Vaginoplasty is a surgery that is performed to tighten up the vagina that is sagged or loose due to multiple child birth or even due to aging.
Labiaplasty is another surgery that can be performed alone or with vaginoplasty. Surgery can be performed on the labia major (the larger, outer vaginal lips), or the labia minora (the smaller, inner vaginal lips). Labiaplasty changes the size or shape of the labia, typically making them smaller or correcting an asymmetry between them.
Genitals are the sexual organs and they are divided into external as well as internal genitalia. Female external genitalia are labia majora ,labia minora which are called labia and clitoris as well as vulva.The openings of vagina and urethra which is the urinary bladder opening are as well present externally .
Indications for genital reconstruction in females include:
- Correcting deformities of the genitals after cancer surgery, birth defects (absence of the vagina or intersex), female “circumcision” and traumas
- Male to female gender reassignment surgery.
Reconstruction is also sometimes indicated for treating urethral injuries, urinary incontinence, and fistulas (abnormal connection between two structures) caused by surgery or radiation in both men and women. These operations are usually done in conjunction with a urologist or a gynaecologist.
In case of males the externally located organs are penis and scrotum.
Indications for genital reconstruction in males include:
- Penile and scrotal swelling due to stagnation of a fluid in body called lymph due to a disease filariasis .
- Any problem with the blood flow to scrotum causes gangrene called fournier’s gangrene which is due to infection.
- Gender change surgery for transgenders.
- Reconstruction of penis and scrotum in cases of genital cancers, trauma and congenital deformities
Reconstruction of the female genitals
Female genital tract reconstruction may involve simple procedures such as split-thickness skin grafts or more complicated ones such as the use of skin and muscle flaps.
Complete vaginal reconstruction is most commonly required for congenital absence of vagina. A new vagina is constructed by creating a space between the urethra and the anal canal and lining it with a skin graft or a skin flap.
Vaginal reconstruction may also be performed to correct deformities that can occur as a result of the surgical removal of parts of the vagina, radiation therapy, and presence of fistulas. The choice of reconstructive surgery depends on the extent of vaginal tissue remaining.
Vulvar and perineal (region between the anus and vulva) reconstruction may include the following techniques:
- Full-thickness graft: Full-thickness grafts are usually used to correct surgical complications such as vulvar scars, infections and narrowing of the vulva. An entire thickness of skin, with underlying muscle and blood supply from a donor site is used in this type of graft. Small grafts are obtained from the groin, upper thigh or the labia minora (inner flap of skin that covers the vaginal opening).
- Split-thickness skin grafting: The surgeon may remove the vulvar skin (skinning vulvectomy), preserving the underlying tissues and blood supply. Following this, split-thickness skin grafting is performed, which involves the removal of the top two layers of healthy skin from another part of your body and implanting it at the region of disease.
- Local pedicled flap: A flap of skin and underlying blood supply from the adjacent healthy skin from the labial region is used to reconstruct tissue death (necrosis), ulceration, fistulas and other problems that could result due to radiation therapy of the female genital region.
Risks may always be present along with the surgery which are:
- Dryness of vagina
- Vaginal infection
- Vaginal prolapse and others
- Scarring may be present
- Sensations may be disrupted