Vaginoplasty

Our team of surgeons uses a surgical technique that includes a single step, i.e. penile inversion (the skin of the penis is grafted inside the vagina) coupled with the autograft of a neurovascular flap from the glans which will be used to create a sensitive clitoris. Doctor Brassard has redefined the standards in vaginoplasty by making improvements to this technique, which has earned GrS Montréal to be considered as one of the best centers in the world in the field of man to woman gender affirming surgery.

It is possible to combine vaginoplasty with one or more other surgeries.

Expected results:

• A vagina deep enough to have penetrative sex;
• A clitoris made up of the sensitive skin of the glans;
• A hood covering the clitoris;
• A vulva with labia minora and labia majora;
• Erogenous zones (clitoral and vaginal) with the possibility of sexual pleasure.

Vaginoplasty requires care that you will integrate into your daily routine for the rest of your life. This care includes a regular routine of vaginal  dilations and hygiene. Following this routine will have a significant impact on the results of your procedure.

Highlights of the surgical technique used:

• The skin of the penis is inverted and paired with the skin of the scrotum to create a vaginal cavity of adequate depth.
• A portion of the glans of the penis is kept attached to its nourishing vessels (artery and veins) as well as to the nerves thus allowing to create a sensitive and erogenous clitoris.
• By using your own tissues to recreate the delicate details of the vulva (labia minora and labia majora, clitoris, clitoral hood).

The surgeon will verify that there is enough penis and scrotum skin to create a fairly deep vaginal cavity. If the total amount of skin from the current genitals is insufficient to line the inner wall of the vaginal cavity, an additional skin graft can be taken from another body part (back, thigh, buttock) and grafted into the vagina. Your surgeon will advise you following your physical examination if it will be necessary to have a skin graft. The area of the skin graft may show slight discolouration once healed.

During the procedure, the surgeon will:

• Remove the scrotal skin, which will be thinned and freed of visible hair through cauterization of the roots;
• Remove the testicles;
• Dissect the penis – the skin will be inverted to be grafted to the interior of the vaginal cavity;
  • The internal structures of the penis and the glans will be exposed:
    • The corpus cavernosa will be removed;
    • Part of the blood vessels and nerve endings will be released to create the clitoris. A piece of skin in the shape of a cone will be taken directly from the glans to form the clitoris. The clitoris will be positioned and fixed. The urethra will be dissected; the remaining tissue will be preserved to coat the inside of the labia minora, which will result in normally pink labia minora providing a more natural result than with a skin graft

• Create the labia majora;
• Create the vagina by dissecting, to a depth of 5 to 6 inches, the tissue below the meatus and along the Denonvilliers fascia (the space between the prostate and the rectum). The prostate is left in place: to remove it would cause irreversible urinary incontinence;   

It is possible to perform a vaginoplasty without creating a vaginal cavity.

Benefits of this surgical technique:

• A surgical technique in one single surgery;
• In the case where skin removed from the penis and scrotum is in sufficient quantity to create the vaginal cavity, no skin graft will be taken from a visible part of the body, such as the abdomen, thigh, or buttock;
• The addition of the scrotal skin to the skin of the penis provides a deeper vaginal cavity;
• The use of existing tissue to recreate the delicate details of the vulva (labia minora and majora, clitoris, clitoral hood) eliminates strain on the tissue forming the new genitals.

* The appearance of the genitals will be very different from person to person. Some people have a more rounded mons pubis, less protruding clitoris, fuller labia majora, or labia minora of varying sizes.

• Vaginoplasty Information Booklet Part A
• Vaginoplasty Information Booklet Part B

Postoperative care:

During your convalescence, you will be provided with the document Information and Postoperative Care – Vaginoplasty. This document contains your surgeon’s instructions and will serve as a guide.

Download the document Information and Postoperative Care – Vaginoplasty.