Vaginoplasty is considered an irreversible and good option for healthy patients who want gender affirming genital surgery.  

 

PREOP REQUIREMENTS for vaginoplasty include:

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• Three letters (2 from mental health professionals, 1 from a hormone provider or primary care doctor).

• Overall good health.

• No smoking, nicotine, or any other inhalational products (including second hand smoke) around 3 months before and after surgery. This can cause about a 5-fold increase in complications. Patients who smoke within this 3 month window before surgery may be rescheduled for a later time when then they have reliably stopped smoking.

• Hair removal.

• Perioperative assistance (friends, family, hired help).

• Surgical technique, anatomy, and genetics dictate most of the individualized aesthetic results.

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PROCEDURE OVERVIEW:

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General information:

• Team members: Reconstructive Surgeon, associated surgical and perioperative care staff

• Duration of surgery: 4 - 5 hours

• Duration at medical facility: 3 nights on average

• In town stay: 4 weeks on average

Surgery:

• The testicles are removed and excess scrotal skin is excised; residual scrotal skin will be used to create the labia majora.

• Penile skin is preserved for construction of the vaginal canal. For a majority of patients, scrotal skin is used as the deeper portion of the vaginal lining. In some instances, additional skin from the groin or abdomen can be recruited.

• Urethral shortening: the urethral excess is excised. A portion of the urethra is used for the internal lining and the inner labia minora. The new urethral opening is placed in anatomical position above the vaginal opening.

• Clitoroplasty: the glans of the penis is reduced in size and positioned appropriately, and a clitoral hood is created; the neurovascular bundle is kept intact. 

• Below are illustrations that represent the procedure. Note that individual results will vary and that each patient may have results that differ from the final cartoon.