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Male-to-female vaginoplasty: Preecha's surgical technique.

Journal article
Authors Burin Wangjiraniran
Gennaro Selvaggi
Prayuth Chokrungvaranont
Sirachai Jindarak
Sutin Khobunsongserm
Preecha Tiewtranon
Published in Journal of plastic surgery and hand surgery
Volume 49
Issue 3
Pages 153-159
ISSN 2000-6764
Publication year 2015
Published at Institute of Clinical Sciences, Department of Plastic Surgery
Pages 153-159
Language en
Keywords gender dysphoria, gender reassignment surgery, sex reassignment surgery, surgical technique, vaginoplasty, male-to-female transsexualism
Subject categories Plastic surgery


Abstract The inverted peno-scrotal flap is considered the standard technique for vaginoplasty in male-to-female transsexuals. Nowadays, great importance is also given by patients to the reconstruction of the clitoro-labial complex; this is also reconstructed with tissue coming from glans penis, penile skin envelop and scrotal skin. Since the first sex reassignment surgery for biological males performed in Thailand in 1975, Dr Preecha and his team developed the surgical technique for vaginoplasty; many refinements have been introduced during the past 40 years, with nearly 3000 patients operated on. The scope of this paper is to present the surgical technique currently in use for vaginoplasty and clitoro-labioplasty and the refinements introduced at the Chulalongkorn University and at the Preecha Aesthetic Institute, Bangkok, Thailand. These refinements consist of cavity dissection with blunt technique, the use of skin graft in addition to the penile flap, shaping of the clitoris complex from penis glans and clitoral hood, and the use of the urethral mucosa to line the anterior fourchette of the neo-vagina. With the refinements introduced, it has been possible to achieve a result that is very close to the biological female genitalia.

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