SRS Surgery Thailand: Biography of Dr. Juta Jansi

SRS Surgery Thailand: Biography of Dr. Juta Jansi: "DR. JUTA JANSI M.D., F.R.C.S.T. PLASTIC AND RECONSTRUCTIVE SURGEON doctorjuta@gmail.com Dr.Juta Jansi is recognized as one of the most exper..."

Biography of Dr. Juta Jansi

DR. JUTA JANSI M.D., F.R.C.S.T. PLASTIC AND RECONSTRUCTIVE SURGEON

doctorjuta@gmail.com

Dr.Juta Jansi is recognized as one of the most experienced cosmetic surgeons in Thailand, for his excellent surgical results and low rate of complications. His cosmetic surgical experiences cover minor and major operations including face, breast, body contouring, and sexchange, especially special exclusive techniques for better results in durability face lift, intraoral facial bone surgery, scarless sexchange surgery(male to female).

EDUCATIONAL BACKGROUND

· Doctor of Medicine, Chulalongkorn University, Thailand, 1984

SPECIALTY TRAINING

· General Surgery, Chiangmai University, Thailand, 1990

· Plastic and Reconstructive Surgery, Chulalongkorn University, 1996

DIPLOMA

· B.Sc.MD.

· Diplomate Board of General surgery, F.R.C.S.T.

· Diplomate Board of Plastic & Reconstructive Surgery, F.R.C.S.T.

MEMBERSHIPS

· Society of Plastic and Reconstructive Surgeons of Thailand

· Society of Aesthetic Plastic Surgeons of Thailand

· Royal College of Surgeons of Thailand

INTERNATIONAL TRAINING/SEMINARS ATTENDED

· American Society of Plastic & Reconstructive Surgeons, Dallas, Texas, USA

· Fellowships in Cranio-Maxillo-Facial Surgery, Changkang General Hospital, Taipei, Taiwan, 1997

· Fellowships in Microsurgery, Changkang General Hospital, Taipei, Taiwan, 1997

WORK EXPERIENCE – 24 YEARS

· General Practitioner, Chiangrai General Hospital, Thailand

·  Surgical Consultant, Surgical Department, Chiangkam General Hospital, Thailand

· Teaching Staff, Surgical department, Srinakarinwirot University Hospital, Thailand

· Plastic and Reconstructive Surgery, Chulalongkorn General Hospital, Thailand (including sexchange surgical training with Dr.Preecha Tiewtranon

· Surgical Staff, Cosmetic Surgery Unit, Yanhee International Hospital, Thailand 1998-2008

· Cumulative cosmetic surgery cases over 10,000 cases

AT PRESENT

· Plastic Surgery Unit, Bumrungrad International Hospital, Thailand

· Cosmetic Surgery Unit, Samitivej Srinakarin Hospital, Thailand

· Miracle Cosmetic Surgery Center Formerly Paknam Cosmetic Surgery Clinic, Bangkok, Thailand

SRS Surgery Thailand: FAQS on Male to Female SRS

SRS Surgery Thailand: FAQS on Male to Female SRS: "Who is the candidate for sex change MTF surgery? A suitable candidate for sex change MTF surgery is a person who has been diagnosed with at..."

FAQS on Male to Female SRS

Who is the candidate for sex change MTF surgery?

A suitable candidate for sex change MTF surgery is a person who has been diagnosed with at least one of the following disorders:

• gender identity disorder
• gender dysphoria
• associated conditions

What are the requirements to have sex change MTF surgery?

As our doctors follow Transgender sex change guidelines from "The Harry Benjamin International Gender Dysphoria Association's Standards of Care for Gender Identity Disorders" a patient must meet the following requirements before having the surgery:

1.) Legal age of maturity age in the patient's nation.

2.) Psychology certificate stating that you are a suitable candidate for sex reassignment surgery by a psychiatrist or clinical psychologist who is a professionally qualified specialist in the field of gender dysphoria.

3.) Hormone therapy certificate stating that you have been on hormone for at least 1 year.

Where can I take hormone treatment?

A patient should see an obstetrician-gynecologist to ask for a hormone prescription. Side effects can be bad if there is over dosage. It is not advisable to take hormone on your own since you should be monitored for side effects while taking it.

Where can I get the psychology certificate?

A patient of sex change surgery should see a psychiatrist or clinical psychologist who is a professionally qualified specialist in the field of gender dysphoria.

What are the effects of estrogen hormone?

Genetic males treated with estrogen may expect the following results: breast growth, some fat redistribution to approximate a female body, decreased upper body strength, softening of skin, some decrease of body hair, slowing or stopping of scalp hair loss, decreased fertility and testicular size, less frequent and less firm erections. These changes are reversible, except for breast growth which may not regress after hormones are discontinued.

How is the sexual life after the surgery?

After sex change surgery, a patient can have normal sexual sensation. Sexual arousal is not only a physical sensation but it is also very much a psychological experience. It means that for you to have a fulfilling sexual experience, you have to be ready in both aspects. During removal of the penis and testicles, the skin, together with its nerve supply, are retained and used to line the new vagina. Also, a new clitoris will be formed from part of your glans penis (head of the penis) also with its nerve supply intact. Therefore, with this in mind, sexual sensation is still guaranteed.

How long should I stay in Thailand for sex change surgery?

In order for a patient to have sex change surgery, the patient should stay inThailand at least 2-3 weeks to complete a whole process and allow the proper healing. On an arrival day in Thailand, a patient should stay in a hotel to relax from a long flight and have a surgery on the following day. Gender reassignment surgery from male to female will require a patient to stay in the hospital for Approximately 14 nights.

How is surgery performed?

