Gender Reassignment Surgery: Dr. Chettasak Explains the Full Procedure

Added: 2026-05-23

[00:00:00]Hi, good afternoon Annaya.

[00:00:02]>> Hi Dr. Ch. So nice to be here. So nice to be in WI. It's lovely out here. Your team is wonderful and I'm having such a blast here. I'm so excited for the surgery.

[00:00:11]>> It's my pleasure and I and my staff is uh we are excited to to u uh provide our good service >> for our best for your surgery and of course the afterare too. So you can introduce yourself.

[00:00:25]>> Hi everyone, I'm Ana Banganger. You might know me as a cricketer, influencer, an activist, all three, whatever you think would suit best. But yeah, I'm here today. I'm here for my surgery, which is the skin grab vaginoplasty that Dr. Chet is going to be doing with me. To be honest, I've waited for this moment for the longest time. Since childhood, I had feelings of gender dysphoria and not being comfortable and fully aligned with my body. And 5 years prior I remember in 2021 that's when I made the decision that I'm going to go through transitioning and I couldn't think of anyone better but Dr. Chet right here.

[00:01:05]Now to be honest it's kind of like the feeling of uh reaching to the to the thing that you always wanted to. It was always something that I wanted with me personally and I'm just about to cross that barrier as well. So at the same time I'm feeling very nervous, scared that I'm going to take this step. I don't know how the recovery is going to be. Is the recovery going to be painful but at the same time I I know this is the right thing for me.

[00:01:32]>> So we met one times consultation. Yeah.

[00:01:35]>> Okay. Yesterday and uh everything uh well planned.

[00:01:39]>> Yeah. uh after I took examination okay and confirm that your your skin and your material everything um no problem for >> okay there are no issues with the surgical area nothing like that >> in terms of u depth is a major thing that a lot of other trans women who might want to do this surgery they would want to know that how much depth should we expect from this how the aesthetics is going to be how's the look of the surgical area going to be and anything else that the other trans women out there that would want to know the people from India a lot of >> good question normally when we prioritize almost of the patient tell me their priority sensation >> yes >> of course the apparent external genitalia and also the function that related to the vaginal dep normally we want all elements to get perfect >> yes >> so that means I emphasize on everything let me explain about the sensation and the external look that you control with my signature technique Dr. Jets in PI.

[00:02:42]>> Yes.

[00:02:43]>> It mean that uh we dedicate the value skin pen skin and uh also the part of special that means >> what is the full form of NPI for the viewers? Uh what would you say NPI stands for?

[00:02:57]>> NPI stands for non P9 inversion.

[00:03:00]>> Okay.

[00:03:01]>> Okay. The concept is we don't use P9 for invert for any lining. So we separate the look external look apart from the inside of the function because if you use value skin being used for the the walining >> yes >> nobody seen right it's just a function yeah >> that means I think about this and develop npi instead of we use the peni >> right >> we switch to use entirely the scrotal >> yes >> so scrotal skin gap work perfectly but require a good technique to convert sclodal to be uh we call skin graph.

[00:03:40]>> Yeah.

[00:03:41]>> Skin glob means a hairless skin because we going to thin the scloal to remove the subcutaneous fat and also some part of the mist that contain the hair follicle. Okay.

[00:03:52]>> That result the lining with skin inside the vagina completely hairless. See science has come way too far.

[00:03:59]>> Okay. So that that concept is very important because uh that means I have the freedom to use pen skin. Yes, >> for entirely work outside. See focus on inner labia and v opening and inner labia and v opening is the answer for modern aesthetic concept.

[00:04:17]>> Yes.

[00:04:18]>> Because uh we want the look of those part to be real like a cale.

[00:04:23]>> Are there any remedies or any preop measures? Let's you mentioned there's hair down there. So would you recommend getting laser hair removal done prior to this? Is it needed or can it be kept as an optional?

[00:04:36]>> Yeah, again good question. So we we going to focus on the area first because uh as I mentioned grow when I use inside for lining I can uh get rid of remove the hair follicles during surgery. So that means you have no need to do any hair removal procedure before surgery on the scrotal.

[00:04:55]>> What the exact location that I want is just we call perinium area.

[00:05:00]>> Okay.

[00:05:00]>> Okay. Did you know pinium?

[00:05:02]>> Yes.

[00:05:02]>> Pinium is the the area that between your anus above the anus and the base of the scrotal.

[00:05:08]>> Okay.

[00:05:08]>> Because we use that skin for construct the floor of the vaginal opening.

[00:05:13]>> Okay.

[00:05:13]>> So if you still have some hair >> existing that means uh after surgering but not inside the canal. So that mean this is just some a minor concern for some patient that they they feel uncomfortable.

[00:05:29]>> Right. But you can access that area for hair removal later. So that means uh this is something that >> you can leave it for later.

[00:05:38]>> Yes, that's correct.

