Vaginoplasty SRS

SRS MTF Vaginoplasty procedures and Techniques 

Edited BY  DR.Phatcharasak  Kraisornphongsakul MD

SRS- Vaginoplasty with penile skin inversion:

The penile skin inversion vaginoplasty, was the most known and utilized technique in the past, until new technologies emerged. The penile skin inversion procedure involves inverting the penis skin to create the vaginal canal and the outer vagina. It’s a relatively short procedure that lasts for about 4 hours.

However, this method isn’t for all patients. It is not advisable for patients with deficient penile skin as it will result in a vagina that may be too shallow

SRS- Vaginoplasty with scrotal skin graft:

This type of Vaginoplasty uses the skin covering the penis to create the inner and outer labia while parts of the glans penis are used to construct the neo-clitoris. A scrotal skin graft is then used to create the vaginal canal. This procedure creates a deeper functional vagina.

In case the patient has scrotal skin deficiency and the vaginal depth is not satisfactory, the plastic surgeon may consider a skin graft from different parts of the body including the groin or lower abdomen to help increase the vaginal depth.

This operation generally lasts between 4-6 hours.

SRS -Sigmoid Colon Vaginoplasty:

This procedure utilizing the sigmoid colon gives the vagina significant depth as well as the ability to self-lubricate. There are two options for this type of surgery:

• Open Method – In this technique, the sigmoid colon is cut as a pedicle flap with the neurovascular bundle intact. This is done via a low transverse abdominal incision on the bikini line. The rest of the colon is then reconnected to ensure the large intestine is normal and separated from the new sigmoid-neovagina. The surgery time lasts about 5 to 6 hours. 

• Laparoscopic Technique – In this technique, the sigmoid colon is harvested through 4 tiny microscopic incisions. The colon is then reconnected with stapler tools. The sigmoid colon is closed at the top end and pulled through the neo-vaginal canal and reconnected to the neovagional opening. This procedure lasts for about 6 hours. 

• SRS -Penile Peritoneal Vaginoplasty – This is the most advanced and innovative procedure utilizing the peritoneal tissue that lines the abdomen. This tissue is the most similar to that of the vagina – it is elastic and self-lubricates. It also doesn’t have the odor sometimes associated with sigmoid colon vaginoplasty surgery. With PPV, patients also don’t require regular dilation.

PPV uses a small amount of penile inversion combined with a peritoneum pull-through technique that creates the neovaginal canal. The labia and visible vagina are created using the penile skin inversion technique while the inner vaginal canal are made using peritoneal tissue.

FAQs for SRS (Male-to-Female) Surgery

What is SRS (Male-to-Female) surgery?

SRS (Sex Reassignment Surgery), also known as Gender Confirmation Surgery (GCS) or Gender Affirming Surgery (GAS), refers to a set of surgical procedures that alter a person's physical appearance and sexual characteristics to align with their gender identity. For male-to-female (MTF) individuals, this typically involves procedures like orchiectomy (removal of testicles), vaginoplasty (creation of a vagina), breast augmentation, and facial feminization surgery (FFS).

Am I a candidate for SRS (MTF)?

To be considered for SRS, you generally need to meet the following criteria:

Persistent gender dysphoria: A strong and lasting feeling of discomfort with your assigned sex.

Mental health evaluation: To assess your readiness for surgery and address any potential mental health concerns.

• Hormone therapy: Typically, 12 months of hormone therapy is required before surgery.

• Real-life experience: Living in your desired gender role for at least a year.

• Age requirement: Most surgeons require patients to be at least 18 years old.

What are the different types of SRS (MTF) surgeries?

• Orchiectomy: Removal of the testicles.

• Penectomy: Removal of the penis.

• Vaginoplasty: Creation of a vagina using penile or colon tissue.

• Breast augmentation: Enlargement of the breasts using implants or fat transfer.

• Facial feminization surgery (FFS): Modifying facial features to create a more feminine appearance.

• What are the risks and complications of SRS (MTF)?

Like any surgery, SRS carries risks, including:

• Infection

• Bleeding

• Nerve damage

• Scarring

• Complications with anesthesia

• Unsatisfactory aesthetic results

It's crucial to discuss potential risks and complications with your surgeon before undergoing surgery.

How long is the recovery period for SRS (MTF)?

• Recovery time varies depending on the specific procedures performed. Generally, patients can expect to stay in the hospital for several days and need several weeks to recover at home. Full recovery can take several months, and regular follow-up appointments with your surgeon are essential.

How much does SRS (MTF) cost?

The cost of SRS (MTF) can vary significantly depending on the specific procedures, surgeon, and location. It's important to get detailed cost estimates from your surgeon or medical tourism agency before making any decisions.

Where can I get SRS (MTF) surgery?

SRS (MTF) surgery is performed in many countries worldwide. Thailand is a popular destination due to its experienced surgeons, affordable costs, and welcoming environment for transgender individuals.

What should I consider when choosing a surgeon for SRS (MTF)?

Choosing the right surgeon is crucial for a successful SRS (MTF) experience. Consider the following factors:

• Experience and qualifications: Look for a surgeon with extensive experience and board certification in plastic surgery or a related field.

• Specialization in SRS: Choose a surgeon who specializes in SRS (MTF) and has a proven track record of successful outcomes.

• Reviews and testimonials: Research online reviews and testimonials from previous patients to get insights into the surgeon's skills and patient care.

• Consultation: Schedule a consultation with the surgeon to discuss your goals, concerns, and expectations.

Let Top Med World support you on this transformative journey.

Contact us today for a confidential consultation.

What are the long-term outcomes of SRS (MTF)?

Most patients who undergo SRS (MTF) report significant improvements in their quality of life, mental well-being, and overall satisfaction with their gender identity. However, it's important to have realistic expectations and understand that SRS is a personal journey with both physical and emotional aspects.

Remember, this FAQ is just a starting point. It's crucial to consult with a qualified healthcare professional to get personalized advice and information about SRS (MTF) surgery.

Dr. Patcharasak Klaisarapongsakul

Specialist in cosmetic surgery and special plastic surgery 

32 years of experience

1100 treatments perfomed

1986 Doctor of Medicine, Khon Kaen University

1992 Certificate of General Medicine, 

Faculty of Medicine, Phramongkutklao Hospital

2001 Certificate of Plastic Medicine, 

Faculty of Medicine, Phramongkutklao Hospital