Need revision of male to female vaginoplasty done elsewhere

Dr. Reed, Had a male to female sex change vaginoplasty last year and the doctor has practically disowned me. Seems as though my clitoris is a lot higher than on natal females. My boyfriend cannot enter the vagina although my depth is about 5 1/2 inches. The labia are spread apart and there is no clitoral hood.   My urinary stream does not go down.  I have to lean forwards a lot to avoid hitting the toilet seat. Please help. Joanne

Dear Joanne,

We are familiar with this type of result and know how to correct it.  The vagina is typically made from inverted penile skin, so unless the pubis skin is undermined to permit ease of transfer, the penile skin will want to return where it came. This will drag everything attached to it upward.  On lateral view there is a 30 degree higher emergence of the penis compared to the clitoris which is more an infra pubic structure.

You will have a wish bone incision in the pubic area.  We’ll remove skin inside the wish bone and bring the anterior commissure together so you will look more natal.  This is also a good time to make a clitoral hood.  If there is narrowing of the entrance way to the vagina (introitus), we will bring in a perineal flap to enhance circumference.  Additionally we may have to incise posterior laterally on the vaginal wall to be sure you have sufficient girth.

At the same time, we’ll lower the urethral opening.


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


Male to Female Vaginoplasty photo, note labia come together

Example #5: Male to Female Transsexual Surgery Recent 2nd stage labiaplasty with correct anatomical spacing between clitoris, urethral meatus (opening) and vagina.

Male to Female Vaginoplasty photo, note labia come together Clitoris is lowered as
is urinary opening (urethral meatus).  Perineal flap keeps the introitus potentially open.

as is u


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