MTF Bottom Surgery in Thailand

Why Thailand for MTF Bottom Surgery

1. ‍Surgical expertise through massive volume. Well-known doctors in Thailand like Dr. Kamol Pansritum and Dr. Theerapong have each performed thousands of gender-affirming surgeries spanning decades of experience, more than most Western surgeons complete in their entire careers. They have perfected their techniques and aesthetics and handled every anatomy, edge case and complication.‍
2. Advanced techniques not available at home. Penile-peritoneal vaginoplasty (PPV) uses abdominal lining tissue which is ideal as it is self-lubricating, elastic, minimal scarring. However, few surgeons worldwide offer this. Kamol Hospital pioneered it in Thailand. For patients with insufficient penile tissue (previous circumcision, small anatomy), colon vaginoplasty provides 7-9 inch depth with natural lubrication. Many Western surgeons only offer penile inversion, but one technique doesn't fit all patients.‍
3. Cost savings of $30,000-$60,000. Vaginoplasty in Thailand: $12,000-$25,000 depending on technique, including surgery, anesthesia, 7-14 day hospital stay, medications, daily nursing care, follow-ups, and airport transfer. In the US this could cost $50,000-$80,000 for surgery alone.‍
4. No delays. Book consultation today, fly to Bangkok in 4-6 weeks. Thailand's WPATH requirements (12 months HRT, psychiatric evaluation) can be completed at home or in Bangkok, no arbitrary bureaucratic delays.‍
5. Global standards. Kamol Hospital and Yanhee International both hold Joint Commission International accreditation, same criteria as top US hospitals. Your surgery happens in operating rooms meeting global standards.

Vaginoplasty Techniques

Penile Inversion Vaginoplasty ($12,000-$14,500)

How it works: Surgeon uses penile skin to create vaginal canal (inverts it), scrotal skin for labia, glans (head of penis) for clitoris. Most common technique globally.

Depth: 5-6 inches typical (varies by original anatomy).

Sensation: Clitoris retains full erogenous sensation. Most patients achieve orgasm post-healing.

Lubrication: Minimal natural lubrication, lubricant required for intercourse.

Maintenance: Lifelong dilation required to prevent narrowing. First 3 months: 3-4 times daily. After 12 months: 2-3 times weekly.

Best for: Patients with adequate penile skin (uncircumcised or minimal circumcision), seeking proven technique, comfortable with dilation routine, wanting lowest cost option.

Recovery: 4-6 weeks before travel clearance, 3 months before sexual activity, 6 months for full healing.

Penile-Peritoneal Vaginoplasty (PPV) ($20,000-$25,000)

How it works: Combines penile inversion for vaginal entrance with peritoneal tissue (abdominal cavity lining) for vaginal canal. Performed laparoscopically through 4 tiny abdominal incisions.

Depth: 6-7 inches, elastic tissue.

Sensation: Full clitoral sensation, vaginal canal has nerve endings (unlike penile inversion).

Lubrication: Self-lubricating tissue—no artificial lubricant needed for intercourse.

Maintenance: Minimal dilation long-term (2-3 times monthly after first year). Tissue doesn't narrow as aggressively as skin.

Scarring: Virtually invisible. Four tiny abdominal scars (look like freckles, fade after 12 months). Genital scars hidden in labial folds.

Best for: Patients wanting self-lubrication, those with limited penile tissue from circumcision, seeking "upgrade" from previous penile inversion, willing to pay premium for advanced technique.

Recovery: 5-6 weeks (slightly longer due to abdominal component), 3 months before sexual activity.

Why it's advanced: Peritoneal tissue is closest match to biological vaginal lining. Elastic, moisture-producing, pH-balanced. Kamol Hospital is world leader in this technique—Dr. Kamol developed the approach for transgender patients (adapted from MRKH syndrome treatment).

Colon Vaginoplasty ($16,000-$25,000)

How it works: Uses 7-9 inch sigmoid colon segment to create vaginal canal. Colon is detached, blood supply maintained, pulled through and sutured to create neovagina.

