chonburi flap in the USA?

[Guest Jo-88]

Ok so some recent threads got me thinking about this (notably the ones about insurance coverage and orgasm post SRS). So I will be frank I would rather have no SRS than penile inversion... I have my reasons for this. I will save the money to pay for Dr. Suporn out of pocket even if my insurance would pay for a US surgeon to do penile inversion. I believe that the chonburi flap technique is technically the most advanced. And as far as tissue to tissue comparisons with a genetic woman the chonburi flap technique is the most accurate (Supposedly) and it also doesnt require genital electrolysis prior to surgery.

It also provides greater sensitivity on the outside of the vagina than the inside which is not really the case with traditional SRS (except for the neo clitoris). Considering I am primarily attracted to women and am more likely to end up in a lesbian relationship, penetrative sex isnt at the top of my post SRS wish list. Now I am sure many or you and many of your doctors may disagree with the above statements but after pouring over the documentation I am convinced they are mostly accurate. Enough that to me it is the only choice.

We only get one shot at SRS, I dont think I am wrong for wanted it to match my needs as well as it can (regardless of money). Not saying there is anything wrong with penile inversion, it is tried and true and has a shorter recovery time that the chonburi flap so for some it may be better... it is just not the option I personally want to go with.

Ok so I have two related questions. First I know that Dr. Suporn trains other surgeons on his technique as his waiting list is a mile long so its not like he is really hurting his business. He has written papers on his technique (known as the chonburi flap) and tries to get others to adopt it. But I cannot find a single surgeon in the US that has performed this procedure. Maybe I am not looking in the right places... so, do any of you know of a surgeon in the US that has performed or will perform the chonburi flap technique of SRS?

Second question is this, assuming someone has insurance that will cover SRS do you believe it is possible for insurance to cover a procedure out of country? I have heard of this happening before but it is pretty rare, but it does make sense because the insurance company would generally save money on out of country operations (Dr. Suporn charges about $10k less than a US surgeon performing penile inversion). My dental insurance is covering a large portion of my dental work in mexico so its not unheard of... but obviously this is a totally different scenario.

I am afraid the answers to both of these are no... but it doesnt hurt to ask.

[Guest LizMarie]

Suporn's rate of complications and revisions seems high from what I have read. One woman who went there and had to undergo revisions there as well said it this way - when Suporn is good, he's very very good; but when he's bad, he's very very bad.

[Drea]

Having looked up the technique, what is unclear to me is how it differs from what other surgeons do?

The key feature seemed to be using scrotal skin for the vaginal lining and penile for externals. How does that differ from other surgeons?

Or is it something else entirely?

[Guest Jo-88]

Having looked up the technique, what is unclear to me is how it differs from what other surgeons do?

The key feature seemed to be using scrotal skin for the vaginal lining and penile for externals. How does that differ from other surgeons?

Or is it something else entirely?

You just said it right there in your post... the penile inversion is the exact opposite, most of the penile skin (which has more nerve endings) goes on the inside and the labia are constructed of the scrotum. With the chonburi flap the labia are entirely penile skin and the vaginal lining is a mix of penile skin and scrotal skin. This means more sensitive labia (theoretically) and a less sensitive vaginal cavity (again theoretically). There is also the upside of not having to have genital electrolysis with the chonburi flap as the scrotal skin is completely removed and then the hair follicles are cut out with a scalpel then the remaining tissue is used like a graft.

There are more risks with the chonburi flap as it is much more complex, requires more time on the operating table, significantly more sutures, etc. Because of this the recovery time is much greater and the after care procedures are much less forgiving. In fact most of the negative results I have read about are because the patient didnt follow the after care instructions to the T. I personally have no problem following exactly what the doc says. And according to the info on his site I am an ideal candidate except for I am circumcised. I believe I would have good results with this technique. Besides lets not forget there are some penile inversion results that are downright horrible... so as with everything YMMV. If you arent willing to take some risks with this then surgery probably isnt a wise thing to do anyway.

