Vaginoplasty
PD Dr. Richard Fakin / Gender Reaffirming Surgery (GRS) / Vaginoplasty
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.
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Post-operative care
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 cases before and after