Two approaches:

• Open technique: 5cm bikini-line scar. Operating time 6 hours.
• Laparoscopic technique: Four tiny abdominal scars. Operating time 7-8 hours. Faster recovery.

Depth: 7-9 inches—deepest of all techniques.

Lubrication: Self-lubricating intestinal tissue. Natural moisture, no lubricant needed.

Maintenance: Minimal dilation (2-3 times monthly long-term). Tissue rarely narrows.

Best for: Patients with very limited penile tissue, those seeking maximum depth, revision patients whose penile inversion lost depth, those wanting "upgrade" from previous surgery.

Recovery: 6-7 weeks (longest recovery due to bowel surgery component). Bowel rest first 3-5 days (clear liquids only). 3-4 months before sexual activity.

Considerations: Requires bowel preparation before surgery. Rare risk of intestinal complications (under 2% at Kamol). Some patients report mild odor (manageable with pH-balanced wash).

Zero-Depth Vaginoplasty ($8,000-$10,000)

How it works: Creates vulva appearance (labia, clitoris) without vaginal canal. For patients not planning penetrative intercourse.

Best for: Non-binary patients, those prioritizing genital appearance over penetrative function, patients with health conditions making full vaginoplasty risky.

Recovery: 2-3 weeks (shortest recovery, no dilation required).

Our Partner Hospitals & Surgeons

We have an extensive network of partner hospitals and clinics to cover a variety of medical procedures. Every partner is accredited and then vetted by our team. For this procedure we recommend Kamol Cosmetic Hospital and Yanhee International Hospital as they specialize in this procedure.

Kamol Cosmetic Hospital

Dr. Kamol Pansritum, M.D.
5,000+ SRS surgeries since 1997. Double board-certified (General Surgery, Plastic Surgery). Pioneered PPV technique in Thailand. Performs 200+ vaginoplasties annually.

Training: Khonkaen University (M.D. 1986), Chulalongkorn University (Plastic Surgery diploma 1997). Member of World Professional Association for Transgender Health (WPATH), International Society of Plastic and Reconstructive Surgery.

Specialization: All vaginoplasty techniques (penile inversion, PPV, colon), revision vaginoplasty, aesthetic refinement (labiaplasty, clitoral hood reduction).

Yanhee International Hospital

Dr. Theerapong Poonyakariyagorn, M.D.
3,000+ SRS surgeries. Extensive international training. Board-certified, WPATH member. Known for reliable results, attentive post-op care.

Dr. Suthat Pattanaporn, M.D.
2,500+ gender-affirming procedures. Double board-certified. Specializes in natural aesthetic outcomes.

Your 4-6 Week Journey

Pre-Arrival (4-8 Weeks Before)

Virtual consultation through Konkai. Submit photos (genital anatomy, full body), medical history, HRT timeline, psychiatric evaluation. Surgeons assess which technique best suits your anatomy and provide a personalized cost indication.

Genital hair removal: CRITICAL. Penile inversion and scrotal graft techniques require complete hair removal from areas used for vaginal canal. Electrolysis only (laser doesn't work on genital skin long-term). Start 6-12 months before surgery. PPV and colon techniques require less extensive removal.

Requirements:

• 12 months continuous HRT (estrogen + anti-androgen)
• Psychiatric evaluation diagnosing gender dysphoria
• Age 20+ (18-19 requires parental consent)
• BMI under 30 (under 26 for colon vaginoplasty)
• Good general health, no untreated infections

Stop before surgery:

• Smoking (4 weeks before, 4 weeks after—critical for healing)
• Blood thinners, aspirin, vitamin E, fish oil (2 weeks before)
• Herbal supplements (can interact with anesthesia)

Week 1: Arrival & Preparation

Day 1: Arrive in Bangkok, adjust to the climate and time zone.

Day 2-3: Pre-op consultations. Surgeon reviews anatomy, confirms technique choice, marks surgical sites. Blood work, chest X-ray, EKG. Anesthesia consultation. Sign consent forms.

Day 4: Pre-surgery prep. Bowel preparation if doing colon vaginoplasty (clear liquids, laxatives). Nothing by mouth after midnight.

