This procedure is done for women who want to correct vaginal laxity after childbirth or those who have a rise in the vagina based on age, menopause, or birth complications. Vaginal tightening may improve the appearance of the vagina, which is a cause of lower self-esteem in some women and may address problems with sexual dysfunction. Vaginoplasty can also be done for both reconstructive and cosmetic purposes.
The most popular technique of vaginoplasty is a penile inversion operation. The penile skin is used in this procedure to create a vaginal liner. Labia majora is made from scrotal skin and the clitoris is made from the delicate skin at the tip of the penis. The prostate is left in a position where it can act as a G-spot-like erogenous zone.
In certain cases, there is not enough skin to cover the requisite depth of the vagina, so the surgeons can take a grafting of the skin from the upper hip, lower abdomen, or inner thigh. Scarring from the donation site is normally concealed or limited.
The use of such skin grafting to create a vulva is a subject of controversy among plastic surgeons. Some claim that the extra skin makes for a better cosmetic look. Others do not agree that versatility should be compromised. Donation site skin is never as sensitive as genital skin.
Penile inversion vaginoplasty is considered the best genital reconstruction procedure by plastic surgeons and is recommended by the Center of Excellence for Transgender Health.
There is another method that uses the colon liner instead of the penile membrane. Research on the effects of this operation is minimal.
One positive aspect of this treatment is that the tissue is self-lubrication, while the vagina made from penile tissue is based on artificial lubrication. However, due to related complications, colon tissue is usually used only in the case of a failed penile inversion.
Many women who have a vaginoplasty end up getting a second operation to enhance the appearance of the labia. The second treatment, called labiaplasty, offers an opportunity for physicians to work with healed tissue to adjust the alignment of the urethra and vaginal lips. And according to the Center of Excellence for Transgender Wellbeing, secondary labiaplasty, which is much less intrusive, provides the best outcomes in cosmetics.
You will consult your surgeon and an anesthesiologist on the morning of your surgery. They’re going to send you an overview of how the day is going to play. They’re probably going to give you an anti-anxiety prescription or some sedative to help you relax. Then they’ll carry you to the operating room.
Through your penile reversal vaginoplasty, you would be under general anesthesia, lying on your back with the legs in the stirrups.
The process is complex, involving delicate tissues, vasculature, and nerve fibers. Here are a couple of broad strokes:
The urethra is detached, shortened, and prepared for repositioning until the remaining portion of the penis is amputated and discarded.
It’s all sutured together and bandages are added. The entire process will take between two and five hours. Usually, the bandages and the catheter remain in place for four days, after which time postoperative measures should be taken.
There are often risks involved with surgery, but complications of vaginoplasty are uncommon. Infections will usually be cleared with antibiotics. Such immediate post-surgical threats include:
Part of the skin around the scrotum is hairy, as are the areas that skin grafts are removed. Speak to your surgeon about where your fresh vaginal skin is being harvested. You can need to complete a full electrolysis process to remove the potential for vaginal hair growth. It can take a few weeks or months.
Follow the orders of your physician the night before and the morning of your surgery. Generally, after midnight on the night before anesthesia, you do not eat or drink anything.
For all other operations, Vaginoplasty preparations often enable you to be conscious of a few do’s and don’t have the following:
Remember to tell your surgeon and anesthetist about your health and all the prescription and non-prescription drugs, including vitamin, mineral, and herbal supplements that you are taking, during your vaginoplasty pre-operative appointment.
Your surgeon will ask for regular pre-operative blood, semen, pap, and pregnancy tests to make sure you are not pregnant.
If you smoke, stop smoking 2 weeks before your vaginoplasty to prevent healing complications during the recovery process.
Eat a healthy diet to help speed up the recovery from vaginoplasty.
Do not eat or drink at least 10 hours before your vaginoplasty.
Do not have sexual relations the night before the phalloplasty to help the surgeon test the vaginal tissues properly.
Speak to other people who have had their experience with bottom surgery.
Converse to a psychiatrist or psychologist in the months leading up to your surgery to brace yourself emotionally.
Create arrangements for the future of your reproduction. Speak to your doctor about your choices for retaining fertility (saving sperm samples).
Create a postoperative plan for your family and friends; you’re going to need a lot of help.