Combined method – male-to-female procedure in Munich
For most patients (transwomen), the desire to have their genitals adjusted is the first priority.
The technique of penile invagination/penile inversion, which has been used most frequently since the mid-1950s, has become established over the years, but in our opinion it has some disadvantages. As a result, more than 10 years ago we developed the technique of the “Combined Method”, which has been used very successfully on a routine basis ever since. This technique can achieve an even better approximation of the genital area in terms of aesthetics and function.
The crucial difference to penile invagination is that, in addition to the penile skin, we also use the scrotal skin and the mucous membrane of the urethra to form the new vaginal cavity. This allows a reasonable vaginal depth to be achieved in most cases, regardless of the size of the genitalia.
Using the urethral mucous membrane can create a moist vaginal environment.
We also pay special attention to the formation of the external genitalia.
The inner leaf of the foreskin is left attached to the glans with vessels and nerves, and the clitoris, the clitoral hood and the labia minora are formed from it. The remaining penile skin is used to form the vaginal entrance.
Apart from the large corpora cavernosa and the testicles, no tissue is removed. During the entire operation, the nerves of the penis skin, clitoris, foreskin and urethra are microscopically dissected and protected. This is the only way to create optimal sensitivity for the entire genital region and vagina.
The mons pubis remains scar-free, with only delicate scars visible on the labia majora, but these fade over time after the operation.
In addition to the operation, aftercare is extremely important for an optimal result. In order to be able to use the constructed vagina optimally and to prevent shrinkage due to scarring, all our patients receive detailed and intensive instruction in how to bougie the neovagina after the operation.
Only when this is possible without any problems will you be discharged from the hospital. The average inpatient stay is a good 2 weeks. Even after your inpatient stay, the team led by Dr Morath and Dr Schöll is available to you at any time with help and advice – 24 hours a day / 365 days a year.
Often a second minor procedure is necessary to improve the result functionally and aesthetically. This can be done 6 months after the first procedure at the earliest. As part of this operation, further feminising procedures can be performed on the body, such as reduction of the larynx, breast reconstruction with implants or fat tissue transplantation (lipofilling) as well as feminising procedures on the face. We take a lot of time beforehand to inform you about all the possibilities and to be able to respond to individual wishes.
Breast augmentation in Munich – with implants or autologous tissue
Facial feminisation surgery in Munich (FFS) – remove typical male facial features
Lip augmentation in Munich – for fuller lips