Sex Reassignment Surgery

TransOp Mexico is excited to add Sex Reassignment Surgery, also known as Gender Reassignment Surgery, to our portfolio of services focused on the needs of the trans community. Our goal is to make SRS/GRS accessible to more patients by making it more affordable and more available without long waiting lists. 

 Dr. Ivan Aguilar is TransOp’s SRS/GRS surgeon. Dr. Aguilar specializes in one-step construction by using the penile inversion and scrotal graft technique, a method he learned from Dr. Marci Bowers, one of the most well-known SRS/GRS surgeons in the world. The expected duration of this procedure is around four hours and is performed under general anesthesia.

In addition, Dr. Aguilar performs an alternate method referred to as Sigmoid Colon SRS. Limited-depth and nullification options are also available for patients not seeking full SRS.

Sex Reassignment Options:

Penile inversion surgery, also known as vaginoplasty, is a gender-affirming surgical procedure performed on transgender women or individuals assigned male at birth who wish to undergo gender confirmation surgery. The goal of this surgery is to create a neovagina that is anatomically and functionally similar to a cisgender woman’s vagina.

We also offer a more conservative surgical approach than the standard SRS which is called “Cosmetic SRS” or a “Limited-Depth SRS”. The operation time of the cosmetic SRS is shorter than standard SRS, it has faster recovery time and the vaginal dilation is no longer required.

Prospective SRS patients who do not wish to have a functional vagina for the use of sexual penetration, the cosmetic SRS should be taken in consideration.

Cosmetic SRS consists of elimination of male genitalia, penis shaft and testes, creation of all external female genital structures which are clitoris, clitoral hood, labia majora and minora, and urethral and vaginal opening. The vaginal opening of up to 1.5 – 2 inches deep is needed to maintain the natural look of female genitalia and make an illusion that it has a vaginal canal.

Sensitivity and orgasm are achievable with cosmetic SRS as the nerves responsible for sensation are carefully preserved during the surgery. Colon technique or skin graft can be used, should the patient decide to create vaginal canal at a later time.

The ideal reconstructive procedure should provide a vagina that has an appropriate length and that requires minimal, if any, dilatation. It should not scar, stenose or contract and should provide a satisfactory cosmetic result. Reconstructing the vagina using intestinal segments creates an aesthetically pleasing vagina, which seems to be more compatible with sexual activity.

After penile inversion skin flap, sigmoid colon technique presents the method of choice in transsexual surgery. Advantages of this procedure include adequate vaginal length, natural lubrication, early intercourse and a low rate of shrinkage. Sigmoid colon is particularly useful because it is anatomically similar to the perineum, with sufficient length and mobility of the segment that allows it to be easily brought into the perineum.

The neovagina will be packed for 7 days, and an indwelling Foley catheter will be left in place for 4 days. At discharge from hospital, patients are instructed to irrigate the neovagina once a day for 2 months and weekly thereafter, and to dilate the introitus of the neovagina on a daily basis with a vaginal dilator.

Dr. Aguilar is the only surgeon in Latin America who offers Nullification surgery, also well known as Male-to-Nullo.

Many Gender Non-Binary patients opt for this more conservative surgical approach than the standard SRS. This surgery is focused on providing no sexual internal and external genitalia, giving the patient an external appearance of no penis or vagina.

What makes Nullification SRS different from the standard SRS in the case of Male-to-Nullo, is that it does not include the creation of a vaginal canal so there will be no functional depth for penile penetration, includes the testis removal and the highly reconstructive procedure to reroute the urethra.

For those patients seeking to preserve sensitivity and an ability to orgasm, we can preserve the part of the glans, embedded under the skin surface.

Frequently Asked Questions (FAQ)

Clitoral hood & clitoris

Dr. Aguilar do not depend on the inversion of the penile skin totally, the scrotal skin, will be remodeled and will create a natural shape of vaginal opening in vertical orientation for the best realistic look and function, this scrotal graft will provide a 6 to 8 inches depth vagina, allowing Dr. Aguilar to use part of the penile skin for the creation of the labia. The vaginal opening can also expand appropriately to accommodate pleasurable sexual intercourse and vaginal dilators in varied sizes.

The process of skin graft technique is delicate as the donor skin from scrotum and groin will be converted to be the intermediate thickness of skin graft which means the superficial part of dermal layer is preserved to maintain skin durability.

