Plastic and Reconstructive Surgery Center

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Pulled directly from an email reply.

Goals of Male-to-Female (MtF) Sex Reassignment Surgery (SRS):#

• To create a sensate and aesthetically acceptable vulva, including the clitoris, labia minora, labia majora, and vaginal introitus, with consideration for the G-spot.
• To shorten the urethra and create a new urethral opening that allows a downward urinary stream.
• To completely eliminate erectile tissue to prevent narrowing of the introitus and protrusion of the urethra during sexual arousal.
• To achieve adequate vaginal depth.
• To preserve orgasmic capability.
• To minimize and conceal scarring.
• To create a realistic neovagina in both appearance and function.

Pre-Requirements Before Scheduling Sex Reassignment Surgery (SRS)#

1. Medical Form

   1.1 Please complete the attached medical form and return it to us. This is essential for our medical team to assess your general health before proceeding. We have attached the medical form for you. Please kindly complete it and forward it back to us via email.

2. Referral Letter (Only One Required)

   2.1. You may submit one referral letter, either from a psychiatrist or a hormone therapist.

   2.2. The letter must be written in English and issued in your home country.

3. Surgical Eligibility

   3.1. You must be in good health, as determined by a medical examination.

   3.2. Please note the following:

   • Even after submitting your referral letter(s) from abroad, you are still required to undergo evaluation by two Thai psychiatrists before surgery.
   • If both Thai psychiatrists do not approve the procedure, the surgery cannot proceed. Your referral letter (s) from abroad is one of best supportive document.
   • We strictly follow WPATH, AsiaPATH, and Thai medical laws regarding MtF surgery.
   • Your local referral letters are valuable and supportive but do not guarantee approval.

The cost for SRS (Penile Skin Inversion) is USD 10,300.#

• If your BMI is between 25 and 30, there is an extra 10% charge.
• If your BMI is over 30, there is an extra 15% charge.
• If your BMI is over 35, there is an extra 20% charge.

The cost for SRS (Penile Skin Inversion with Scrotal Skin Graft) is USD 10,860.#

• The same extra charges apply based on your BMI: 10% for BMI 25–30, 15% for over 30, and 20% for over 35.

Each surgical technique includes the following:#

• Accommodation for 5 days in hospital private room after surgery for Penile Skin Inversion/Scrotal Skin Graft
• Operating Room Charges: OR Room Use, Recovery Room, Scrub & Circulate Nurse
• Regular menu food charges during recovery period in hospital
• Laboratory Testing: necessary for the procedure as CBC, EKG, UA, Anti -HIV, Chest X-Ray (pre-operative evaluation must be done before surgery to ensure patient’s safety and fit for the procedure)
• ( If age over 45 need to check Cardiology. An extra charge is 100 USD + - )
• Medical Equipment and Medical Supplies
• General Anesthesia – Pre-Anesthetic Drugs, Anesthesia and Medical Gas (Oxygen, Nitrous Oxide)
• Free two sizes of plastic GRS Dilator penile skin inversion, if acrylic dilator per set is 120 USD (3 sets) for Penile Skin Inversion
• A pack of sanitary napkin ring
• Medical Treatments
• Doctor fees
• Anesthesia fees
• Nursing services
• Take home medication and supplies
• Post op cares
• Transportation picks up

Post-Operative Stay Requirements in Bangkok#

To ensure optimal recovery and continuity of care, patients undergoing gender-affirming surgery at PAI Clinic are required to remain in Bangkok for the following minimum durations: These timelines are essential to facilitate proper medical follow-up, wound care, and to monitor the healing process.

Penile Skin Inversion Technique#

A minimum stay of 18 days is required, which includes both pre-operative preparation and post-operative care.

While you are with us, both before and after your hospital stay, we recommend booking a hotel nearby PAI’s clinic for your comfort and convenience. Many partner hotels offer special rates of around USD 50 - 70 per night, including breakfast. Our team will be happy to assist you with hotel recommendations or arrangements, so you can focus on resting and recovering close to the clinic.”

Scheduling Your Appointment or Surgery at PAI Clinic#

1. Referral Letter Requirement
   • Before scheduling your surgery, you must provide at least one referral letter from a licensed mental health professional or hormone therapy provider. The letter should confirm that:
     • You have undergone appropriate psychological or hormonal assessment.
     • You are eligible and ready for gender-affirming surgery.
     • The surgery is a medically indicated step in your transition.

This documentation is a critical part of ensuring we meet international standards of care.

2. Select Your Preferred Surgery Date

   • Please consider your availability and desired time frame for the procedure. Send us your preferred dates, and we will do our best to accommodate your request.

3. Surgery Date Confirmation

   • Once we have received your referral letter and preferred dates, our team will review your information. We will contact you to confirm your official surgery date and provide next steps.

4. Book Your Airline Ticket

   • After your surgery date has been confirmed, you may proceed with booking your flights to Bangkok. Please ensure your travel schedule allows for the required pre- and post-operative stay:
     • Penile Skin Inversion: minimum 18 days
     • Sigmoid Colon: minimum 20 days

5. Accommodation Assistance

   • If you would like assistance with booking accommodation, we can provide recommendations and help arrange your stay at one of our partner hotels.

Rates typically range from USD 50–70 per night, including breakfast (cooperative rate).

6. Airport Pickup

   • We will arrange for a driver to meet you upon arrival in Bangkok.

Remarks:#

• We accept cash payments for the surgery fee in the following currencies: USD. Please prepare the most recent version of the bill, ensuring that it is clean and free of any corrections or scratch marks.

• For patients who are HIV-positive, an additional charge 50% may apply. Prior to surgery, please ensure your CD4 count is above 500 and your viral load is undetectable.

• Prior genital electrolysis, laser hair removal or permanent genital depilation is unnecessary. During your surgical times, the doctor will do all hair follicles manually excised (cut) from the scrotal skin and they will not grow subsequently. Although, if you still prefer to do electrolytic hair removal or laser hair removal just to reassurance. This is also accepted. Please finish all sessions at least a month before the surgery date. The use of electrolysis hair removal or laser hair removal should focus on the perineal region (perineum) between the anus to the scrotum.

• In compliance with Thai medical law, two independent evaluations by licensed Thai psychiatrists are required prior to surgery. Each psychiatrist must issue a separate letter of approval, with a fee of USD 50 per letter (total two letters). The consultation typically lasts 30 minutes per psychiatrist. Upon approval, the letters will be issued in accordance with WPATH, AsiaPATH, and applicable Thai medical regulations. These letters are necessary for surgical clearance.

• An additional charge of 3% applies if the surgery fee is paid by credit card (Visa or MasterCard). No extra charges apply to other expenses.

• The diagnosis and the scope of surgery are based solely on the details you provided or based upon the similar case from previous patient.

• The appropriate surgery plan may need to be adjusted once our doctors have the opportunity to evaluate and examine the patient at Preecha Aesthetic Institute. This process may require additional tests.

• The above estimated cost is already included Pre-operation expenses. But no other investigations, treatment of underlying disease.