How does your one-stage male to female vaginoplasty differ from colonic vaginoplasty?

Dr. Reed,  How does your one-stage male to female vaginoplasty differ from colonic vaginoplasty? Deshondra

Dear Deshondra,

The concept of one-stage vaginoplasty is that you have an acceptably cosmetuic and functional rwesult with labia minor and majora, and a hooded clitoris.

Colonic vaginas tend to be red in appearance.  Redder sometimes than your inner cheek. The last comment you want to hear in an intimate situation is “what’s that?”

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Colostomy and colonic vaginoplasty pictures

(below taken from  Healthline)


Penile inversion procedure

The most common vaginoplasty technique is a penile inversion procedure. In this technique, penile skin is used to construct the vaginal lining. The labia majora are created using scrotal skin, and the clitoris is built from the sensitive skin at the tip of the penis. The prostate is left in place, where it can serve as an erogenous zone similar to the G-spot.

In some cases, there is not enough skin to achieve the necessary vaginal depth, so surgeons will take a skin graft from the upper hip, lower abdomen, or inner thigh. Scarring from the donation site is typically hidden or minimal.

The use of skin grafting to build the vulva is a topic of controversy among plastic surgeons. Some believe that the extra skin allows for a better cosmetic appearance. Others believe that functionality should not be sacrificed. Skin from donation sites is never as sensitive as skin from the genitals.

The penile inversion vaginoplasty is considered the gold standard genital reconstruction technique among plastic surgeons, and it is recommended by the Center of Excellence for Transgender Health.

Colon procedure

There is another technique that uses the lining of the colon instead of penile skin. Research on the outcomes of this surgery is limited.

One positive aspect of this procedure is that the tissue is self-lubricating, whereas vaginas made from penile tissue are dependent upon artificial lubrication. Because of the associated risks, however, colon tissue is typically used only in the event of a failed penile inversion.

Many people who have a vaginoplasty end up having a second surgery to improve the cosmetic appearance of the labia. A second surgery, called a labiaplasty, provides an opportunity for surgeons to work with healed tissue, where they can correct the positioning of the urethra and vaginal lips. According to the Center of Excellence for Transgender Health, a secondary labiaplasty, which is much less invasive, ensures the best cosmetic results.


Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery | Dr. Harold Reed | Miami

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