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Had prior vaginoplasty and has lost depth

Dear Dr. Reed,

Have vaginal atresia.

I am trying to call the office there and I have tried a couple of different phones but for some reason you guys can’t hear me. I am calling from the UK, not had a problem international before so not sure what is happening. You guys probably think I am a prank caller?!

Anyway, I would like to ask some advice on costings – I have had prior vaginoplasty in the past but lost depth and I read that Dr Reed does a lengthening procedure.

I wanted to know more about options and costs?

I have a complicated history and I have androgen insensitivity and was born without a vagina – I had a technique performed 10 years ago which i have tried to maintain and failed. I don’t even remember being given clear advice on follow up i.e. dilation and subsequently have lost length. I wonder if Dr Reed can help me.

I have suffered several botched attempts at labiaplasty also and one vaginoplasty – any advice appreciated.

Thanks, Darice

Dear Darice,

Yes, we do surgery for vaginal stenosis.  Please see http://srsmiami.com/photography-m2f.html
example # 15/1-3  Our novel approach has been done so far on 25 patients with generally good results, but with one notable surgical
site bleeding complication.  We published an article 2 years ago.

  • Non-grafted Vaginal Depth Augmentation for Transgender Atresia, Our Experience and Survey of Related Procedures. Harold M. Reed, Rafael E. Yanes, Joan C. Delto, Yumna Omarzai & Kailee Imperatore (87 references)
    Aesthetic Plastic Surgery ISSN 0364-216X Aesth Plast Surg DOI 10.1007/s00266-015-0523-7 (2015)

We create the space, pack for one week, remove packing and allowing your skin to re-epithelialize the space
extending your vagina inwards.  All the time you must be very diligent with stent dilations to maintain the space and build upon that.

Other approaches include:

A. The McIndoe procedure (creating a vagina with a skin graft).

B. The Vecchietti procedure

A semi-surgical method that takes advantage of laparoscopy to accelerate dilation. An olive-shaped device, placed at the vaginal opening, is connected with sutures to a traction device on the lower abdomen. Under laparoscopic guidance, the traction device is tightened daily, gradually pulling the olive-shaped device inward to create a vagina. This takes approximately one week. The device is then removed and further manual dilation performed).  Please see this video from the Mayo Clinic http://surgeryu.com/play-video.php?id=1226

C. Colonic augmentation.

Requires an abdominal incision and removes part of your bowel to become a vagina.  May have some unpleasant odors and can have narrowing at the junction or a red stop light sign in the vulvar area that will raise questions.  Colonic mucosa is more red than pink. Lubrication varies, but most doctors who do a rectal exam for other medical reasons put lubricant on their gloves.  Some patients swear by it (like it).

Please see http://www.mayoclinic.org/vaginal-agenesis/treatment.html

Each has its pros and cons.

Our fees are 250 for consultation which can be initiated over the phone.  7000 for surgery to include anesthesia, use of the facility and any followup care I provide.   In the unlikely event of hospital transfer I will provide care there gratis, but you may expect a bill from the hospital and any consultants who may participate in your care.

You will be required to purchase 500 worth of medical grade vaginal stents.  If you are not sexually active you will need to dilate after wound healing several times a day to maintain your vagina.   This is also true for MTF patients who never have stenosis.

Plan on staying at an nearby hotel Daddy O’s (305-868-4141) or the Baltic Hotel (305 861 8845) for a good 10 days post op, so we can start stent dilations in the office after removal of your packing.  These hotels are the exception to the thought, doctors don’t make house calls anymore.

Best wishes and have a productive week,

Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery – Miami
305-865-2000

Example #2: Male to Female Transsexual Surgery Note clitoral hood, glans, and sulci. Ample introitus is confirmed by passage of our largest stent.

Photo of patient who had vaginal atresia, practicing dilations 3 times a day

 

 

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