrical labias, or labias where there’s been a small detachment (which leaves a small hole), or issues around the urethra. Sometimes it’s also cosmetic things — Dr. Suporn intentionally leaves as much tissue as possible in case of tissue necrosis (so that there’s remaining tissue he can work with), but the trade-off is that some patients end up with really large labia, which they don’t like from an aesthetic POV (and yes, I know cisgender women have labias of all different shapes and sizes), but it bothers some people.
Some people also have him do the posterior commissure of the vulva (where the outer labia join behind the vaginal opening toward the perineum). Dr. Suporn doesn’t do this initially because dilating would just cause it to tear. He’ll only do it if you can skip dilation for about a month, and one trade-off is that it does make your a bit tighter (since the reconstructed skin isn’t quite as stretchy as the factory-installed tissue). It’s one of the “tells” that someone’s had GRS, but honestly I doubt very many cisgender people notice. OTOH, we trans women can be extremely self-conscious about a variety of things that cisgender rarely notice.