Male to Female Gender Reassignment Surgery

The penile skin inversion technique is an extensive procedure and involves many steps.

Part of the head of the penis, with its blood and nerve supply, is moved to become the clitoris. This neo-clitoris allows sensation which can allow patients to have an orgasm. Skin is sometimes used to create a clitoral hood. During the penile skin inversion technique the testicles are also removed. The penile skin is inverted to create a vagina. Typically the amount of skin available from the penile shaft will determine the depth of the vagina. For patients with short penile shafts, the vaginal depth can be increased with skin grafts from extra scrotal skin. This skin should be hairless to prevent growth of hair inside the vagina. To make sure this skin is hairless, the hair is removed first with laser hair removal or by multiple electrolysis treatments. We perform laser hair removal on as much scrotal skin as possible to allow maximal usage for skin grafting. Our goal is to prevent hair growth in the vagina which can cause dysfunction. Other sources of skin graft can include the abdomen and the flank. The scrotum utilized to contour and make the labia majora. The labia minora are created using other specialized techniques.

Though our aim is to achieve the best possible result in one procedure, there may be a need for touch up or secondary surgeries.

The vaginoplasty using the rectosigmoid colon is a specialized technique. This procedure combines penile inversion with the creation of an anstamosis (connection) to a portion of the rectosigmoid colon along with skin grafts to construct the vaginal canal. The benefits of this technique is the neo-vagina has more depth and lubrication as compared to the penile inversion technique. This procedure, however, is more invasive and does require an abdominal entry point to access the colon.

The procedure that best suits your specific needs will be discussed with your surgeon during your consultation.

At the Transgender Surgery Institute of Southern California, it is our goal to give our patients the best possible results. However in order to achieve this, sometimes secondary procedures are needed to obtain better appearance and or function. These procedures may include:

1. Labia minora augmentation
2. Clitoral hood augmentation
3. Labia major augmentation
4. Augmentation or recontouring of the mons pubis
5. Urethral set back
6. Removal of scar tissue or excessive urethral tissue
7. Vaginal canal augmentation with skin grafting

These procedures can be difficult and have to be performed in a surgery center or in a hospital in order to monitor the patient post-operatively for up to a week (at times) if there is a risk of tissue loss or infection. You will always be closely monitored by your surgeon and cared for by our amazing, dedicated surgical staff. Your safety is our priority.