Vulvoplasty (zero-depth vaginoplasty)

Vulvoplasty is the reshaping of external genitalia (vulva) with plastic surgery. Some people in sex and gender minority communities ask for bottom surgery that does not include creating a full vagina. This is also called zero depth vaginoplasty (ZDV) or shallow-depth vaginoplasty (SDV), and it’s sometimes referred to by the slang term “dimple.”

This option is sometimes chosen by:

  • people with health risks
  • people with concerns about complications form vaginoplasty
  • people who do not wish to have penetrative vaginal sex
  • people who can’t or won’t maintain a dilation schedule

The procedure has been performed on people with differences of sex development and has been offered in Asia for some time, especially by Thai surgeons. A 2018 study by Jiang and others found that among those who had vulvoplasties, the procedures was “associated with high satisfaction and low decision regret.”

References

Milrod C, Monto M, Karasic DH (2019). Recommending or Rejecting “the Dimple”: WPATH-Affiliated Medical Professionals’ Experiences and Attitudes Toward Gender-Confirming Vulvoplasty in Transgender Women. J Sex Med. 2019 Apr;16(4):586-595. https://doi.org/10.1016/j.jsxm.2019.01.316. Epub 2019 Mar 2.

Jiang D, Witten J, Berli J, Dugi D 3rd (2018). Does Depth Matter? Factors Affecting Choice of Vulvoplasty Over Vaginoplasty as Gender-Affirming Genital Surgery for Transgender Women. The Journal of Sexual Medicine 2018 Jun;15(6):902-906. Epub 2018 Apr 26. https://doi.org/10.1016/j.jsxm.2018.03.085

Hourtane M, Leheuzey MF (1994). [Disorder of gender identity in a child with asymmetric gonadal dysgenesis with complex karyotype abnormality]. Arch Pediatr. 1994 Jul;1(7):659-62. French. PMID: 7987465

Sohn M, Bosinski HA (2007). Gender identity disorders: diagnostic and surgical aspects. J Sex Med. 2007 Sep;4(5):1193-207; quiz 1208. Review. https://doi.org/10.1111/j.1743-6109.2007.00580.x

Masumori N (2012). Status of sex reassignment surgery for gender identity disorder in Japan. Int J Urol. 2012 May;19(5):402-14. https://doi.org/10.1111/j.1442-2042.2012.02975.x. Epub 2012 Feb 28.

Mañero Vazquez I, García-Senosiain O, Labanca T, Gómez Gil E (2018). Aesthetic Refinement in the Creation of the Clitoris, Its Preputial Hood, and Labia Minora in Male-to-Female Transsexual Patients. Ann Plast Surg. 2018 Oct;81(4):393-397. https://doi.org/10.1097/SAP.0000000000001532

See also

Transgender surgery in the United States

Resources

Marci Bowers (marcibowers.com)

GRS Montreal (grsmontreal.com)

Trans HealthCare (transhealthcare.org)

MTF Surgery (mtfsurgery.net)