Vagina anatomy is all wrong

[KylaStorms]

Hi all, I had my srs on May 31st, today I decided my swelling had gone down enough that I would compare it to internet pics (ie labialibrary). While doing so, I've found something wrong with the anatomy - my vaginal opening is outside my labia. Without a pic, the best way I can explain is:

(o) - 'normal' vulva

( )
o - my vulva

I'm feeling heartbroken rn, that all this time and effort has been for this. Is this something revision surgery/labiaplasty can fix? Im only 22 but now I'm considering never letting anyone see it of I can't be made right

[TinaVane]

May we ask who you went to ?


Sent from my iPhone using Tapatalk

[KylaStorms]

Phil Thomas, in the UK

[mmmmm]

This, like you explained it with () and o under, is the usual result of penile-inversion based techniques. If you look at SRS results online, this is the common shape, as penile flap is inverted, it means that labia minora starts above vaginal entrance, instead of being all around vaginal entrance. I dont want to ask any inappropriate question, but how come you were not aware of this before surgery? I mean, you were shown photos of your surgeons previous results?

How much can be this improved with revision depends on your anatomy. Experienced SRS surgeons have experience with this, as many patients come back dissatisfied with exactly the same thing as you are. But there simply arent many post-revision photos out there, even less before-after results. Maybe the best chance to see what can be done, is consult with surgeons, and ask to see pictures.
One way this can be improved, is to use some of labia majora skin, and make it into a fold, starting from lower end of vaginal entrance up until above vaginal entrance, where they can join it with labia minora. I cant promise you anything. Best that you can do now is wait until you are healed enough, that your surgeon can give a fair evaluation on what can be done and corrected. Until you are fully healed he can only speculate on what he will and will not be able to do.

Best wishes

[Beth Andrea]

The OEM vaginas I've had the pleasure of knowing all had the "o" in the lower half of the "( )". The upper third or so was the clitoral area.

Does the L majora just need lengthened?

This, like you explained it with () and o under, is the usual result of penile-inversion based techniques. If you look at SRS results online, this is the common shape, as penile flap is inverted, it means that labia minora starts above vaginal entrance, instead of being all around vaginal entrance. I dont want to ask any inappropriate question, but how come you were not aware of this before surgery? I mean, you were shown photos of your surgeons previous results?

How much can be this improved with revision depends on your anatomy. Experienced SRS surgeons have experience with this, as many patients come back dissatisfied with exactly the same thing as you are. But there simply arent many post-revision photos out there, even less before-after results. Maybe the best chance to see what can be done, is consult with surgeons, and ask to see pictures.
One way this can be improved, is to use some of labia majora skin, and make it into a fold, starting from lower end of vaginal entrance up until above vaginal entrance, where they can join it with labia minora. I cant promise you anything. Best that you can do now is wait until you are healed enough, that your surgeon can give a fair evaluation on what can be done and corrected. Until you are fully healed he can only speculate on what he will and will not be able to do.

Best wishes

I wasn't aware that this was "the usual result" of penile inversion. Before this thread, most cosmetic issues I'd read about was the vaginal opening being slightly ajar when legs are spread a bit. Just curious if you have a source? (I'm scheduled for PI in a year).

[mmmmm]

If you look at SRS results photos online, this will likely be the best source. 

As for labia majora lenghtening.. Its not labia majora that is the problem (except if I misunderstood Kyla), its labia minora. You cant simply lenghten and stretch it further down (at least not by much), as lower part of skin flap is inverted for vaginal wall, and upper parts are labia minora and hooding. From what I understand (and I could be wrong), the only real option that surgeons can do is to take some of the labia majora skin, and basically fold it into labia minora. This is what one surgeon told me. Maybe other surgeons know a way how to do it differently, at least he wasnt aware of any.


Beth, I believe you should discuss such aspect of your surgery during pre-op consultation(s). Some surgeons like Bowers, Satterwhite, Schaff and some other european surgeons, are already advancing their PI technique for  improving this issue. The main idea is simply to use more penile skin on the outside for longer labia minora, and less penile skin for vaginal wall, and compensate for consequent lack of depth with larger scrotal graft. There just arent many latest photos available from these surgeons, so we can only speculate how this more recent results look like, while we can look at the older photos (unless those who have a chance to see recent results at consultations).

[KylaStorms]

@mmmmm you're the first person to understand it, yeah the inner labia stops right above my vaginal opening. Is this really that common? From all sources (accounts on internet, surgeon reviews, my own consultation) most neovaginas are indistinguishable from natal ones, how can that be so if the vagina is in the wrong place? I've looked up post-op photos and the few I can find have the vagina within the inner labia :/

i was shown pics at my consultation, but 1) the labia were kinda closed up, so I presumed everything inside was normal and 2) they were really really hairy so details were hard to notice.