[VickySGV]

Well -- you just described my basic surgery with Bowers as far as the labia, scrotal skin and penile skin. Brassard in Canada does very close to this same thing. You are close enough to Bowers' office that it would not hurt you to call them and see if you can go in and watch her video of the surgery. Even if she is not in the office the girls can put it on the video in the waiting room, in fact someone was watching it the day I had my packing taken out and was told it was ok to go home. I did not have any scrotal electro for my surgery, although she said it was an option as just in case.

What I do not have is some bulk from erectile tissue that Suporn stuffs in above your clitoral hood. That is the stuff that causes the most need for revision and can goof up urination even if you take the best care in the world.

If you are intent on Suporn, go ahead, you are the young and beautiful type of patient that Suporn wants to have on his table.

[Guest Jo-88]

Oh yea Vicky you touched on another difference, the retention of some of the erectile tissue around the labia and behind the clitoris. Yes it definitely can go wrong, but if it is done right that would be appealing to me. And of course there are similarities with all the SRS techniques, it is not as though they are completely different.

Also I may be young, but I am not beautiful by any means... if you met me in person you would see >_<

[Guest Valerie]

Jodie

From what I have researched Dr. Suporn has increased bis price as of last month. He now charges $21,000.00 USD for his SRS. With his procedure he promises a deeper depth then other surgeons produce.

I decided to go with Dr. Preecha's clinic instead. He is the person that has taught all of the surgeons in Asia.

Dr. Preecha is also the doctor that all the other doctors send their patients to when they can't fix their mistakes.

From my research and talking to other ladies, I agree with Vicky. When he is good, he is very good and when he is bad he can be very bad.

Good luck.

[Guest KimberlyF]

This can quickly turn into a fanboy-type discussion. My video game is better than your video game!

I've said in the past that if I had the choice to end up on the table of any of the well respected surgeons one day, I'd see it as a good thing in my life.

I do have to say, though, that blaming the patient for something going wrong also falls into the 'my system is better' mentality. It does not make a difference how perfect one takes care post-op, things can happen. The more involved a surgery, the more likely it is that something can go wrong. A simple cough can pop a suture. A coughing spat?? Would that in some way be concidered not following post-op care?

All surgeons make mistakes. It is a reality anyone looking in to surgery should understand. And attacking people with complications post-op based on surgeon loyalty is silly. Nobody knows all the facts. Unless the patient blatantly talks of not following directions. "Dilating is so stoooped! I lost some depth because Meltzer sucks!" If something like this happens, then yeah patient error could be the cause and mock away.

I also had no laser or electrolysis done prior to surgery. I don't get any compensation or validation for talking up my surgeon, so I won't. Just have to point out misinformation (like the electro) when I see it. So much 'research' is done by reading others posts and things on the net. If unsure, the best source would always be the surgeon themselves.

That said, I've not heard of any surgeon in the US doing this procedure. Not saying it doesn't happen? Maybe there's some guy in Idaho who does breasts, cleft palates and Chonburi flap-speaking of fanboys, it sounds very Trekkie or Trekker if you prefer.

[Drea]

Having looked up the technique, what is unclear to me is how it differs from what other surgeons do?

The key feature seemed to be using scrotal skin for the vaginal lining and penile for externals. How does that differ from other surgeons?

Or is it something else entirely?

You just said it right there in your post... the penile inversion is the exact opposite, most of the penile skin (which has more nerve endings) goes on the inside and the labia are constructed of the scrotum. With the chonburi flap the labia are entirely penile skin and the vaginal lining is a mix of penile skin and scrotal skin. This means more sensitive labia (theoretically) and a less sensitive vaginal cavity (again theoretically). There is also the upside of not having to have genital electrolysis with the chonburi flap as the scrotal skin is completely removed and then the hair follicles are cut out with a scalpel then the remaining tissue is used like a graft.

