A Refinement Technique to Conceal the Scar Along the Labia Majora in Gender-affirming Vaginoplasty

Although the traditional gender-affirming vaginoplasty technique has been successful in closely resembling natural female anatomy, the surgical scar on the labia majora has been a significant concern for many. To address this issue, the author has developed a technique to conceal the scar resulting from the trimming of excess scrotal skin within the robustly reconstructed interlabial sulcus, thereby reducing its visibility and improving vulvar aesthetic outcomes. Of the 107 patients who underwent gender-affirming vaginoplasty, 72 underwent the traditional technique, whereas 35 underwent the technique in which scars from scrotal skin excision were concealed within the interlabial sulcus. The outcomes from the latter group showed that surgical scars were completely concealed in 32 (91.4%) patients, whereas 2 (5.7%) patients experienced scar migration lateral to the interlabial sulcus, and 1 (2.9%) patient had a loss of interlabial sulcus definition. By comparison, all patients who underwent the traditional technique exhibited visible scars in the center of the labia majora. This technique, which conceals the scar within the interlabial sulcus, demonstrates superior vulvar aesthetic outcomes compared with the traditional method.