Introduction: Gender-affirming vaginoplasty can be performed with or without neovaginal canal creation. While hopefully rare, a minority of patients undergoing minimal depth vaginoplasty may request conversion to full depth at a later date. This represents a dilemma for surgeons as reconstructive options are limited and genital tissue for canal lining is no longer available. Our objective was to describe an operative technique for conversion of minimal to full depth vaginoplasty. Methods: This video features a revision vaginoplasty in a patient with a history of minimal depth vaginoplasty who later requested full depth canal creation. We demonstrate revision using harvest of peritoneal flaps and additional skin grafts. Results: Postoperatively, the patient has been able to dilate successfully with canal depth of over 6 inches and had no post-operative complications. Conclusions: For patients who have a minimal depth neovagina who request conversion to full depth, canal revision can be accomplished safely using peritoneal flap harvest and skin grafts. SOURCE OF Funding: None