The reason I posed the question is that the things I mentioned and you mention are features of what I know other surgeons are doing. I suppose there are some surgeons out there still doing a pure penile inversion, but I don't know who they are. As Vicky has pointed out there are two surgeons we are doing the same thing. I know such had been done 20 years ago including not needing to do genital electro and including using some of the erectile tissue. Now the only thing mentioned about that procedure that sounds possibly unique is using erectile tissue in labia, but to me that seems...well just odd.

Now maybe there are some other subtle differences, how and where cuts are made but even some of the details you described I know match what other surgeons do.

There is a great deal of wrong information out there however.

The need to do genital electrolysis. Lots of surgeons don't require it for the exact reasons you describe. I know part of the problem with the faulty information is partly due to the surgeons themselves having dated material. I know in Montreal with Menard and Brassard had wrong info years after they personally were saying never need with them to have genital electro and even the office people would give out the wrong info.

The thing about using scrotal skin, that was being done 20 years ago by other surgeons.

I've been told by some they were going to Bowers because she is the only one using a single step procedure. That she invented it even. Despite the fact that others were doing it for a decade prior to when she started doing the surgery.

Depth, that can be another discussion. If it is just using scrotal skin that gets the extra depth, how does it differ from others who use that skin? Now I could name a couple US surgeons who I know who don't typically provide good depth, but there are also ones that do.

One thing I find in the depth discussion that never gets mentioned is there is only so much distance internally till one runs into the back side of the pelvic bone. Now the curved dilators help with that, but by time 5 or 6 inches is reached you are in that area.

I am not making judgments about this doc. I have heard positive things for sure. I am just noting that the comparison only works with a surgeon doing a pure penile inversion and I don't think most are these days. And that other things like no need for electro aren't unique either.

[Guest Jo-88]

This can quickly turn into a fanboy-type discussion. My video game is better than your video game!

I've said in the past that if I had the choice to end up on the table of any of the well respected surgeons one day, I'd see it as a good thing in my life.

I do have to say, though, that blaming the patient for something going wrong also falls into the 'my system is better' mentality. It does not make a difference how perfect one takes care post-op, things can happen. The more involved a surgery, the more likely it is that something can go wrong. A simple cough can pop a suture. A coughing spat?? Would that in some way be concidered not following post-op care?

All surgeons make mistakes. It is a reality anyone looking in to surgery should understand. And attacking people with complications post-op based on surgeon loyalty is silly. Nobody knows all the facts. Unless the patient blatantly talks of not following directions. "Dilating is so stoooped! I lost some depth because Meltzer sucks!" If something like this happens, then yeah patient error could be the cause and mock away.

I also had no laser or electrolysis done prior to surgery. I don't get any compensation or validation for talking up my surgeon, so I won't. Just have to point out misinformation (like the electro) when I see it. So much 'research' is done by reading others posts and things on the net. If unsure, the best source would always be the surgeon themselves.

That said, I've not heard of any surgeon in the US doing this procedure. Not saying it doesn't happen? Maybe there's some guy in Idaho who does breasts, cleft palates and Chonburi flap-speaking of fanboys, it sounds very Trekkie or Trekker if you prefer.

Like I said Kim every single surgeon I have read about has bad results at some point or the other. I think the tone of your response tells me the kind of attitude I can expect from these sorts of questions on Lauras. This will be the last time I ever ask any surgery related questions on Lauras.

P.S. I was bullied for years for being a video game nerd and now I work in the industry for a living. Your analogy was obviously meant to make my question seem childish and that is unacceptable in my opinion. Besides since you like analogies how about this one... if you have to buy one car and that car has to last you for life and lets say all cars cost the same but each dealership only sells one type of car, do you go listen to what the car dealer has to say about their car? Or do you go talk to people who have bought the car? Also if it costs the same and you have to live with it, do you go with the ever reliable honda... or do you take the risk on getting the BMW? I personally would risk getting a lemon and go with the BMW, that is me and that is my decision... all I am asking on this forum is *where I can buy said BMW.