[00:05:39]>> And for other people how out there who are questioning between sigmoid colon technique or the skin graph vaginoplasty technique what would you recommend? What are the pros and cons off of it and what's your take on it? Uh before we discuss about pro and cons for for those technique >> the fact is uh when we have the two techniques or even more >> including the PPV skin graph vaginal plasty colon vaginal plasty and perinium of PP vaginal plastic that means each technique have pro and cons right so that we should understand what's a pro and okay >> in some fact that you also need to realize for example Colon vaginoplasty I confirm that it's the best remedy to treat for for those that have a fail vaginroplasty >> okay >> like when you have uh whatever reason that you shorten or cut the collapse vagina with the other technique like skin graph or ppb colon vag is reserved close here >> so just in case what you're trying to say is like if there's any complication or any issue with the skin graft vaginoplasty there's an option to go for the colon on sigmoid colon vaginal plast.

[00:06:54]>> Okay. So this is why some patient if they realize like this.

[00:06:58]>> Yeah.

[00:06:58]>> So they go with the standard skin grab first.

[00:07:02]>> Yeah.

[00:07:02]>> Because a colon always a reserve procedures. Right. Unless you really concerned about self lubrication.

[00:07:09]>> Right.

[00:07:10]>> Self lubrication is the nature of the colon mucose so that they can secrete like a mucus lubrication is quite similar to a mucus production from the cis vaginal.

[00:07:21]>> Oh wow. mucose of the colonies can provide the self lubrication but the fact is about the amount of the production of the mucus lubrication >> we can say we cannot control it depends on individual so that means it's pro and cause see uh but in my experience is uh just feel patient that experience something we can say too much or abundant >> right >> uh secretion or almost the case that they're happy but this is the fact that we should discuss Yeah, we should discuss and we let we should let the reviewers know what needs to be done.

[00:07:55]>> Yeah. Yeah. Because this is kind of the uh the information that some sometime is um difficult to to to find the answer from from from real specialist.

[00:08:06]>> And uh what are the requirements prior to getting this surgery? Are there any documents that one person or trans person needs to provide for the surgeries that they want to opt for?

[00:08:17]Let's say they want to do a breast augmentation or a facial feminization or have a sex chain surgery for in fact like is there any uh paperwork that needs to be provided before or is it something that in Bangkok you need you need to have some sort of regulations or you need to speak to doctors beforehand how does that work in Bangkok >> so when you going to plan for gender affirming surgery for for me it's kind like I I stay at the in station.

[00:08:47]>> Yes.

[00:08:48]>> The so that mean I expect >> yes >> your journey >> so that you can met some your local specialist at least >> so a local psychiatrist >> right but uh in Thailand now the regulation is I can say it's very flexible >> that means they require at least one letter from Thai psychitis.

[00:09:10]>> Yes. So, uh, if you got your recommendation from your local specialist, that's great because it's it's helpful for me and our Thai psychiatrist to get that kind of information and then it's maybe easier, right, to know. But if you didn't get that letter in hand, I think this is still flexible that you can express your desire, right? whatever that you can discuss with our specialist Thai psychiatrist that uh we have the competent Thai psychiatrist that I think they have a very experience in transgender not general psychiatrist but they familiar with the transgender. So they they understand they have a flexible mindset to listen to whatever that you your concern or desire.

[00:10:04]>> Okay. So that mean I I think we have the the great team to support.

[00:10:09]>> So basically WI has their own dedicated psychiatrist as well at the same time who can speak to patients who want to undergo the surgery and they can get them assessed. Yeah, we can. Yeah, we can even offer online >> online >> because uh some psychiatrist they they quite um traditional street not refuse consult online but I think nowaday um we in the modern >> that uh it should be flexible >> to listen and support the patient either online or on site >> at the hospital. Yeah. And in terms of recovery as a sports person like myself and who's going through the surgery as well after tomorrow >> like how long should I expect for the recovery to be compared to a normal person for me to be back on the ground and playing cricket again?

[00:11:03]>> Okay.

[00:11:04]>> Yeah.

[00:11:04]>> It's quite straining activity. So I would say 3 months.

[00:11:09]>> 3 months.

[00:11:10]>> 3 months. Right.

[00:11:10]>> Three months is the minimum. And >> yeah. And for normal activities, how how long should I expect the recover? 2 months.

[00:11:18]>> Right.

[00:11:18]>> So for the first two months, bed rest is crucial is what you're saying, right?

[00:11:23]>> I can say you can resume light ACBC >> start from maybe protocol after surgery. I even encourage my patient to to get early ambulation.

[00:11:37]start from but the the trick is about you since everything is so new the wound genital wound.

[00:11:45]>> So you just careful about your your your posture >> not stretch the wound. So whatever posture see that we will teach you how to get get out get in the bed, >> how you sit, how you move without impact to the surgical area >> and >> how important is posttop care which is known as dilation after the surgery is done. How thorough you need to be with the dilation to make sure and how long you need to dilate for is also another question that I would like to ask for my viewers as well that how long should a person be thorough with the dilation and how important it is for them.

[00:12:29]>> Okay, thank you for this for ask me this very important >> questions. So the concept is about the we can say kind of exercise or practice like a play sport. Yeah, >> you need to keep regular practice or or or do something like so that you can maintain the the your ability.

[00:12:53]>> Yeah.

