Vaginoplasty is a procedure to create or repair a vagina. It is also a Genital affirmation surgery that helps transgender patients to recognize their authentic gender. At IM GENDER, we are experts in the three different MTF vaginoplasty techniques available, such as penile inversion vaginoplasty, penile inversion vaginoplasty with graft, and colovaginoplasty.


At IM GENDER, we have the most advanced tools and technologies to perform transgender vaginoplasty with safety. Our team is continuously undergoing training and has extensive experience in this type of genital surgery. In addition, we understand the different sexual preferences that transgender people may encompass. Consequently, we also offer vulvoplasty, an option that provides the same aesthetics and sensitivity as vaginoplasty but without the creation of a tunnel. 

We know that every person is unique and has specific needs, which is why we offer personalised attention that adapts to your needs. Our team will be by your side to guide and support you at every step, from the initial consultation to postoperative care. At our clinic, we ensure that the vaginoplasty process is as safe and comfortable as possible, so that you can enjoy the results safely and without worry. We are committed to your well-being and satisfaction.

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    Vaginoplasty results

    At IM GENDER, we know that knowing real cases is important before making any decision. In these images, you can see real cases of patients who have been treated at the clinic, so that you can get an idea and help you make a more consolidated decision.


    For certain trans women, vaginoplasty may be a vital and significant transition stage, while for others, it might not be a required procedure. Consequently, every trans individual should make personalised choices that cater to their unique needs.

    Before undergoing vaginoplasty surgery, the IM GENDER team will determine the appropriateness of the surgery for each person, considering factors such as their overall health, medical background, and exploring all available alternatives.

    Preparation before trans vaginoplasty

    Before undergoing male to female vaginoplasty, preparation before to create a vagina is as important as postoperative care. It is important to have a blood test at least 3 months before the surgical procedure. It is also essential to control your diet and clean your intestines. In addition, it is very important to refrain from any alcohol, tobacco, or drug consumption one month prior to the surgery. Not doing so may endanger your health, increasing the risk of postoperative complications.

    Furthermore, it is crucial to note that estrogen is not routinely discontinued before surgery. At IM GENDER, we understand the importance of maintaining hormonal medication continuity in trans women. As for anti-androgens such as cyproterone, spironolactone, and triptorelin, experience has shown that their withdrawal is not necessary. Therefore, they can be continued up until the surgery. Their complete discontinuation will take place one or two weeks after the transgender vaginoplasty.

    Finally, during your stay at the clinic, it is important to keep in mind that you will have a urinary catheter in place.

    When you visit your doctor, everything will be explained and any doubts that may arise will be clarified.


    A member of the medical team will instruct you on how to prevent possible complications and what to do in case they happen. If you have any doubts or abnormalities after the procedure, you should consult your doctor so that they can diagnose the issue and provide a solution.

    These are the most common complications that may arise:

    • Dehiscence or opening of the wound.
    • Urinary tract infection while the catheter is in place.
    • Local infections.

    If you have any doubts or discomfort, you should consult your referring surgeon or the patient care team. A 24 hour phone line will be available for you to make your inquiries.

    However the vaginoplasty risks, this procedure has enormous benefits on people’s mental health who affirms to achieve an improvement of their quality lifes.


    What is vaginoplasty surgery?

    Vaginoplasty surgery allows to repair a vagina that had been injured due to the childbirth or to solve pelvic floor disease complications. But also, vaginoplasty is a gender-affirming procedure performed on transgender women as part of their transition process. It has 3 main aims:

        • Sensitivity: We preserve all the nerves that go through the glans and prepuce, and use those structures to create the clitoris and labia minora. After the surgery, erogenous sensitivity and orgasms will be located in those areas.
        • Aesthetics: We create all the feminine structures that a vulva has, including the labia majora, labia minora, and clitoris. We also shorten the urethra and create the vaginal introitus.
        • Functionality: Depending on the patient’s sexual preferences, we adapt the surgical needs. If her willing is to be penetrated, then we will need to cover the deep vaginal canal with either penile skin or a portion of the colon.

    This surgery involves the creation of a neovagina, typically by using penile and scrotal skin, to provide the patient with a vagina that has both functionality and appearance similar to a cisgender woman’s vagina. The procedure may also include the creation of a clitoris, labia (MTF labiaplasty) and vaginal opening. The primary goal of the treatment is to help transgender women align their physical appearance with their gender identity, thereby improving their overall quality of life and well-being.

    What are trans vaginoplasty procedures like?

    When a trans woman requests genital affirmation surgery or vaginoplasty, the medical team must plan the surgery carefully, considering the needs, medical history, characteristics and personal circumstances of every single woman. Our team will evaluate the case by classifying it into three main techniques described below to remove the penis and achieve a functional and aesthetically complete vagina.