[mmmmm]

Sadly we cant post pics or link to the pics... But make sure you look at photos from surgeons who do penile-inversion based technique, not Chettawut or Suporn or some other Thai surgeons, thats a different technique (all penile skin is used for labias, hooding and vaginal entrance). If you look only at penile inversion technique, you will see that this is the usual result (surely there are many variations between results, and you actually need a photo with legs spread to see the labia minora definition)...

Its not that vagina is in the wrong place. Vagina is in the right place. Its just that labia minora are not anatomically correct (anatomically correct in comparison to cis female vaginas). 

...about that "indistinguishable from natal ones"... Yes, people like to say that. But people also often arent concerned with details, and anatomically correct aspects. When you stand, legs close, labia majora will be closed together, and everything will look indistinguishable from cis female vagina. Many people arent concerned with anything other than that. But with legs wide spread and someone who understands the anatomy and knows what to look for, not so manyy will look indistinguishable anymore. The closest thing (meaning practically almost all anatomical aspects are correct) are Suporn vaginas and Chettawut vaginas AFTER secondary revision for anterior and posterior commissure (hooding and fourchette).

[KylaStorms]

I knew the vaginal openibg would be further down cos of pelvis stuff, but I thought that meant they mived the whole vulva down too... Not just the vagina itself. Since this realisation, Ive been lookibg at other pics. Even with the labia closed, none have the hole below them like I do. Tbh I am on 3*day dilating so its mega obvious, but on them its non-existant.

When I heard 'indistinguishable' I took it to mean the average guy wouldnt notice. I'm pretty sure anyone who knows whats up would clue on when the anatomy is this mixed up. Or do stealth women not actually have sex?

I wish I had been told this beforehand...

[Beth Andrea]

If you look at SRS results photos online, this will likely be the best source. 

...

I have looked at many "before and after", and saw one example of this. The others were all pretty close to standard.

[Serenation]

This, like you explained it with () and o under, is the usual result of penile-inversion based techniques. If you look at SRS results online, this is the common shape, as penile flap is inverted, it means that labia minora starts above vaginal entrance, instead of being all around vaginal entrance. I dont want to ask any inappropriate question, but how come you were not aware of this before surgery? I mean, you were shown photos of your surgeons previous results?

This is just incorrect. Aesthetics vary from surgeon to surgeon as well as from person to person.

[mmmmm]

Of course aesthetics vary from person to person and surgeon to surgeon (Im not saying anything about that). But that doesnt change the fact where labia minora begins with penile inversion and how it goes all around vaginal introitus in cis-female, and closes together at the bottom as fourchette, which could probably be taken as anatomically correct. Or am I wrong?

I dont know which photos you were looking .. I went and rechecked, and at dr. Bowers gallery and dr. Mcginns gallery, there wasnt one example out of all fully healed results, that would have (o) labia minora. Most of them had labia minora either starting at the top of "o" or literally coming out of the top of "o". In some results was labia minora practically separarated from vaginal entrance. Maybe we are not looking at the same photos. If you go to PAI penile-inversion section, you have a very good looking penile-inversion result published there, despite the fact that it has typical penile-inversion appearance. 

[Serenation]

mmmmm a lot of surgeons discard excess skin regardless of technique, what they make the vaginal canal out of does not dictate what the rest looks like.

there's no way you can tell the difference between a 70/30 60/40 90/10 scrotal + penile combo or a 20/70/10 groin + scrotal + penile canal or even 100 penile. Meshing vs non meshing has more relevance, was the patient circumcised, how much skin did they have to work with. How long were they on hrt.

To the op wait and see how it settles 3 months is a good idea. revisions are common, I recently was talking about width with my surgeon and he said the positioning of the vagina canal is a compromise between aesthetics and function, his preference was aesthetics and making it so most penis sizes would fit. Maybe your bone structure required it to be lower, maybe the surgeon just prefers to do that way. That's something only they can answer. I'm sure they will do a revision if you want it.

[KylaStorms]

@mmmmm I'd never looked at any us surgeon bc I read that since every surgeon used different techniques it wouldn't accurately reflect what I would get. The pics I looked at were generic, with no surgeon's name attached. I've just been and looked, and you're right, they do have a similar structure (my vagina is still outside the outer labia but theyre still healing). They still dont look like natal vaginas tho. I dont get why people say they do.

@serenation I hope I can get one, I've heard Thomas can be stingy with revisions cos of the NHS thing

[Beth Andrea]

OP--

May 31st is less than a month post-op. Give it some more time to heal.