Week 1-2: Surgery & Hospital Stay

Day 5: Surgery Day

Operating time: 4-6 hours (penile inversion), 6-8 hours (PPV/colon).

What happens:

1. Orchiectomy (testicular removal)
2. Penectomy (penis removal, tissue preserved)
3. Vaginal cavity creation (between rectum and prostate)
4. Vaginal lining (penile/scrotal skin, peritoneum, or colon)
5. Clitoroplasty (glans converted to sensitive clitoris)
6. Labiaplasty (inner/outer labia sculpted)
7. Urethral repositioning (female position)
8. Vaginal packing (gauze maintains depth/shape)

Hospital Stay: 7-14 days depending on technique and healing progress.

Daily routine:

• Nursing checks: vitals, wound inspection, dressing changes
• Pain management (prescribed schedule)
• Limited mobility first 3 days (bed rest with legs slightly apart)
• Light walking encouraged after day 4
• Packing removed day 5-7 (uncomfortable but quick)
• Catheter removed day 7-10
• First dilation training day 7-8

Week 2-4: Hotel Recovery

Discharged from hospital once urinating independently, pain controlled with oral meds, walking comfortably, dilation technique learned.

Hotel stay near hospital. Daily or every-other-day follow-up appointments for wound checks, dilation supervision, swelling assessment.

Pain/discomfort: Manageable with prescribed medications. Most patients rate post-op pain 4-6 out of 10. Dilation causes pressure/stretching sensation, not sharp pain if done correctly.

Activities:

• Light walking: encouraged daily
• Stairs: okay after day 10
• No swimming (infection risk), heavy lifting/strenuous exercise or sexual activity

Swelling/bruising: Peaks day 3-4 post-op, improves weekly. Genital area looks swollen and bruised—this is normal. Ice packs help. Final aesthetic appearance visible 6-12 months after swelling fully resolves.

Week 4-6: Final Clearance

Follow-up appointments: Suture removal (day 14-21 for external sutures—internal sutures dissolve). Surgeon assesses healing, approves travel. Final dilation instructions for home.

Flying home: Minimum 4 weeks post-op, preferably 5-6 weeks. Flying earlier risks DVT (blood clots), increased swelling from cabin pressure, limited mobility during healing phase.

Trip Cost Breakdown

Budget Approach

• Vaginoplasty surgery (penile inversion): $12,000
• Round-trip flights (economy from US/Australia): $1,200-$1,800
• Accommodation (42 nights at $60-80/night): $2,520-$3,360
• Meals (42 days at $40-60/day): $1,680-$2,520
• Travel insurance with medical coverage: $300-$500
• Ground transportation, dilators, supplies: $500-$800

Total: $18,200-$21,980

You save $28,000-$58,000 compared to US surgery-only costs of $50,000-$80,000.

Premium Approach

• Vaginoplasty surgery (PPV): $22,000
• Premium economy flights: $2,000-$2,500
• Accommodation (42 nights at $100-130/night): $4,200-$5,460
• Meals (42 days at $60-80/day): $2,520-$3,360
• Travel insurance: $400-$600
• Ground transport, private nursing, quality dilators: $1,000-$1,500

Total: $32,120-$35,920

Still $14,000-$44,000 less than US surgery alone.

How Konkai Helps

Medical tourism for gender-affirming surgery involves: comparing surgeons you've never met, understanding technique differences that affect your entire future, navigating WPATH requirements across countries, managing 6-week stay in foreign city during vulnerable recovery.

Free personalized quotes from your preferred surgeon. Get an accurate cost indication, recommendation on which surgery techniques are the best option and get any questions answered.

Complete journey coordination at no extra cost: Virtual consultations, surgery scheduling and hotel recommendations near hospitals. See us as a local friend who helps you through it all.

Support during your stay. English-speaking team available via WhatsApp, phone and email.

Honest guidance, not sales pressure. We do not push you towards certain hospitals, surgeons or procedures. We provide the information for you to make an informed choice and assist with scheduling and coordinating your travel and care.