The sex change surgery is safe and effective. It takes approximately 4-8 hours. The procedure begins with the surgeon creating the vaginal cavity between rectum and the urethra by cutting some of the pelvic floor muscles to insert the neo-vagina. The surgeon then makes an incision to open the penis. The urethra is shortened and re-routed to emerge lower, just above the new vaginal opening. After the vaginal cavity is created, the surgeon cuts the scrotal skin to removes the testicles. The scrotal skin including the surrounding tissue is then used to construct the external genitalia such as labia minora and labia majora to create a neo-vagina similar to the biological female genitalia.

The surgeon uses the “Penile Inversion Vaginoplasty” technique which turns the penile skin inside out to line the vaginal wall. This technique limits the depth of the vagina depending on the amount of the penile skin available. In patients with short or small penis or who have had circumcision, the surgeon uses the scrotal skin graft in conjunction with the penile skin to increase the vaginal depth, usually 6-7 inches. The surgeon then constructs the clitoris by retaining a small section of the glans penis with its blood supply and nerves intact, since the nerves of the glans penis is analogous to the nerves of the clitoris in female. This is then positioned above the urethral meatus. At the same time the labia minora is created using part of glans penis and prepuce skin.

What is the post-surgical care?

After sex change surgery, the patient will be under the surgeon’s close supervision and he will inform you of everything you need to know. The following post-operative care guidelines should be observed:

• The first 2-3 days the patient will be on a clear liquid diet and must avoid fibers and milky beverages that can induce defecation to avoid infection.
• At bedtime, use the wrap to lie between legs while sleeping to prevent the wound being pressed.
• Use a vaginal douche or sterile solution to clean the wound to prevent infection.
• The patient will be able to walk after 5-7 days
• Use a small size dilator and gradually increase in width and size, as you feel fit. You should dilate the neo-vagina 3-4 times a day. Dilation is needed everyday for 2-3 months then once a day after one year.
• 2 weeks after surgery return for a follow-up check and removal of stitches.

You should not engage in sexual intercourse until at least 2 months after the surgery.

What are the possible risks and complications?

The possible main risks are swelling, bruising, bleeding, infection, scarring and numbness, or change in sensation. Following the surgeon’s advice will reduce risks and complications. 

SRS Surgery Thailand: Adam's Apple Shaving (Thyroid Cartilage Shaving)

SRS Surgery Thailand: Adam's Apple Shaving (Thyroid Cartilage Shaving): "Adam's Apple Shaving (Thyroid Cartilage Shaving) is a surgical procedure in which the thyroid cartilage is reduced in size by shaving down ..."

Adam's Apple Shaving (Thyroid Cartilage Shaving)

Adam's Apple Shaving (Thyroid Cartilage Shaving) is a surgical procedure in which the thyroid cartilage is reduced in size by shaving down the cartilage to achieve a more feminine appearance. The procedure can be done as an out patient surgery under local anesthesia or under a general anesthesia. The incision is usually 2-3 cm in length. The surgeon makes a horizontal incision at the highest crease of the skin on the throat below submental (chin) area then the vertical muscles in the throat are separated to expose the cartilage.  The thyroid cartilage is reduced, usually by shaving in the most prominent area and the rim of its upper border. The thyroid cartilage contouring is a delicate process and need to be done meticulously especially for those who have calcified (hard) cartilage due to aging process.

Duration of the operation:

The feminization of the Adam’s apple (trachea shave) takes about 1 hour

Post operative care:

• During the first 24- 48 hours, patient may experience some varying degrees of swelling and temporary mild voice weakness that includes lowering of pitch and hoarseness following surgery.
• Apply ice pack to the surgical site for a couple of days to gradually decrease swelling. Swelling will subside over 1-2 weeks and bruising resolves in 1-3 weeks.
• Patient must rest voice following surgery. Avoid shouting or singing for 2 weeks after surgery.
• The procedure leaves a prominent red scar that lightens over 1-3 months.
• Patient will have stitches often supplemented by surgical tape or butterfly bandages for a few days.
• Wound dressing is performed daily. Stitches and tape must be kept dry at all times.
• Patient must avoid electrolysis immediately around the incision until surgeon recommends it to continue.
• Application of antibiotic ointments, vitamin E oil, or other topical preparations is prescribed by some surgeons to aid healing process.

Recovery period:
A piece of gauze will cover the incision for the first 2 or 3 days after Adam’s apple reduction. For about 7 to 10 days you will probably have a burning sensation and some difficulties when swallowing or talking. Patients who underwent Adam's apple removal report that the post op sensation is very similar to a simple sore throat, including a reduction in the ability to speak loudly.

Possible risk and complications:
Complications include permanent change in vocal quality which is the result of too much revision or over dissection of the cartilage that may injure the vocal cords, infection may also occur and hematoma.

Anesthesia use:
Adam's apple removal is done under general anesthesia, with other procedures of facial feminization surgery, or alone.

Hospital admission:
This procedure may be performed in the cosmetic surgeon’s office-based facility, an outpatient surgery center, or at a hospital. This procedure is usually done on an outpatient basis

Preparation before the surgery:

• Assessment of the medical history (any allergies, serious medical condition and all medications taken both prescribed and non-prescribed), physical examination, and laboratory tests will be performed during consultation.
• Blood and urine samples will be collected for routine preoperative laboratory tests. X-rays may be taken to evaluate the individual's bone structure.
• Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process.
• You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout your recovery period.
• Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.

SRS Surgery Thailand: Scarless Male To Female Sexual Reassignment Surger...

SRS Surgery Thailand: Scarless Male To Female Sexual Reassignment Surger...: "With the rapid advances in knowledge, several techniques were used to create the vagina; however, Dr. Juta”s technique is one of a kind, “Th..."