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Figure 1

Figure 1

A 48 year old male to female transsexual, who underwent sexual reassignment surgery

A) Pre-operative penis

B) 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.

C and D) 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.

E) The white stent (balloon) is inside the new vagina, which is composed of penile shaft skin sutured to scrotal skin graft. The suture line is seen.

F) The patient at the end of surgery. The new clitoris is placed in the normal position. A portion of normal urethra extends from the urethral opening to the clitoris, adding to normal appearance. A catheter is in the bladder, and the soft stent is in the vagina. Notice the lack of outer skin sutures on the incisions, which decreases scarring.

Figure 1 A

Figure 1 B

Figure 1 C

Figure 1 D

Figure 1 E

Figure 1 F

Figure 2

The same patient 3 months after sexual reassignment. She healed without complication.
A) Standing
B) Laying with her legs relatively close together. Notice the relatively normal labla majora
and minora.
C) Laying with her legs spread apart. Notice the minimal scars.
D) 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.
E) Vaginal dilators
F) The vaginal dilator at the vaginal opening.
G) The vaginal dilator deep within the vagina, which reveals a depth of over 6 inches.

Figure 2A

Figure 2B

Figure 2C

Figure 2D

Figure 2E

Figure 2F

Figure 2G

Figure 3:

28 year old who is 3 1/2 months after MTF sexual reassignment
A: Legs spread apart
B: Legs together

Figure 3 A

Figure 3 B

Figure 3 C

Figure 4

33 year old who is 6 months after MTF sexual reassignment
A: Legs spread apart
B: Legs together

Figure 4 A

Figure 4 B

Figure 5

26 year old male to female

Figure 5 A

Figure 5 B

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