Vaginal Deepening

History

The Vaginal Deepening Procedure (VDP) is performed primarily upon patients of other surgeons, who lack depth either due to failure at the initial procedure, lack of skin or technical obsolescence (Dr. Biber, for example, performed only a simple penile inversion technique without grafting and many Thai surgeons abandon their pursuit of depth when complications arise). If depth was once available, patients can qualify for treatment with the Vaginal Re-opening Procedure (VRP) which is performed entirely as an outpatient and does not require re-lining of the vagina. The outpatient re-opening procedure has risks but is remarkably less expensive.

Procedure

The Vaginal Deepening Procedure (VDP) is delicate and potentially complicated, primarily due to the need to re-line the deepest portions of the vagina and to re-dissect through previously operated upon tissue. It normally requires grafted skin from either the primary surgical site and/or skin from the lower abdomen or any other potential source (arm, etc.) where excess skin can be harvested. A last course skin alternative is autologous donor skin matrix (Repliform, Alloderm, etc). Labiaplasty is included in the fees for the procedure and the procedure normally requires a 1 – 2 night hospital stay at Mills-Peninsula Hospital. Costs approach the full GRS cost although hospital stay is less. Total stay in the area is 9-11 days.

The VRP procedure deepens the vagina by surgically dissecting along the vaginal plane previously established, then packing the region and utilizing the original vaginal lining to heal after packing is removed. This reduces cost markedly. The procedure is completely outpatient at the San Mateo Surgery Center. Total stay in the area is 6-7 days.

Recovery

Recovery for both deepening procedures is shorter than primary GRS with resumption of activities in less than 4 weeks although sexual activity may be limited for the usual full 12 weeks. Mild pain killers, antibiotics and 7 days of limited activity are suggested.

Cost

Cost is significantly more for the VDP than the VRP due to hospitalization and cost of the grafting. Robin and Janet can help with insurance authorization.

Complications

Again, in our experience, complications are few and far between. Theoretic complications are significant due to the need to potentially re-dissect and re-line the entire vaginal cavity. But, in our extensive experience, the fears historically outweigh the reality.