[Guest kristendk]

Jodie,

I don't know if that was Kimberly's intent or not, but I appreciate this kind of question and hope you will continue to ask them.

Kristen

[Guest KimberlyF]

Like I said Kim every single surgeon I have read about has bad results at some point or the other. I think the tone of your response tells me the kind of attitude I can expect from these sorts of questions on Lauras. This will be the last time I ever ask any surgery related questions on Lauras.

I'm glad that you have discovered how to pick up tone on the net. It's a rare gift. I'm sure mine will be easier to pick up this time. I mentioned the fanboy thing because on vid game forums, someone would mention a platform, and people would take sides based on who made it and which system they liked best. It doesn't make your question lack relevance and I pointed out that I show zero loyalty to my surgeon. We had a business arrangement. Others can take these discussions personally as if by slighting their surgeon, you are slighting them.

P.S. I was bullied for years for being a video game nerd and now I work in the industry for a living. Your analogy was obviously meant to make my question seem childish and that is unacceptable in my opinion. Besides since you like analogies how about this one... if you have to buy one car and that car has to last you for life and lets say all cars cost the same but each dealership only sells one type of car, do you go listen to what the car dealer has to say about their car? Or do you go talk to people who have bought the car? Also if it costs the same and you have to live with it, do you go with the ever reliable honda... or do you take the risk on getting the BMW? I personally would risk getting a lemon and go with the BMW, that is me and that is my decision... all I am asking on this forum is *where I can buy said BMW.

I said "This can quickly turn into a fanboy-type discussion. My video game is better than your video game!"

This CAN quickly turn into...my video game is better...

So it hasn't yet. It has zero to do with any post you've made. It has to do with post-ops defending their choice, their video game. You are still in the shopping phase. YOU DONT EVEN HAVE A VIDEO GAME. It doesn't apply to you. I don't know if by pointing out that as a pre-op, it doesn't apply to you now makes you offended that my analogy is exclusionary. I'm also very sorry that you obviously couldnt follow my analogy and choose to be offended from the onset based on your tone reading skillz. I wonder if this choice isn't limited to just this topic? Do you often storm away feeling wronged from situations instead of trying to talk through the conflict?

I also said "I've said in the past that if I had the choice to end up on the table of any of the well respected surgeons one day, I'd see it as a good thing in my life."

Now if I was not obsessed with the surgeon I ended up with, why would I care one bit how much time or effort you spend looking for yours? Honda, or BMW...I couldn't care less. Do you think I'm lying to you?

I mentioned that I know of nobody who does the procedure here in the USA. That is an answer to the actual question that was asked. None of the surgeons that are considered near most peoples 'tops' list do it. Is that what you mean by what to expect to an answer to your question here? An answer?

So in your analogy you believe talking to the actual surgeon is like a car dealer? Yes, the surgeon is trying to sell you something, but on the net, you can't even tell if the person on the other end is old enough to drive, let alone owns the car they're talking to you about. Like that analogy? Obviously the surgeon is going to be pushing their product, but I said the best source of information or facts like type of procedure, cost, time to recover, side effects, qualifications, number of procedures performed, things such as weight and electrolysis and testing needed prior to surgery-for this stuff and others, the best source of factual up-to-date information would come from the surgeon or surgeon's office.

[Guest Jo-88]

Excuse me but I have a right to have a problem with snarkiness and your response was snarky and this one is even more so... if we can't approach this topic like adults then lets not discuss it at all. As the OP I am requesting we keep the discussion focused on the two questions asked... Do other surgeons outside of Thailand (USA specifically) do this procedure? What is the likelihood of insurance covering out of country procedures?

Anything else is outside the scope and will lead to this thread devolving out of control.