Vulvoplasty
Vulvoplasty is a surgical procedure that creates the appearance of female external genitalia, including the labia majora, labia minora, and clitoris, without constructing a vaginal canal. For many transgender women, this procedure is an affirming and deeply personal choice, especially for those who do not desire penetrative sex or are not able to undergo a full-depth vaginoplasty for medical or anatomical reasons.
At Avané Clinic, we understand that gender-affirming surgery is not one-size-fits-all. Our board-certified plastic surgeons work closely with each patient to create natural-looking results that align with their goals, identity, and body. Whether you're considering vulvoplasty as a standalone procedure or as a step in your transition journey, we welcome you to schedule a private consultation to discuss what’s right for you.
Vulvoplasty is a gender-affirming surgical procedure that creates the appearance of female external genitalia without constructing a vaginal canal. It’s often called a “zero-depth vaginoplasty” or “shallow-depth vaginoplasty” because it focuses on the outer appearance rather than internal depth. The procedure is commonly chosen by transgender women who do not desire penetrative sex or for whom a full vaginoplasty carries increased medical risks.
Using the penis and scrotal skin—or skin grafts if needed—the surgeon creates a vulva that typically includes the labia majora, labia minora, and clitoris. The urethra is repositioned to allow for urination in a seated position. This procedure is sometimes covered by health insurance plans, depending on the policy and whether it's recognized as medically necessary gender affirmation surgery.
Vulvoplasty is typically performed under general anesthesia and takes several hours. The procedure begins with hair removal, pre-surgically via electrolysis or laser, to reduce the risk of post-op complications. The surgeon then removes the testicles and repurposes penile and scrotal tissue to sculpt the external genitalia.
The glans of the penis may be reshaped to form a clitoris with preserved sexual sensation, and the labia are created using remaining skin. If there is not enough skin is available, grafts may be taken from other areas. The urethra is shortened and repositioned; careful attention is given to aesthetics and symmetry. No vaginal canal is created, which reduces risks associated with dilation and complications near the bladder or rectum.
Vulvoplasty creates external female genitalia and is often pursued by transgender women experiencing gender dysphoria related to the appearance of their genitals. It may also be appropriate for patients with medical conditions or an anatomy that prevents them from safely undergoing full vaginoplasty, or for those who are older, unable to take hormones, or prefer not to engage in penetrative sex.
This procedure can reduce mental and emotional distress tied to gender identity. For many, it helps them feel more comfortable in their own bodies, in intimate settings, or wearing certain types of clothing. Vulvoplasty is also an option for those who are not candidates for vaginoplasty due to age, scarring, or previous surgeries.
Vulvoplasty offers many benefits for transgender women, especially those seeking gender affirmation through external changes without undergoing a more extensive vaginoplasty. The physical results typically allow patients to urinate while seated, feel more at ease in their bodies, and avoid the need for lifelong dilation.
It may also lower the risk of complications associated with full-depth procedures, like fistulas, prolapse, or infections. Recovery time is often shorter, and there is no need to maintain a vaginal canal. Emotional benefits—such as relief from gender dysphoria and improved quality of life—are commonly reported by patients.
You may be a good candidate for vulvoplasty if you are a transgender woman seeking external genital reconstruction without vaginal depth. This procedure is often chosen by those who are not interested in penetrative sex or are medically unable to undergo a full vaginoplasty.
Candidates should be in good overall health, emotionally stable, and ideally have completed at least 12 months of hormone therapy. Hair removal on the surgical site is required before surgery. Patients should not smoke or use nicotine products, as these increase risks and slow healing. It is important to have realistic expectations about appearance, sensation, and recovery.
Most patients stay in the hospital for a day or two after valvuloplasty. Swelling and bruising are expected, and rest is essential. For 4 to 6 weeks, you’ll need to avoid strenuous activities, including lifting and exercise. The surgical area should be kept clean and dry, and you may be prescribed antibiotics or pain relief medications.
You’ll be able to urinate normally and won’t need to dilate, since there’s no vaginal canal. Some patients experience changes in sexual sensation as nerves heal. Follow-up appointments are essential to monitor healing and address complications like infection or wound separation.
The goal of vulvoplasty is to create realistic, feminine-appearing external genitalia that align with your gender identity. Most patients can wear swimwear and tight clothing without concern, and many feel significantly more confident and affirmed in their bodies.
While results are permanent, swelling may take several months to resolve fully, and scars may take several months to fade. Sensation, particularly in the clitoris, may continue to improve over time. The procedure does not create a vaginal canal, so penetrative intercourse is not possible—but for many, that trade-off brings peace of mind and a more manageable recovery.
At Avané Clinic, we recognize that vulvoplasty is more than a cosmetic procedure—it’s a vital step in many patients’ gender affirmation journeys. Our surgeons specialize in plastic surgery techniques that prioritize function and aesthetic appearance, and we tailor each vulvoplasty procedure to the individual’s anatomy and goals.
From your first consultation through your final follow-up, you’ll be supported by a team that respects your identity and listens to your needs. We’ll talk through risks, options, and realistic outcomes to ensure you feel informed and confident every step of the way.
Vulvoplasty creates the outer appearance of female genitalia but does not form a vaginal canal, while vaginoplasty includes internal depth for penetrative sex.
Yes, the changes made during valvuloplasty are considered permanent. However, as with any plastic surgery, some natural settling and healing will occur over time.
Most surgeons, including those at Avané, recommend at least 12 months of hormone therapy before surgery to optimize results, but exceptions are sometimes made.
Sensation varies by individual. Many patients retain or regain clitoral sensation, but this can depend on surgical technique and nerve healing.
Yes, the urethra is repositioned so that patients can urinate in a seated position. Some swelling may temporarily affect flow, but this usually improves.
The testicles are removed as part of the procedure, and the scrotal skin is often used to help create the labia majora.
Yes. Hair removal from the penis and scrotum is required before surgery to reduce the risk of hair growth inside the newly constructed vulva.
Some insurance plans do cover vulvoplasty as part of gender affirmation surgery. Coverage depends on the provider and whether it’s deemed medically necessary.
As with any surgery, risks include bleeding, infection, scarring, and delayed healing. There’s also a small risk of complications with sensation or urethral issues.
In some cases, yes. If enough tissue is preserved and your anatomy allows, vulvoplasty can be a step toward full vaginoplasty in the future.
The cost of a vulvoplasty can vary significantly depending on several factors, including the surgeon’s experience, the clinic or hospital setting, the geographic location, and whether the procedure is covered by health insurance. In the United States, the out-of-pocket cost for vulvoplasty typically ranges from $10,000 to $25,000 for those paying privately. This estimate may or may not include anesthesia, hospital fees, preoperative hair removal, or follow-up visits. Our team can provide an accurate quote for your procedure as part of the consultation process.
If you are seeking vulvoplasty as part of gender-affirming care, some health insurance providers may partially or fully cover the cost, especially if the surgery is deemed medically necessary. However, insurance requirements often involve documentation from mental health providers and evidence of hormone therapy, so it’s essential to confirm the details with both your provider and your surgeon’s billing team.