        • Colovaginoplasty: We use this technique when the penis is small or when there has been a major circumcision prior to genital reconstruction. It is also performed when there is a lack of penile development as a result of hormonal inhibitors used during the pre-puberty stage. In that case, the penile inversion technique is not recommended, as the vaginal depth would be too shallow and would not allow the trans woman to have a satisfactory intercourse.
        • Penile inversion vaginoplasty: Penile inversion vaginoplasty is performed when the size, thickness, length and quality of the penis skin allows to make a vaginal canal of sufficient width and size to have regular sexual intercourse.
        • Penile inversion vaginoplasty with graft: When a trans woman does not have the right dimensions penis for a successful penile inversion, but does not require a colovaginoplasty, she can choose to have what is known as vaginoplasty with skin graft. This technique gives a vagina the right depth and dimensions without having to use the rectosigmoid flap technique.

    Does surgery require hospital admission?

    Yes, you will be admitted one day before undergoing the operation at IM CLINIC. During that day, all the relevant tests and a bowel cleansing will be carried out, through the consumption of laxatives and antibiotics. Performing intestinal cleansing is essential due to the proximity between the intestine and the new vagina that will be created.

    Will I be able to have children?

    If you are going to undergo a transgender vaginoplasty, you can consider the option of storing sperm – sperm cryopreservation – before having this surgery, in case you wish to have children.

    Is there sensitivity with MTF vaginoplasty?

    Yes, there is sensitivity after trans vaginoplasty. Surgeons strive to preserve and create as much sensation as possible in the neovagina and surrounding areas. The clitoris, which is typically constructed using the sensitive glans tissue of the penis, often retains sensation. The overall extent of sensitivity may vary from person to person, and it can take time for nerves to heal and sensation to fully develop after surgery.


    What is the MTF vaginoplasty recovery like?

    Wound care and dilation begin at the clinic between the third and seventh day after the procedure. A member of the medical team will instruct the patient on the dilation and washing technique. For this purpose, two dilators of different sizes and a vaginal washing kit will be provided, which should be used as directed by the doctor, usually on the day of discharge.

    Will I have to be hospitalised?

    After this transgender genital surgery, you will have to stay in the clinic for at least a week so that the surgeon can follow your evolution and provide you with the necessary care for your complete recovery.




    You will eat a normal diet after surgery. But it is important that it is rich in fiber, since the first days it is common for constipation to appear. If so, you can also take a laxative.

    Urinary catheter

    You will need to carry a urinary catheter for approximately 4/6 weeks. It is important to alternate the leg on which the tube will be attached each day.


    You will have to do a relative rest, that is, you can take short walks, but you should avoid all kind of efforts and you should not overload your legs.


    Dilation is the most important aspect of your recovery. During the first month after surgery, it is necessary to perform a vaginal douche before each dilation.


    You should avoid playing sports until recommended by your surgeon. Afterwards, the medical team will tell you what type of activity you can introduce.


    It is very important you do not miss any visits after your surgery. The treatment will be personalised depending on each case and the technique used.

    IM GENDER Team

    At IM GENDER we have been specialising in the care of transgender people for more than 20 years. Two decades of experience, professionalism, research and training endorse our medical team and staff.

