To explore the feasibility of vagina reconstruction with a free vaginal flap. Methods: Vagina flaps can be constructed using three methods. The first two procedures involved the creation of a flaps through surgicalization of vaginal skin grafts. The third method requires no incisions but still involves some scarring because it requires the creation of a flap from tissue that is not always available from the patient’s own body. Outcomes: All three procedures were successful.
In July 2021, a twenty-eight-year-old married woman from Philadelphia, Pennsylvania presented to our office with a complaint of incontinence. She was having trouble getting her urine to come out and was not able to stand long enough to go to the bathroom. This was a problem since she was losing a lot of weight. It was not uncommon for women to lose large amounts of weight after giving birth to a child. This patient was no exception.
The patient had a history of significant weight loss, which was accompanied by severe vaginal dryness. At this time, her doctor had recommended vaginoplasty (the surgical reconstruction of the vagina), but the patient was concerned about the potential long-term risks. Two different incision techniques had been proposed. One involved creating a new vaginal surface through the use of skin from another part of her body; the labiaplasty (the other technique) involved cutting and completely reshaping the labia. Both of these procedures had been previously approved by the FDA for vaginal rejuvenation procedure.
The patient was advised that she would need to have a laparoscopic revision procedure to create flaps from her own vaginal tissue. After doing some research, we located and got in contact with a best plastic surgeons with experience performing these types of surgeries. The plan was to remove the excess skin and create a brand new vagina flap using this material as a base.
We made several visits to our surgeon’s office and were impressed with his surgical skills. On the second visit, he created what we believe is the first free flap using the modified version of the labium. The result? Flaps that look very similar to the vaginal reconstruction being performed in our photograph, but with the difference that it is much tighter and sturdier than the previous procedure.
So, we had three surgeries (free flap, modified flap, and final implantation) performed within eight months postoperatively. The overall result was impressive: our patients had noticeable improvements in the appearance and feel of their vagina over four to five months postoperatively. One sexual partner even told me that they now have a tighter vagina! All thanks to Cosmetic Surgery for Vagina Reconstruction!