ABDOMINOPLASTIC SECONDARY FULL-THICKNESS SKIN-GRAFT VAGINOPLASTY FOR MALE-TO-FEMALE TRANSSEXUALS

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.