Dr. Aguilar and Dr. Mendez perform gender reassignment surgery (GRS) in one step construction by using the penile inversion and scrotal graft technique, his technique learned from one of the top surgeon in United States in GRS Dr. Marci Bowers, with whom Dr. Aguilar was trained, will provide gender reassignment surgical results that have anatomical appearance and physiological function.

Clitoris Hood and Clitoris

The clitoral hood is a fold of skin that surrounds and protects the clitoris. It is vital not only in protecting the clitoris, but also in achieving pleasure during sexual arousal, this hood is perform with the penile skin and the urethra mucosa for achieve this sensation.

Dr. Aguilar expertise is to preserve specific sensory nerve to provide excellent sensation and successful achievement of orgasm, the neo-clitoris is made from the dorsal part of glans pens, the most sensitive area of the glans and the preservation of the neurovascular bundle will ensure the sensation and achievement of orgasm guarantee.

The vulva is made from the ventral part of the penis when is inverted and a lining of the urethra mucosa, will provide lubrication and pleasure sensory, due to its pudendal innervation and the inner labia is normally pink in color and extends to the bottom of the vulva vestibule to become the posterior fourchette which is similar to the appearance of inner labia in biological women.

Vaginal Canal

Dr. Aguilar do not depend on the inversion of the penile skin totally, the scrotal skin, will be remodeled and will create a natural shape of vaginal opening in vertical orientation for the best realistic look and function, this scrotal graft will provide a 6 to 8 inches depth vagina, allowing Dr. Aguilar to use part of the penile skin for the creation of the labia. The vaginal opening can also expand appropriately to accommodate pleasurable sexual intercourse and vaginal dilators in varied sizes.

The process of skin graft technique is delicate as the donor skin from scrotum and groin will be converted to be the intermediate thickness of skin graft which means the superficial part of dermal layer is preserved to maintain skin durability.

To ensure that the skin graft will be 100% hairless, the hair follicles of the scrotal skin will be cauterized, so if the patient did not got a proper laser hair treatment or Hydrolysis, Dr. Aguilar will take care of the hair follicles during the surgery.

Self-lubrication can be also expected by preservation of specific secretory glands around the urethral & vaginal opening, but Dr. Aguilar recommends lubricant for intercourse, for less vaginal trauma.


The urethral orifice is set above the vaginal opening at the correct anatomical position to allow female pattern of urine flow, being Dr. Aguilar a reconstructive urologist, the urethra reconstruction is guarantee it won’t close, major complication seeing in plastic surgeons urethroplasty.

All spongiosum muscles around urethra are completely removed to prevent tissue engorgement during sexual arousal which can narrow the vaginal opening, create the sensation of Cystocele or cause difficulty during sexual intercourse.

The surgery time last around 4 hours, and it performed by Dr. Aguilar and Dr. Carlos Mendez, his associate who is a board certified Plastic Surgeon, to achieve the external genitalia the best results.

Post-Operative Care

Our highly qualified surgical nurses will assist you after the operation, they will be with you 24/7 in the hospital at your bedside, after you are discharged they will come to visit your daily at the hotel and they will do their best to provide all necessary after care for you, it is our policy to provide only well-trained and specialized surgical nurses who know all the details of your surgery to closely monitor and take care of you during your recovery.

Upon discharge, we will provide you will be provided with all necessary oral medications including the detailed instruction on how to take the medications correctly, post-surgical garment to retained the vaginal package ( Special Diaper), GRS certificates containing the original handwritten signatures of Dr. Aguilar and Letter of postoperative care management and dilation system.

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