Bowtie technique—a novel approach to correct the widened ventral labia majora after male-to-female gender reassignment surgery

European Journal of Plastic Surgery. 39. 10.1007/s00238-016-1191-9.

Liang, D. & Dusseldorp, Joseph & Schalkwyk, C. & Haertsch, P

Abstract

Male-to-female gender reassignment surgery is a procedure that has evolved significantly since its inception. To create an aesthetic and functional vagina is the primary focus. Despite its evolutions, second stage revisions are frequently utilised to correct labial and clitoral hood defects (e.g. loss of clitoral hood, widening of the ventral labia major and exposure of the anterior commissure). Our objective is to present a simple and effective surgical step in the male-to-female gender reassignment operation in order to reduce the need for second stage interventions. The Bowtie technique is performed as the last step to the male-to-female gender reassignment procedure and aims to emphasise the clitoral hood, reduce the space of the ventral labia major and diminish the exposure of the anterior commissure. Having been performed by the senior author since 1992, outcomes have been satisfactory with no need for secondary procedures in those patients for the described defects. The Bowtie technique is a beneficial addition in male-to-female reconstructive surgery, which allows for the procedure to be performed in one stage without the need to correct common post-operative aesthetic defects. Level of Evidence: Level V, therapeutic study.