    Anna La Spisa
    Anna La Spisa
    28 Noviembre 2023
    Esperienza positiva chirurghi ottimi, infermiere molto preparate e dolcissime, Aida e Rosa super umane, ma la dottoressa Brandalisio ha fatto la differenza su tutti, preparata, umana, dolce, disponibile, un'amore di persona. Una critica costruttiva devo farla tutto lussuoso ma non pensato per stendere pochi indumenti lavati
    Tone Vik
    Tone Vik
    31 Julio 2023
    I had GRS in May 2023. Here is a short summary of my experience. When you contact the clinic, you’ll get a personal patient coordinator that will answer and support you through the whole process, both before and after the surgery. The communication is professional, personal and efficient. WhatsApp is the main communication platform, and it works very well. The clinic is beautiful and top notch on all levels. You almost forget that you are in a clinic and might think of it more as a hotel (with surgery services). Please see the attached pictures, and you will understand what I mean. The staff is warm and friendly and really do what they can to make you feel comfortable, from the nurses to the cleaning personnel. It is really nice to be so well looked after, and I have such good memories from my week at the clinic. The surgeons, I was so fortunate to have Dr. Labanca, but they are all world class, which ensures that the results probably will exceed your expectations. Of course this is a very personal opinion, but for me it was like that. It’s hard to describe how happy I am now. You can bring a friend or a family member for no extra cost the week you are at the clinic. My best friend came down on the 5th day, and that was also one important factor when I chose this clinic. The support you get from having a friend or family member present is almost priceless. A short 5 minute walk from the clinic you’ll find apartments you can stay at for an additional week or two while you recover and heal. It was very reassuring and comforting to have the clinic so close the two weeks I stayed after checking out from the clinic. An important part of the healing process is to just move your body, and the beautiful city of Sant Cugat is a nice 20 minute walk from the apartment, where you can enjoy shopping, restaurants and just the nice relaxing atmosphere. The aftercare and regular follow up when you have left the clinic ensures that everything is working as it should, and if not, they will correct at no extra cost. The aftercare period lasts one year after the surgery. To sum up, you are really in the best hands and in the best place at IM Clinic. I highly recommend this clinic for GRS.
    Victoria Timoniere
    Victoria Timoniere
    24 Abril 2023
    Due mesi fa ho avuto la grande fortuna di affidarmi al team di IMgender , un esperienza indimenticabile che mi ha cambiata la vita facendomi rinascere finalmente nel corpo giusto . La clinica è super moderna è attrezzata , pulita e tutto lo staff è super gentile e accogliente .
    Renn Love
    Renn Love
    14 Abril 2023
    My experience with IM Clinic from the start to where I am today has been nothing but exceptional. From my initial contact with Aida, to my consultations with my surgeons Dr's Gómez, Herrero and Beltrán, my anaesthetist and care from the nurses. The cleaning staff were extremely discrete and the food for both myself and my wife, who was also looked after during my stay, was good. Myself and my wife were made to feel welcome from the moment we arrived. On the day of my surgeries my surgeons continuously re-assured me as they could see how nervous I was and it felt like nothing was too much trouble. My wife was also informed of my progress during surgery and reassured all was ok. I highly recommend IM Clinic and would not hesitate in returning, should I feel the need.
    Sun Belardinelli
    Sun Belardinelli
    11 Marzo 2023
    Ho aspettato qualche mese dopo l'operazione prima di scrivere questa recensione perché volevo essere sicuro dei risultati. La parola che mi viene in mente è PERFETTO, la clinica è perfetta, l'operazione è andata ancora meglio di quanto sognassi, il trattamento che ho ricevuto da TUTTI, medici, infermiere, tutto il personale, è stato impeccabile, caloroso e amichevole; mi hanno fatto sentire meglio che a casa (non solo a me, ma anche alla persona che mi accompagnava), ancora meglio di un hotel di lusso; mi hanno veramente trattato come un re, non solo come un paziente. L'operazione in sé è stata perfetta, il pre- e post- operatorio gestiti benissimo anche a distanza; mi hanno dato istruzioni chiare e medicinali appositi per curare le ferite e il dolore. Grazie a questo sono rimasto tranquillo per tutto il tempo, sapendo di essere nelle migliori mani. Un consiglio che mi sento di dare a chi vorrebbe operarsi da IM è: fate tutte le domande che vi vengono in mente e anche quelle che non vi vengono in mente! Soprattutto per chi viene dall'estero come ho fatto io è importante avere ben chiaro ogni dettaglio, e le persone con cui parlerete saranno felici di chiarire qualsiasi dubbio. Raramente ho trovato persone così pazienti, competenti e alla mano. Se e quando avrò bisogno di fare un'altra operazione la farò sicuramente da IM. Ormai ho trovato il posto dei sogni e non lo lascio più!
    Alexa Valianatos
    Alexa Valianatos
    10 Agosto 2022
    Hey, I am Alexa Valianatos and on 14th June i had my vaginoplasty surgery at IM Clinic. Here i found a greate, super friendly and profesional team which whose totally prompt answering to all my needs. Viewing my research before surgery and my experience in the clinic and after that, i can say that IM Clinic I'd the best clinic in Europe at least regarding my surgery tipe and my needs, i can say 100% that i found the 5* clinic . After two months from my surgery i already decide to make the next steps for next surgery in the same clinic . Many worm thank to doctor Ivan Mañero and entire clinic team . You are the best .
    Aaron O'Donnell
    Aaron O'Donnell
    19 Julio 2022
    Thank you IM Clinic!!! I had FtM Top Surgery (double mastectomy/gender reassignment) at IM clinic in July 2021. As I was travelling from the UK I was weary about the procedure, however their standard of care goes above and beyond to accommodate their patients and ensure maximum comfort. I had surgery with Dr Herrero, who was an absolute pleasure to meet and a brilliant surgeon. The team were a delight and made me feel genuinely safe and as comfortable as possible. The procedure I had is not very common and is somewhat hard to acquire in the UK, but the team at IM Clinic took me in with ease and listened to my worries and requests. The care i received at IM Clinic was impeccable - between the food, the staff, the surgery and everything else - i cannot fault it. I am forever grateful to Dr Mañero, Dr Herrero and the entire care team at the clinic. Thank you so much!! I am now one year post-op and happier than ever.

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