The penile inversion procedure is one of the most common surgical techniques used in male-to-female (MTF) gender affirmation surgeries, specifically for genital reconstruction surgery. It involves the transformation of the penile and scrotal tissue into the neovagina.

Here’s a general overview of the penile inversion procedure:

1. Pre-operative Preparation: Prior to the surgery, you will undergo a comprehensive evaluation by a qualified surgeon who specializes in transgender surgeries. They will assess your overall health, discuss your goals and expectations, and provide you with information about the procedure.
2. Anesthesia: On the day of the surgery, you will be placed under general anesthesia to ensure you are comfortable and pain-free throughout the procedure.
3. Penile Dissection: The surgeon will make incisions along the penile shaft, carefully preserving the neurovascular structures. The penile skin is then dissected away from the underlying erectile tissue.
4. Testicular Removal: If desired, testicular removal or orchidectomy may be performed as a separate surgical procedure prior to the penile inversion.
5. Penile Inversion: The penile skin is inverted and used to create the lining of the neovagina. The scrotal skin is often used to create the labia minora. The surgeon will shape and refine the tissue to create a natural-looking vaginal canal.
6. Clitoral Creation: The glans of the penis is typically preserved and used to create a clitoris. Sensation and sensitivity are important considerations in this step.
7. Closure: Once the neovagina is created, the surgeon will carefully close the incisions, using dissolvable sutures or stitches that will need to be removed later.
8. Post-operative Care: After the surgery, you will be given instructions for post-operative care, including wound care, pain management, and dilation techniques to maintain the depth and width of the neovagina.

It’s important to note that the penile inversion procedure is a complex surgical procedure that should only be performed by experienced surgeons who specialize in transgender surgeries. Each individual’s surgical plan may vary depending on their specific needs and goals. Consulting with a qualified surgeon is crucial to obtain detailed information about the procedure, potential risks and complications, and expected outcomes.