[00:12:53]>> So the the newer the new newagen is is kind of made from the new tissue. It's for skin grab.

[00:13:02]>> Yeah. That means uh if without the exercise stretching stretching exercise like you stretch your body right.

[00:13:14]>> So that kind of exercise prevent the contraction.

[00:13:19]>> Yeah.

[00:13:20]>> Because the nature of the skin graph will contract without >> exercise stretching exercise. Right.

[00:13:27]>> Okay. So dilation is similar to playing a sport or exercising. It needs to be done every day. And how long does dilation need to be done? Is it >> lifetime or is it like for the first few years you have to do it regularly? And if a person is active sexually then what is that person supposed to do?

[00:13:48]>> Understand?

[00:13:48]>> Yeah.

[00:13:49]>> Uh we can say the first year is >> very important. Yeah.

[00:13:53]>> Right. So you require daily basis. Okay.

[00:13:58]But the the the time per day is uh according to to to the protocol that I provide the patient.

[00:14:06]>> Okay.

[00:14:06]>> Now I try to be uh that uh it's just two times per day. Okay. Let's say around 45 minutes >> per session each session. But you know when we talk about the number like this the times it's just a guideline I I try to explain the patient is a flexible that you can maybe more or less >> so you're saying that you you're basically curating a flexible timeline for dilation for each patient according to their uh schedules or lifestyles.

[00:14:42]>> That's correct. But you you just try to make the app >> according to my instruction.

[00:14:50]>> But would say that sometime you can do less >> and do you compensate for the next session something like that.

[00:14:58]>> But the most important is about how do you control the regular basis every day.

[00:15:04]>> Yeah.

[00:15:04]>> For the first year >> but the best is the first two years.

[00:15:08]Yeah.

[00:15:08]>> See and after that you can gradually >> decrease the schedule.

[00:15:14]>> Okay.

[00:15:14]>> Yeah.

[00:15:15]>> Wow.

[00:15:16]>> I think these are all the questions that I have but is there something that you would like to tell me or the people who are watching this as well?

[00:15:25]>> So I think the uh when you decided for vaginal plastic >> Yeah. I think you commit for your responsibility for do uh watchation. Yes.

[00:15:38]>> I think this is something that you understand that is something that without regular maintenance you got uh maybe a chance >> yes >> to to get the loose depth. See?

[00:15:54]>> Yeah.

[00:15:54]>> Yeah. But in some detail of some type of puropacy like >> colon >> there's something that maybe you're going to not not lose the depth >> but some area of the width.

[00:16:08]>> Yeah.

[00:16:08]>> Like the area that joint with the opening made from skin and the colon joint >> is going to to contract like this.

[00:16:16]>> See? So that means you if you got colon and you lack of dilation maybe not lose step but you have some contraction >> and get the obstruction typical today it's maybe different >> and this happens if you don't dilate >> Mhm.

[00:16:34]>> On a personal note it's less than uh 48 hours that I'm going to do the surgery.

[00:16:40]I'm I'm very >> scared about the pain about how it's going to be. What what would your best advice be for this?

[00:16:49]>> Understand? Because uh this is we can say is major surgery for gender affirming surgery.

[00:16:55]>> Yeah.

[00:16:56]>> Uh it's quite long operation >> five to six hour because there's some a lot of detail.

[00:17:03]>> Yeah.

[00:17:04]>> That I going to construct to each structures. Right. So uh first during operation you will take care with my anestheist that uh we have good team that understand the nature of the long operation >> and he will uh help me to control everything uh both anesthetic part and also even your posture position.

[00:17:29]>> Yeah.

[00:17:30]>> Um make sure that everything uh based on the patient safety.

[00:17:35]>> Right.

[00:17:35]>> All right. And of course control pain during operation of course with the general anesthesia. Okay will be control with the special medication and also we provide uh combine the we call it's regional anatia plus general anesthesia region ania that I mentioned is about we call epidural block.

[00:18:01]>> Yeah. So that this help anesthesia to reduce anesthetic drug >> get less during operation. So you you got less side effect of the anastic drug >> and of course after surgery you got less pain or some patient even no pain.

[00:18:22]>> Yeah. Um we have uh experienced that the combined epidural block and generalia is so effective but we done by the specialist >> lovely I'm I'm sure I'm under great hands even I I was actually having a chat with Sisha Shindai and Trinra last night only about the surgery and they they just said that I'm at the best place possible and Dr. will look after me perfectly which >> I'm so proud because um I have a lot of Indian patient and some have the have influence >> influencer or even in the past maybe 15 years ago something I have uh one patient I think her name is >> Kas.

[00:19:11]>> Yeah. Okay. She she she have the uh put some information >> right >> regarding her surgery in the uh in the um social media in India. Yeah. And a lot of patient got uh useful information.

[00:19:29]>> I'm glad. I'm glad and thank you so much once again for having this chat with me and looking forward to the surgery.

[00:19:36]>> Thank you so much. Okay. And I see you on surgery day.

[00:19:39]>> Perfect.

[00:19:40]>> Thanks. Bye. Thank you so much. Okay.

[00:19:43]Lovely. Very good. Thank you.