Vaginoplasty with graft

This skin is usually taken from the scrotal area. The scrotal skin is usually removed after forming the labia majora, which are narrower and finer than the scrotum itself. The excess skin, instead of being discarded, is prepared for use as a graft. Grafting depths of three to six centimeters are used, as more would be unfeasible.

Since the skin of the scrotal area is usually hairy, it is very important during the graft generation process to remove the hair follicles using electrocautery so that they do not grow back. However, sometimes not all of these hair follicles may be removed, with some follicles remaining.

The rest of the surgery process is exactly the same as penile inversion, except for the last stage of surgery. Here, the skin graft is inserted inside the cavity we have formed to create the vaginal tunnel. Once inserted, it is sutured at the end of the cavity.

Who can undergo graft vaginoplasty?

You should bear in mind that grafting is a technique used by surgeons to cover wounds so that they do not close. However, it is difficult to predict how much of the graft will take.
Lengthening or deepening your vagina is possible so long as the graft is not large. This is because grafted skin tends to be more vulnerable. In this vaginoplasty technique, the graft is added to the end of your penile skin to increase your vagina’s depth.
However, the skin that can be used for such a graft tolerates rubbing very poorly. During sexual intercourse, over time and if adequate lubrication is used, chronic wounds can appear that will create fibrosis and closure of the end of your vagina.

Should I stop my hormonal treatment before vaginoplasty with graft?

Many people who undergo surgery such as vaginoplasty are following treatment with estrogen and anti-testosterone drugs. Taking oestrogens carries a risk of deep vein thrombosis during surgery. This is why we withdrew this treatment about a month before surgery. As for anti-testosterone drugs such as Androcur or Decapeptyl, experience has shown that you do not need to withdraw from them. So you can keep taking them until your operation. Complete withdrawal will be until one to two weeks after vaginoplasty. IT IS ESSENTIAL THAT YOU SEE YOUR ENDOCRINOLOGIST before and after surgery and that you follow their instructions.

When should dilations be performed in the postoperative period of vaginoplasty with graft?

When penile inversion vaginoplasty with a graft has been performed, the dilation processes must be undertaken much more carefully. If in a penile inversion vaginoplasty without a graft, or colovaginoplasty, it is usual to start dilations seven or eight days after surgery, with a penile inversion vaginoplasty with a graft it is necessary to wait a few days longer to avoid losing the graft. Alternatively, you can begin early dilations just at the beginning of the vagina, without entering the graft. And always follow the guidance of both your medical team and your specialized physiotherapy team at IM GENDER. If the graft does not take for various reasons, we can consider colovaginoplasty, so as to obtain greater vaginal depth.

Will I need to attend postoperative visits after vaginoplasty with graft?

Yes. It is very important not to skip any of your post-operative visits with a member of the IM GENDER team. Only they will be able to assess the progress of your vaginoplasty recovery.