When inversion of combined penile and scrotal skin flaps for vaginopla
sty in male-to-female transsexuals has become impossible or has not le
d to functional results, alternative vaginoplasty techniques should be
considered. Colocolpopoiesis involves major surgery and often leads t
o disappointing long-term results. An Abbe-McIndoe vaginoplasty applyi
ng split-thickness skin grafts often does not provide favorable result
s in the scarred area encountered after complications of skin flap inv
ersion surgery. Because thicker skin grafts show less tendency to shri
nk, the use of a full-thickness skin graft has been advocated for vagi
noplasty in females. In this paper, we present our technique of succes
sful secondary vaginoplasty appling full-thickness skin grafts in six
male-to-female transsexuals. In patients with sufficient groin and abd
ominal skin to spare, a miniabdominoplasty allows for acceptable donor
site scarring combined with correction of the abdominal skin surplus.
In flat-tummied patients, the conventional abdominoplasty will allow
for sufficient skin to be harvested to ensure successful secondary vag
inoplasty. Abdomino-plastic vaginoplasty has been proven to provide a
good alternative whenever a laparotomy is not favored or is contraindi
cated in secondary cases.