48 year old male to female transsexual
A) The small triangle on the glans (head) of the penis will be made into a clitoris. The nerves and vessels to this new clitoris are preserved. A small amount of penile skin under the glans is preserved to form a clitoral hood.
B,C) The scrotal skin marked with a circle is used as a full thickness skin graft to form the deep vagina. The scrotal and perineal skin marked with an inverted V is placed on the floor of the vagina. These areas must be hairless.
D) The white stent (balloon) is inside the new vagina, which is composed of penile shaft skin sutured to the scrotal skin graft. The suture line is seen.
E) The patient at the end of surgery. The new clitoris is placed in the normal position. A catheter is in the bladder, and the soft stent is in the vagina. Notice the lack of outer skin sutures in the incisions, which decreases scarring.
The same patient after sexual reassignment. She healed without complication.
G) Laying with her legs relatively close together. Notice the relatively normal labia majora and minora.
H) Laying with her legs spread apart. Notice the minimal scars.
I) The labia minora are spread apart revealing the clitoris at its normal position, which is partially hidden by a clitoral hood. The clitoris retains its normal sensation. The reddish color is due to a retained portion of the urethra.
J) Vaginal dilators
K) The vaginal dilator at the vaginal opening.
L) The vaginal dilator deep within the vagina, which reveals a depth of over six inches.