Vaginoplasty is a surgical procedure typically performed to reconstruct or create a vaginal canal. This procedure is often sought by transgender women (male-to-female) as part of their gender confirmation surgery, though it can also be performed on cisgender women who have congenital conditions, trauma, or other medical reasons requiring vaginal construction. The procedure involves the careful reshaping and contouring of existing genital tissue, such as the penile and scrotal skin, to create a neovagina that closely resembles biological female anatomy both functionally and aesthetically.

The surgery generally starts with the administration of anesthesia to ensure the patient is unconscious and comfortable. Surgeons then make an incision at the penile tissue, preserving nerves and blood vessels to maintain sensation. The penile skin is inverted to form the vaginal canal, and in some cases, skin grafts from other areas of the body may be used to achieve the necessary depth. The glans penis is often preserved to create a clitoris, allowing for potential sexual pleasure. The labia are formed from the scrotal skin, and the urethra may be repositioned to match typical female configuration. Post-operatively, patients may require pelvic floor physical therapy and the use of dilators to maintain vaginal depth and prevent complications such as strictures or stenosis. Recovery includes regular follow-up appointments to monitor healing and manage any potential risks, which can include infection, bleeding, and issues with urinary function.