Dr. Alter’s Before and After
INTERSEX & COMPLEX FEMALE RECONSTRUCTION

Dr. Alter specializes in female genital surgery and has spent decades perfecting his reconstructive techniques. All patients featured in this gallery are unique and an individualized treatment plan was developed for each case.

PATIENT 1

INTERSEX AND VULVA RECONSTRUCTION

23-year-old with adrenogenital syndrome and ambiguous genitalia. Had previous clitoris reduction and vulva reconstruction. Presents with clitoris enlargement and multiple deformities.
a. Pre-operation: Large glans clitoris, no clitoral hood, poorly defined labia minora, and high labia majora. b. Post-surgeries after several years: Clitoris reduced, clitoral hood reconstructed, labia majora advanced downward, and vulva reconstruction c. Pre operation from oblique angle d. Post-surgery from oblique angle

PATIENT 2

INTERSEX AND VULVA RECONSTRUCTION

30-year-old woman with adrenogenital syndrome and ambiguous genitalia. Had reconstructive surgery in the past including a partial clitoral reduction and labia reconstruction. Presents with clitoris enlargement and multiple deformities.
a. Pre-operation: Large glans clitoris, no clitoral hood, and poorly defined labia minora.
b. Post-operation: Immediate. Clitoris reduced, clitoral hood reconstructed, and labia minora reconstructed. c. Pre-operation from oblique angle d. Post-surgery from oblique angle

PATIENT 3

INTERSEX AND VULVA RECONSTRUCTION

37-year-old hermaphrodite. Had previous surgery at age 18. Presents with clitoris enlargement, and multiple vulva deformities including urethral and vaginal narrowing.
a. Pre-operation: Large clitoris, no clitoral hood, vulvar deformities, and poorly defined labia majora. b. Post-surgery: Immediate. Clitoris reduced, clitoral hood reconstructed, vulva reconstructed, urethra and vaginal opening enlarged, and labia majora advanced downward.

PATIENT 4

INTERSEX AND VULVA RECONSTRUCTION

30-year-old with adrenogenital syndrome. Previous surgery at age 4. Presents with clitoris enlargement, absent clitoral hood, absent labia minora, and high labia majora.
a. Pre-operation: Large glans clitoris, no clitoral hood, high upper labia minora, and high labia majora. b. Post-surgery: Immediate. Clitoris reduced, clitoral hood reconstructed, labia majora advanced downward, and labia minora reconstruction (right labial flap and left YV advancement). c. Pre-operation: Vulva opened d. Post-surgery: Oblique angle

PATIENT 5

INTERSEX AND VULVA RECONSTRUCTION

59-year-old hermaphrodite had surgery at age 12. Presents with vulva deformity and absent vagina.
a. Pre-operation: No real clitoris, no clitoral hood, urethra opening high, no vagina, concave pubic area. b. Post-surgery at 7 months: Creation of clitoral hood with revision of pseudo-clitoris, repositioning of urethra, reconstruction of labia minora, construction of small vagina, excision and reconstruction of pubic concavity.

PATIENT 6

INTERSEX AND VULVA RECONSTRUCTION

33-year-old with labia minora and posterior vaginal opening deformities due to recurrent rectovaginal fistulae and perianal infections resulting from Crohn’s disease. She had previous perineal and anal reconstruction
a. Pre-operation: Deformities of bottom of right labium and perineum, absent left labium. b. Post-several staged procedures: Right and left labia minora reconstruction along with reconstruction of bottom of vagina. c. Pre-operation: Vagina open
d. Post-surgery: Vagina open

PATIENT 7

INTERSEX AND VULVA RECONSTRUCTION

23-year-old with congenital genital deformity (probably minor exstrophy variant) with double clitoral head, no clitoral hood, enlarged labia minora, and wide pubic scar.
a. Pre-operation with above findings b. Post-surgery: Reconstruction of clitoral hood, labia minora reduction, and revision of pubic scar

Patient-First Policy

Dr. Alter and the entire team are dedicated to providing every patient with exceptional individualized care—from consultation to recovery. We take the time to learn about your concerns, goals, and desires, so we can build a plan that addresses your concerns and gets you the
results you deserve.

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