Vaginoplasty: Penile Inversion

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


PREOP REQUIREMENTS for vaginoplasty include:

  • 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.



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


  • 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.