Our Summary

This research paper studies a new surgical technique used to improve the results of revision labiaplasty, which is a common follow-up procedure after a vaginoplasty. Vaginoplasty is a type of gender-affirming surgery that often results in high patient satisfaction. However, many patients still need a revision surgery, mostly because the inner lips of the vagina (labia minora) often merge with the outer lips (labia majora), causing them to lose their distinct shape. This can result in patient dissatisfaction.

The new technique proposed in this paper involves the use of cartilage from a deceased donor (cadaveric costal cartilage allograft) that is inserted into the revised labia minora to help maintain its shape.

The researchers tested this technique on a 38-year-old patient who had previously undergone a vaginoplasty. Six weeks after the procedure, the patient showed a lasting and clearly defined shape of her labia minora without any negative side effects.

This suggests that this new technique could be a safe and effective solution for patients who want a more distinct labia minora after their vaginoplasty.

FAQs

  1. What is revision labiaplasty and why is it often required after a vaginoplasty?
  2. How does the technique of incorporating cadaveric costal cartilage allograft into the revised labia minora help in increasing definition?
  3. What were the results of the procedure demonstrated on the 38-year-old MTF patient and were there any adverse effects?

Doctor’s Tip

A doctor may advise a patient undergoing vaginoplasty to discuss their desired outcomes and concerns with their surgeon prior to the procedure. This can help ensure that the surgeon understands the patient’s goals and can tailor the surgery to meet their specific needs. Additionally, patients should follow their surgeon’s post-operative care instructions carefully to promote proper healing and minimize the risk of complications.

Suitable For

Patients who have undergone vaginoplasty and are dissatisfied with the appearance of their labia minora, particularly those who have experienced the labia minora becoming incorporated into the labia majora and losing definition, may be recommended for this technique of incorporating cadaveric costal cartilage allograft into the revised labia minora. This technique may be especially beneficial for transgender women who have previously undergone inversion vaginoplasty and are seeking more defined labia minora.

Timeline

Timeline of patient experiences before and after vaginoplasty:

Before Vaginoplasty:

  1. Patient undergoes thorough evaluation and counseling with a gender-affirming surgeon to discuss goals, risks, and expectations of surgery.
  2. Patient may undergo hormone therapy and/or psychological evaluation to ensure readiness for surgery.
  3. Patient schedules surgery date and makes necessary preparations for recovery.

After Vaginoplasty:

  1. Patient undergoes vaginoplasty surgery, which involves creating a neovagina using penile and scrotal tissue.
  2. Patient experiences initial post-operative pain and discomfort, which is managed with pain medication and follow-up care.
  3. Patient follows a strict post-operative care plan, including dilation exercises to maintain vaginal depth and prevent complications.
  4. Patient attends follow-up appointments with the surgeon to monitor healing and address any concerns.
  5. Patient may experience changes in sexual function and sensation as the body adjusts to the new anatomy.
  6. Patient may seek additional surgeries, such as revision labiaplasty, to address aesthetic concerns and improve satisfaction with the results.
  7. Patient undergoes revision labiaplasty using cadaveric costal cartilage allograft to enhance definition of the labia minora.
  8. Patient experiences lasting definition of the labia minora post-operatively and reports high satisfaction with the outcome.
  9. Patient continues to follow-up with the surgeon for long-term care and monitoring of the surgical results.

What to Ask Your Doctor

  1. How common is it for patients to require revision surgery following vaginoplasty?

  2. What are the potential complications or risks associated with vaginoplasty and revision labiaplasty?

  3. How long is the recovery process for vaginoplasty and revision labiaplasty?

  4. What are the expected outcomes in terms of appearance and sensation after vaginoplasty and revision labiaplasty?

  5. Are there any alternative techniques or procedures that could be considered for achieving a more defined labia minora?

  6. How long do the results of incorporating cadaveric costal cartilage allograft into the labia minora typically last?

  7. What is the success rate of using cadaveric costal cartilage allograft in labiaplasty procedures?

  8. Are there any potential complications or risks associated with using cadaveric costal cartilage allograft in labiaplasty?

  9. What is the cost associated with incorporating cadaveric costal cartilage allograft into the labia minora during labiaplasty?

  10. How soon after vaginoplasty can revision surgery, including incorporating cadaveric costal cartilage allograft, be performed?

Reference

Authors: Sellke N, Callegari M, Mishra K, Long T, Gupta S. Journal: Turk J Urol. 2022 Nov;48(6):455-459. doi: 10.5152/tud.2022.22079. PMID: 36416336