To ensure that the skin graft will be 100% hairless, the hair follicles of the scrotal skin will be cauterized, so if the patient did not got a proper laser hair treatment or Hydrolysis, Dr. Aguilar will take care of the hair follicles during the surgery.

Self-lubrication can be also expected by preservation of specific secretory glands around the urethral & vaginal opening, but Dr. Aguilar recommends lubricant for intercourse, for less vaginal discomfort.

Vaginal canal

 We also offers a more conservative surgical approach than the standard SRS which is called “Cosmetic SRS” or a “Limited-Depth SRS”. The operation time of the cosmetic SRS is shorter than standard SRS, it has faster recovery time and the vaginal dilation is no longer required.

Prospective SRS patients who do not wish to have a functional vagina for the use of sexual penetration, the cosmetic SRS should be taken in consideration.

Cosmetic SRS consists of elimination of male genitalia, penis shaft and testes, creation of all external female genital structures which are clitoris, clitoral hood, labia majora and minora, and urethral and vaginal opening. The vaginal opening of up to 1.5 – 2 inches deep is needed to maintain the natural look of female genitalia and make an illusion that it has a vaginal canal.

Sensitivity and orgasm are achievable with cosmetic SRS as the nerves responsible for sensation are carefully preserved during the surgery. Colon technique or skin graft can be used, should the patient decide to create vaginal canal at a later time.

Urethra

The urethral orifice is set above the vaginal opening at the correct anatomical position to allow female pattern of urine flow, being Dr. Aguilar a reconstructive urologist, the urethra reconstruction is guarantee it won’t close, major complication seeing in plastic surgeons urethroplasty.

All spongiosum muscles around urethra are completely removed to prevent tissue engorgement during sexual arousal which can narrow the vaginal opening, create the sensation of cystocele or cause difficulty during sexual intercourse.

Post-operative care

Our highly qualified surgical nurses will assist you after the operation, they will be with you 24/7 in the hospital at your bedside, after you are discharged they will come to visit your daily at the hotel and they will do their best to provide all necessary after care for you, it is our policy to provide only well-trained and specialized surgical nurses who know all the details of your surgery to closely monitor and take care of you during your recovery.

Upon discharge, we will provide you with all necessary oral medications including the detailed instruction on how to take the medications correctly, post-surgical garment to retain the vaginal package (Special Diaper), SRS certificates containing the original handwritten signatures of Dr. Aguilar and Letter of Postoperative Care Management.

For Penile Inversion SRS you will be required to purchase a set of dilators:

soulsource.com 

Sensitivity & orgasm

Sensitivity and orgasm are well achievable with all types of SRS as the nerves responsible for sensation are carefully preserved during the surgery. 

Are complications common?

Like with any surgical intervention, complications do happen but they are rather rare. Mainly, complications are related to vaginal canal, that may lose depth or even close up, if dilating regimen is not closely followed or done improperly. We have performed hundreds of SRS surgeries to date and are only aware of 2 patients who lost depth due to failure to dilate. Rectal injury is also a possible risk with certain patients. In over 10 years of practice, we only had one (1) such case.

Remember, after you leave hospital, it is your sole responsibility to closely stick to dilation regimen, to avoid closure of vaginal canal.

Note that none of these risks are present for cosmetic SRS, which does not involve creation of a vaginal canal or any dilating at all. More and more of our patients choose cosmetic SRS.

Can I have a private online consultation with the surgeons?

Yes, absolutely! Our doctors are available for private consultations via WhatsApp (up to 30 minutes per patient, Please see schedule and instructions on how to join).

IMPORTANT: All patients will also have a private consultation with our doctors one day before surgery.

Is medical tourism insurance required?

es, gender reassignment surgery is a serious procedure that potentially carries certain risks, especially for older patients or patients with special health conditions. To protect our patients from unexpected expenses in an event of unexpected complications, while they are undergoing medical treatment in Mexico, all patients are required to purchase travel health insurance:

Purchase Novamar Medical Tourism Insurance Policy

Do I need a letter from my therapist?

Yes. Just like any other SRS surgery hospital, we are no exception.

In some cases we can help obtain the letter while you are already in Mexico, for patients coming from countries where obtaining such letter can be difficult.

Click on the photo to see SRS Results

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