Transsexual Surgery Thailand’s Penile Inversion + Scrotal Skin Grafting Method

Scrotal skin grafting is a non-penile inversion SRS procedure that entails building a neovagina and its primary components utilizing skin grafts from the penis and the scrotum.

The most frequent procedure at our clinic and the one that is advised for most SRS patients is scrotal skin graft and flap surgery. In this method, the clitoral hood, clitoris, vestibule, urethra, and labia are constructed together with a neovagina using skin grafts and preputial flaps. Typically, the procedure takes 6-7 hours.

Using this method, the neovagina is created from various components of the natural genitalia. The freshly created neovagina is functioning and possesses erogenous sensitivity, with the majority of its nerves and arteries still there. Furthermore, the neovagina will resemble a cisgender woman’s in terms of beauty, color, form, arrangement, and size thanks to the careful selection of the material utilized.

Scrotal Skin Grafting Technique Characteristics
Clitoral hood: The dorsal prepuce flap that connects to the clitoris and the penile skin form the clitoral hood.
Clitoris: The apex of the glans penis is used to create the clitoris, preserving the nerves that nourish it. resulting in clitoris and labia that are sensitive.
Vulvar vestibule: A short strip of urethral mucosa and portions of the glans penis with intact sensory nerves and arteries make up the vulvar vestibule, which is the portion of the vulva between the labia minora.

Labia minora: The inner labia are built using the prepuce flap with unharmed sensory nerves. The pink labia minora can be extended exactly like other labia and covers the neoclitoris, upper vulva, urethral aperture, and upper section of the vaginal opening.
Labia majora: The labia majora will be formed from the scrotal skin. The scrotal flap is positioned tightly to resemble a young woman’s labia majora.

After creating the labia majora, the remaining scrotal skin, the perianal skin flap, and (rarely) the inverted penile skin flap will be utilized to create the vaginal wall, which will develop completely functional depth, elasticity, and natural color.
G-Spot of neovagina: The prostatic capsule, labia minora, clitoris, and a portion of the urethral flap make up the g-spot area. An erogenous g-spot for the neovagina is created by this complex of sensory organs.

Advantages: 

Both people with longer penises and those with shorter ones that are shorter than 4 inches can have surgery.
The skin-grafting procedure results in an attractive and realistic-looking neovagina.
The depth of the neovagina, which is typically between 5 and 6 inches, is enough for vaginal intercourse.
Since it is a one-step treatment, most patients won’t require a followup labiaplasty.
Comparatively speaking, the procedure takes less time than a colon vaginoplasty.
quicker healing time than after a colon vaginoplasty.

Disadvantages:
This method is really advanced.

Inclusion Standards:
Patients must meet the following prerequisites in order to have vaginoplasty utilizing the skin grafting method:

-be younger than 60 years old
-possess enough scrotal skin to create a scrotal flap

Surgical Technique: 
Our Clinic uses a highly specialized method for scrotal skin grafting. Our board-certified surgeons, who specialize in aesthetic and neovaginal reconstructive surgery, perform it. To provide the greatest surgical outcome, a multidisciplinary teamwork is used from the very beginning of the preoperative period through post-operative care. The following steps are generally followed when performing the surgery:

The patient receives a general anesthesia. The patient is then placed in a conventional lithotomy position. A silicone cushion is placed beneath the back and legs of the patient during surgery to relieve pressure and provide protection and comfort.

For the eventual formation of the vaginal hole, the perineal skin flap is cut and prepped. Below the prostate gland and the urethra (urinary tube), the vaginal opening and lining develop. Next, the prostate capsule is raised. Inside the body, a 4-inch (or larger) pocket is created. The neovagina will have a space created as a result. The vaginal canal will thereafter develop and begin to bend toward the recto-vesical pouch. This freshly created neovagina will typically be 5 to 6 inches deep.

An orchidectomy involves the removal of the testicles and spermatic cords. The labia minora are created by arranging the inverted penile skin flap. The inverted penile skin flap is occasionally combined with a perineal skin flap to create the vaginal lining. A scrotal skin graft is typically inserted to increase the vagina’s depth.

One takes out the penis shaft. The clitoris is formed by using some of the glans penis’ sensory nerves. The vaginal opening (introitus) is located below the urethral aperture. Urine flows similarly to that of a cisgender woman thanks to the urinary tract’s shortening and arrangement. Between the clitoris and urethral entrance, there is urethral mucosa that mimics moist vulva.

The clitoris is created from segments of the glans penis that still have their nerves and blood vessels. The rebuilt clitoris will therefore be erogenously sensitive and have a very natural appearance. To avoid tissue engorgement during sexual arousal, extra erectile tissue is eliminated from the area surrounding the urethra. The tissue engorgement could constrict the vaginal entrance and make it difficult to engage in sexual activity if left untreated. The inner labia are formed from the prepuce flap, which is a pink skin flap covering the glans penis. This flap will be long enough to cover the upper portion of the vaginal opening, the urethra, and the neoclitoris. During the labiaplasty stage, which can be performed later, the inner labia lip can be made thinner if necessary. The neovagina is made up of all of its components. Inside the neovagina, a vaginal packing is placed, and it will be taken out five days after the procedure.