Vaginoplasty in Madrid & Zurich

PD Dr. Richard Fakin / Gender Reaffirming Surgery (GRS) / Vaginoplasty

Gender-Affirming Vaginoplasty for Trans Women (GRS M-to-F)

Madrid | Zurich

Gender reassignment surgery aims to harmonize physical appearance with gender identity, significantly improving quality of life. In this context, vaginoplasty is one of the most requested procedures, as it helps resolve gender dysphoria by creating functional and aesthetically pleasing female genital anatomy.
Dr. Richard Fakin, an internationally experienced specialist, performs these surgeries based on the Thai surgical technique he learned during his training with Dr. Preecha at the Preecha Institute of Aesthetics (PAI) and the King Chulalungkorn University Hospital in Bangkok.

Length

3 – 5 hours (including breast augmentation)

Discharge from the clinic

1 week

Fit to go back to work

4 – 6 weeks

Fit for everyday activities

14 days

Anesthesia

General

Recovery time

2 – 3 months

Existing techniques in vaginoplasty for trans women

Gender reassignment surgery aims to harmonize physical appearance with gender identity, significantly improving quality of life. In this context, vaginoplasty is one of the most requested procedures, as it helps resolve gender dysphoria by creating functional and aesthetically pleasing female genital anatomy.
Dr. Richard Fakin, an internationally experienced specialist, performs these surgeries based on the Thai surgical technique he learned during his training with Dr. Preecha at the Preecha Institute of Aesthetics (PAI) and the King Chulalungkorn University Hospital in Bangkok.

Penile Inversion (PSI)

  • The penile skin is inverted to form the neovagina.
  • Additionally, a skin graft from the scrotum can be used to ensure the desired depth, regardless of the initial size of the penis.
  • Generally, a depth of between 12 and 14 cm is aimed for, considering that natural vaginal depth usually ranges between 8 and 11 cm

Interposition of sigmoid colon

  • A segment of approximately 14 cm of the sigmoid colon is used to form the vaginal cavity.
  • This segment is closed at one end and attached to the vaginal opening, while the colon is reconnected to maintain its functionality.
  • This procedure is performed in collaboration with a team of colorectal surgeons via laparoscopic surgery, ensuring a minimally invasive approach and reduced scarring.
  • From an aesthetic standpoint, the external appearance of the vulva is identical to that achieved with the penile inversion technique.

The right method for each patient

From the outside, both methods, explained above, are identical in the final aesthetic result, however, the construction of the vaginal cavity is subordinated to the predilections of each patient and to their own anatomy.

We suggest that patients with a smaller penis opt for neovaginal reconstruction with the segment of intestine (sigmoid colon interposition). For patients with an  average size, the most common choice is to opt for the penile inversion technique (PSI) combined with skin grafting. For patients with a large penis size  , the most common choice is to opt for the penile inversion technique (PSI) without the need for skin grafting. Likewise, the colon technique has an additional advantage that consists of greater natural lubrication, since the secretion from the intestine is similar to vaginal discharge. To choose the ideal method for each patient, it is essential to assess the advantages of each technique.

Learn more about Vaginoplasty interventions belonging to the field of Female Genital Surgery aimed at Transgender women on our  Facebook profile.

Post-operative care and Recovery

Proper postoperative care and the use of specific materials are essential to achieve optimal aesthetic and functional results. Regular dilation during the first 12 months is particularly important to maintain the neovagina’s depth and flexibility.
Our nursing team provides close and personalized support, supplying each patient with a set of dilators and detailed pre- and postoperative instructions. Over the years, periodic follow-up examinations with a gynecologist are recommended. Our clinics offer guidance and advice to ensure comprehensive clinical follow-up.

Learn more about Vaginoplasty interventions belonging to the field of Female Genital Surgery aimed at Transgender women on our  Instagram profile.

PD Dr. Richard Fakin's experience in sex reassignment surgery

Recognized as one of the international references in transgender surgery, Dr. Richard Fakin has organized and participated in numerous international conferences and has an extensive list of scientific publications. His statistics show complication rates up to 10 times lower than those reported in some international studies.
After training with Dr. Preecha Tiewtranon (PAI, Bangkok) and at the King Chulalungkorn University Hospital, Dr. Fakin introduced the Thai technique in Europe, leading the gender reassignment program at the University Hospital of Zurich. Professionalism, respect, safety, and trust are the pillars of his practice.

Learn more about Vaginoplasty interventions belonging to the field of Female Genital Surgery aimed at Transgender women on our Facebook profile.

Real Patient Cases – Before and After

Frequently Asked Questions About Vaginoplasty for trans women

What is vaginoplasty and what are its main goals?

Vaginoplasty is a gender-affirming surgical procedure designed to create external and internal female genitalia. The main goal is to achieve a functional, natural-looking vulva and neovagina that reflects each patient’s identity. At his clinics in Madrid and Zürich, Dr. Richard Fakin offers a personalized approach using modern surgical techniques to ensure results that are both aesthetically balanced and sensitive to individual needs.

Who is vaginoplasty suitable for?

Vaginoplasty is intended for transgender women and individuals on the transfeminine spectrum who wish to align their physical anatomy with their gender identity. Dr. Richard Fakin evaluates each case individually, taking into account medical history, physical characteristics, and personal expectations to determine the most appropriate surgical plan.

What surgical techniques does Dr. Fakin use in vaginoplasty?

Depending on each patient’s anatomy and previous treatments, Dr. Fakin applies different surgical techniques, including penile inversion and other modern approaches. The aim is to achieve a neovagina with appropriate depth, sensation, and natural appearance. The procedure is always tailored to each person’s body and preferences, with a focus on safety, symmetry, and long-term satisfaction.

What is recovery like after vaginoplasty?

Recovery typically involves several weeks of progressive healing. In the first days after surgery, patients remain under medical supervision. At home, rest, hygiene, and dilation routines are essential to ensure proper healing and maintain vaginal depth. Dr. Fakin and his team provide continuous support and guidance throughout the recovery process, both in Madrid and Zurich.

Why choose Dr. Richard Fakin for vaginoplasty?

Dr. Richard Fakin is a leading expert in aesthetic and gender-affirming surgery, with years of experience performing vaginoplasty and related procedures. His dual presence in Madrid and Zurich allows patients to access top-level care in two European medical hubs. His work is known for combining surgical precision, natural-looking results, and a deep commitment to the emotional and physical well-being of each individual.

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