People say they look OEM because that's often the feedback they get from others, even when they don't know a person's Trans status.

Keep in mind that vulvas, like penis, come in all sorts if shapes and sizes, some visually appealing and some less so. But, they're all good if they are otherwise healthy and functional (and even that has some variability).

Be sure to love your body and all of its parts...

[Richenda]

Sadly we cant post pics or link to the pics... But make sure you look at photos from surgeons who do penile-inversion based technique, not Chettawut or Suporn or some other Thai surgeons, thats a different technique (all penile skin is used for labias, hooding and vaginal entrance).

For people coming new to this thread it's important to note that lots of us do not agree with mmmm's assessment of so-called penile inversion. Most surgeons, esp in Thailand, now perform a combination of techniques which are constantly refined. Mmmm is rather behind the times in this regard. PAI (Preecha) institute for instance do either a colon graft or a peno-scrotal inversion which incorporates some of the techniques pushed by Dr Suporn. An abstract (without 'nudity') of the Preecha institute can be found here: http://www.ncbi.nlm.nih.gov/pubmed/25356769
If you want to see the full article which has graphic pictures of their surgical SRS technique there is a link on the abstract.
It's a myth to push the idea that such-and-such a surgeon has a dramatically new or different technique. They don't. Differences nowadays are very minor.

Back to Kyla's agony. The first thing to say is that there is massive variety in cis-female vaginas. I've seen so many different types that there really isn't a standard natal vagina.

That having been said, I would have thought some revision in a little while should be more than possible, perhaps by extending the labia as has been suggested above?

Take care hon and push for some revision x

[Jenna Marie]

(I disagree with that opinion of penile inversion as well, but as the only way to disprove it would be to post pics of my genitalia to the internet, I've accepted that I won't be able to convince some people. )

There are cis women who lack the fourchette as well. (The fourchette is, as has been explained, the part where the inner and outer lips come together under the vaginal opening.) Heck, there are cis women who don't have labia minora to speak of. I think there was even a woman on this board whose cis female partner had a vulva that was "less natural" than her own post-op results... which  makes it clear that it's sometimes not worth fretting about what is and is not natural, when the variation in people born with vaginas encompasses such outcomes.

The fourchette is a difficult bit of anatomy to construct in the initial operation because so much stress is placed on it by dilating; I can attest to this personally, as I do have a rudimentary fourchette and dilation actually caused a fairly painful and seriously annoying tear there where the stitches pulled loose from the tension of dilation.

In other words, the results you have gotten *are* within the range of vaginas and vulvas handed out by nature at birth. But if you're still unhappy with it when you're fully healed, you also have the option that cis women do of seeking minor plastic surgery/revision to perfect the aesthetics. However, a month post-op is VERY early, and I also wouldn't leap to any conclusions about what the final results actually will look like. Oftentimes swelling reduces and healing finishes and then the labia settle and drape much more naturally.

[KylaStorms]

I feel like I'm not explaining the problem very well. I have a fourchette, its still healing but I do have one, the problem is that my vaginal opening is below it. Where both labia minora and major meet at the bottom of my vulva, my vaginal opening is below that, theb its straight onto my perianum.

[AnonyMs]

I believe I've seen photo's of the kind of result your describing. I used to do a lot of research on SRS surgeons and I think I found some like that among the Thai results (actually Thai porn). I don't know who the surgeons were. It was long ago and I don't have links. I never found many photo's for the British surgeons.

I've seen photo's of post revision Suporn results (including fourchette), and I while they are very good I can still tell they are a result of SRS.

I'll pm you something.

[Jenna Marie]

Kyla : Well, it's not really a "fourchette" unless it *does* meet below the vaginal opening, so that's probably the source of the confusion. I understand now, though - you're saying that the labia do come together, but above the opening.

No, that's not normal or typical (and it's not a usual result of penile inversion, either, where the expected "flaw" would be a lack of fourchette/the labia don't meet at all). However, it should be easy enough to fix simply by undoing the point where the labia connect. As I understand it, revisions that don't require extra material or additional fine detail work are usually much easier than the rest; you may even be able to find a non-GRS plastic surgeon who can open that back up. (If you want the true fourchette constructed below the vagina, that would be more complicated but probably still doable by a GRS surgeon who handles revisions.)

I don't blame you for being unhappy, and this means the comments saying that you should have known it was possible are irrelevant; this is a case of the surgeon *adding* a detail that isn't anatomically correct, which is not something most surgeons will advertise beforehand and not a known issue with penile inversion. (The only other time I've seen what you describe was on a patient of Dr. Rumer's, who very clearly did have the labia meeting and closing up well above the vaginal opening.)