Susan's Place Transgender Resources

I will see my surgeon in 2 months but I can't stop thinking about it so asking here as well ^^

So I get SRS for free in my country, but one nurses I see every 6 months said that creating a labia minora isn't standard here, which is kinda wtf to me, never heard of that before. I know some get it though and I'm young etc and considered a good candidate they've said. What worries me is if they tell me I won't be getting a labia minora, the result doesn't seem very anatomally correct. Therefor I am wondering if I have the surgery in my country and they do not create a labia minora, will I be able to go to another surgeon for a revision and have this fixed or is the part used to create the labia minora discarded during surgery?  Can't really afford having the entire surgery with another surgeon, but I'm assuming that if fixable then it wouldn't cost nearly as much for this small change.

Could very well be the nurse has no idea what she's talking about and her thougts are outdated, but idk yet.

With dr brassard I asked him this question.. he said he makes the labiA minora with urethra mucosal tissue... that's why when it's healed it is pink in colour... labia majora is from the scrotal sac


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This paper describes a study of the anatomical variation in the vulva/vaginas of 50 natal women.  There are 4 photos near the end of the paper which show the wide variation in appearance of the labia minora among natal women.  In my consultation with Dr. Chettawut prior to undergoing surgery, the matter of goals and priorities was discussed, but nothing of a detailed nature regarding the labia minora, not even whether or not he would attempt to construct them.  I just assumed that was a part of the surgical operation which took 7 hours as compared to the typical 2 hours for the penile inversion method.  I was surprised then to find that my labia minora are not as well defined as shown in these photos.  I would need revision surgery to achieve more prominent labia minora.  There appears to be enough labia majora tissue to accomplish the revision, but I have no plans for followup surgery at this time.  I'm reasonably happy with the results Dr. Chet achieved.

Mod edit, link removed

I'd want to see photo's of the surgeons results, preferably independent ones. I have the impression that there's a lot of variation in the quality of surgeons work and I'd not just automatically trust one.

Yeah that's not really possible.. There are like 3 surgeons I think that perform this surgery here and I have been shown like 2-3 pics don't even remember, and I don't know what surgeon performed the surgeries in the pics I saw.. They told me they are currently working on contacting people who have had the surgery and asking them if they would allow photos being taken..
Maybe I'll see something at the consultation in 2 months though but I doubt it.

Any chance you can find people in your local trans community who could give you some advice? Or even search online. Its hard work but I've managed to find photo's for a number of surgeons.

Quote from: AnonyMs on October 20, 2016, 04:39:04 PM
Any chance you can find people in your local trans community who could give you some advice? Or even search online. Its hard work but I've managed to find photo's for a number of surgeons.

Lol cant even find a picture of my surgeon. The hospital put me in contact with someone who had previously had surgery there, she was happy with everything. She had a different surgeon though.

I've tried to reach out via groups etc but no one in them seem to be this far in the process...

Yeah, there are cis women born without labia minora, but it's not *typical.* So I'm rather startled that they routinely do not even try to create inner labia.

What is used varies by surgeon, but in general, unused tissue is discarded... suggesting that, indeed, what might have been used in your case will no longer be available post-op. :( However, there is always the option of a skin graft; the downside is that the skin will be taken from elsewhere, creating a new wound and likely leaving a scar, but the upside is that this is a possibility that is essentially permanent as a method of correction.

(Brassard creates the outer side of the outer labia from the hair-bearing skin of the scrotum [which reflects the fact that cis women grow hair there], the inner side of the outer labia and the outer side of the inner labia from hair-scraped scrotal tissue and/or a perineal graft [the skin removed at the site where the vagina will go is saved and used as a graft], and the inner side of the inner labia from urethral mucosa that was removed from the penis when the urethra was shortened. All of this skin would in fact be either used or discarded; there's no real way to "save" any of it with a blood supply post-op.)

Quote from: Jenna Marie on October 21, 2016, 10:46:16 AM
(Brassard creates the outer side of the outer labia from the hair-bearing skin of the scrotum [which reflects the fact that cis women grow hair there], the inner side of the outer labia and the outer side of the inner labia from hair-scraped scrotal tissue and/or a perineal graft [the skin removed at the site where the vagina will go is saved and used as a graft], and the inner side of the inner labia from urethral mucosa that was removed from the penis when the urethra was shortened. All of this skin would in fact be either used or discarded; there's no real way to "save" any of it with a blood supply post-op.)

What she said :)

"standard" is rather a moving target. Recently standard was 2 stage with no attempt to form labia minora in the PI procedure. Inner labia being formed in a second procedure.

Drs Satterwhite and Wittenberg use what's described above, the excess urethral mucosa being used for labia minora. The new team at BMC provide an animation that suggests they use the excess urethra as part of the neovaginal wall.

In ancient times (ok, 15-20 years ago) the glans was left in place to form a neocervix at the base of the penile inversion.