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lost depth after Vaginoplasty elsewhere and skin graft didn’t work

I’ve had GRS (MTF) surgery in Philadelphia back in May. I was wondering if you can perform a surgery to help with lost vaginoplasty depth? A another doctor in Florida tried to fix a skin graft and made things worse.

Let me know, Roberta

Dear Roberta,

The natal female pelvis has many suspensory ligaments and intra-peritoneal
features designed to maintain patency and suspension of the vagina.

The male pelvis does not, and nature abhors a vacuum. Dilation ideally
several times a day are advised if you are not sexually active.

Yes, we do surgery for vaginal stenosis or lost vaginal depth.  Please see
http://srsmiami.com/photography-m2f.html
example # 15/1-3  The attached is a letter we send
to prospective MTF patients which may be of interest.

Our novel approach has been done so far on 25 patients
with generally good results, but with one notable surgical
site bleeding complication.

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 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 Beach Place Miami
305 866 3313) 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
305-865-2000

Patient presented with vaginal stenosis. Her depth was only 1 1/2″. This was recovered with a suburethral approach restoring the pelvic space, and allowing skin to epithelialize in. Her responsibility: frequent dilations to keep the space open for several weeks until new skin could re-line the vaginal vault.

      

Patient presented with 1 1/2″ of depth

Her depth now is 5 1/2″ and gaining. Able to have penetrable sex following our non-grafted technique

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