Vaginoplasty: Exploring the Potential Benefits and Risks

Are you suffering from a loose vagina? Do you feel embarrassed by how your vagina looks? Do you wish to get a more smoothened and tightened vagina? If the answer to any of these questions is yes, then my friend, a vaginoplasty is the best solution for you. It is a cosmetic surgery that treats various medical issues like loosening of the vagina, trauma to the vagina, congenital vaginal anomalies, and ambiguous genitalia.

The surgery addresses another serious condition, gender dysphoria (a situation in which you feel trapped in the wrong body). As part of gender affirmation surgery, vaginoplasty can also be done to construct a vagina.

It is a highly specialized procedure that skilled surgeons must perform. Choosing the right destination for a cosmetic procedure is of utmost importance. Countries like Thailand, Turkey, and India have gained immense popularity due to their advanced cosmetic and plastic surgery hospitals.

Surgery costs are also less in these countries without compromising the quality of treatment. The cost of vaginoplasty in India is between INR 50,000 to INR 1,20,000. This cost depends on various factors discussed further in this blog.

What is Vaginoplasty?

Vaginoplasty is a procedure done to reshape or construct the vagina. The surgery resolves gender dysphoria by removing the penis along with the testicles and creating a vagina. 

Vaginoplasty is offered to people who have the following concerns:

• If the vaginal structure is changed due to aging, pregnancy, or weight loss
• Pain during intercourse, bicycle riding, horse riding, etc
• Childbirth has reduced sensation during sexual activity
• Stressful urinary incontinence

What are the Benefits of Vaginoplasty?

Vaginoplasty is a necessary procedure for transgender individuals undergoing gender affirmation surgery. Women undergoing radiation or total vaginal excision for treating cancer also need vaginoplasty.

The surgery offers several benefits:

• Tightening of the vaginal canal 
• Reduced or no urinary leakage 
• Feeling more confident while wearing clothes like bikini bottoms and tight pants
• Improved sexual satisfaction
• Increase in self-confidence

What are the Different Types of Vaginoplasty?

Several types of vaginoplasty are available to cater to the individual needs of the person requiring the surgery. Your cosmetic surgeon will select the best suitable type for you. The patient's age and why you require the surgery are important in choosing the best type.

Vaginoplasty is of the following 5 types:

• Intestinal or Sigmoid Vaginoplasty is a laparoscopic procedure that uses a small part of the colon intestine to create a new vagina (neovagina). The surgery is done by detaching a small part of the colon and then rotating it down to make the lining of the vagina. The drawback of sigmoid vaginoplasty is excess mucus in the vagina that has an unpleasant smell.
• Peritoneal Vaginoplasty: Also known as Luohu operation, peritoneal vaginoplasty uses the peritoneum (lining of the abdominal cavity) to make the vagina. It is also a laparoscopic procedure like intestinal vaginoplasty. Patients undergoing peritoneal vaginoplasty do not necessarily need dilation to keep the vagina open. This is true if they are having regular sex. The side effect of surgery is a rectovaginal fistula.
• McIndoe Vaginoplasty: It is an entirely different surgery from intestinal or peritoneal vaginoplasty as it does not require abdominal surgery. In the McIndoe procedure, a space is created in the genital area where a vaginal mold is placed. A skin graft is used to line the mold. Since skin is not a mucosal tissue, it does not self-lubricate. A dilator is used to maintain the vaginal opening.
• Buccal Mucosa Vaginoplasty: The tissue lining the mouth (buccal mucosa) is used to create a neovagina. The buccal mucosa is similar to the vaginal lining as both secrete mucus and are hairless. But still, it is not ideal for making a new vagina as only a small area of tissue is available. 
• Penile Inversion Vaginoplasty: This surgery is only possible in transgender and males who wish to change their gender. Penile inversion vaginoplasty is done by removing the skin from the outside of the penis and inverting it to form the lining of the vagina. The Penis head is reshaped to make the clitoris. The final step involves making the labia majora and minora using scrotal skin.

What Happens Before Vaginoplasty?

• Preparation of vaginoplasty involves consultations with the cosmetic surgeon, where proper preoperative instructions are given. The surgeon takes a proper medical history and assesses the patient's general health through various tests. 
• The patient must stop smoking and drinking before the vaginoplasty as these affect healing.
• Medicines like aspirin and anti-inflammatory drugs are also stopped before the surgery.
• The patient is adequately counseled regarding the risks involved with the surgery, potential benefits, and postoperative care requirements. 
• Transgender people have specific requirements to fulfill. These include:
  • The patient should be on cross-gender hormone therapy for one year.
  • They have to live in gender-congruent roles for a year.
  • They will also be required to produce two mental health letters stating their suitability for the surgery.

What to Expect During Vaginoplasty?

• Vaginoplasty is done for both reshaping and rejuvenating the already existing vagina or for creating a new vagina. 
• The time of vaginoplasty depends on the nature of the surgery. Vaginoplasty for tightening the vagina is a one-hour-long procedure. However, creating a new vagina requires more hours.
• It is done under general anesthesia, and nerve blocks are also given to numb the vaginal area.
• If the vaginoplasty is done for rejuvenating purposes, it involves removing the extra skin and using stitches to secure the loose tissue.
• When done to treat congenital disabilities and gender dysphoria, the surgery involves creating a functional vagina.
• If the surgery is being done as a part of the gender affirmation surgery, the penis is removed, and its parts are used for making the vagina.
• Once the surgery is done, the vagina is covered by surgical packing, and the patient is taken to the recovery room.

What are the Risks and Complications Involved with Vaginoplasty?

Just like any other surgery, vaginoplasty also has a few associated risks. The general risks associated with vaginal reconstruction are systemic infections, excessive bleeding, and anesthetic accidents. Specific complications include:

• Nerve Damage: There are chances of nerve damage while dissecting tissues in the pelvic and perineal areas. It can lead to dysesthesia or hypoesthesia. Harm to the nerves also leads to chronic pain.
• Risks of Intestinal Vaginoplasty: Since it is a major procedure, complications like paralytic ileus, constipation, difficulty in urination, diversion colitis, and peritonitis may occur. 
• Vaginal Odor: Bacterial overgrowth and colonization cause excessive vaginal discharge and a foul odor. The complication is treated with antibacterial and antifungal medicines.
• Fistula: Urethrovaginal or rectovaginal fistulas occur due to injury to the urethra or rectum during the surgery. Fistulas may require a second surgery for their treatment.

The risk of fistula and other complications can be decreased by selecting skilled surgeons. Cosmetic surgeons in India, Thailand, Germany, Turkey, and UAE are rich in experience and use cutting-edge technologies for vaginoplasty.

What is the Cost of Vaginoplasty?

The cost of vaginoplasty depends on factors like the country, type of hospital, surgeon's experience & qualification, type of procedure, and complications (if any).

India is the most cost-effective country for cosmetic surgeries. It offers vaginal reconstruction surgery in the price range of INR 50,000 to 1,20,000.

Thailand has the world's best cosmetic surgeons. The cost of vaginoplasty in Thailand is between USD 6,000 to USD 9,500. The slightly higher price of the surgery is justified by the successful results their surgeons provide.

These prices are inclusive of initial consultations with the surgeon, cost of surgery, hospital stay, medicine cost, and postoperative costs.

To Summarise

Vaginoplasty is a broad term that addresses a variety of disorders and is performed in various ways. The two most common uses of vaginoplasty are the reconstruction & repair of the vagina and the creation of a new vagina. The surgery helps in giving a confidence boost to women and also improves sexual satisfaction. A few risks associated with vaginoplasty are bleeding, infection, bladder injury, scarring, and pain.