Vaginoplasty is an operation aimed at reconstruction. Generally speaking most of the patients are congenitally without a vagina and need to create one artificially. The first step of the procedure is to create a space where the normal vagina is located, which is the first step of the procedure: the separation of the urethrorectal space, which is the basis for both the destruction and the construction of the vagina. The first step is not enough to make it a vagina, but a “lining” has to be made on the surface of this space. Then, the choice of material for the lining becomes the focus of the gynecologist’s thoughts. The basic requirement for the “lining” is to be able to survive, and the high standard requirement is to resemble the normal vaginal mucosa. Based on this, the gynecologists came up with the simplest method, the “top-in” method, which is to use a support to press the space out and the mucosa of the vulvar vestibule to grow in, forming a vaginal “lining”, which is the closest to the normal vaginal mucosa. The “lining” is the closest thing to the normal vaginal mucosa and can be used as a substitute for the real thing. It is suitable for patients with good vulvar “condition”, which means that the perineal navicular fossa is loose and can be easily inserted with the index finger for about 2 cm. In addition, the patient needs to be able to master the technique of the apex entry and be willing to accept this method that requires a long treatment time, usually about six months. What happens if the patient cannot master the technique of the “jacking-in method”? Gynecologists have designed another kind of surgery, that is, the surgical method to change the “top” to “traction”, that is, “traction with the method of entry”, that is, through surgery from the abdominal cavity, pelvic cavity. This is done by surgically opening the space from the abdominal cavity and pelvic cavity from top to bottom and tracting a round hard object from the vulva upwards to slowly bring the vulvar vestibular mucosa into the space, forming the vaginal “lining”. This is an additional surgical route through the abdominal and pelvic cavities than the “top entry” method, which increases the surgical trauma, but can be used for patients who cannot master the “top entry” technique. For those who cannot accept this long treatment and give up halfway, gynecologists have designed another procedure for patients to choose, namely the “flap method”. It uses the labia minora of the vulva to heal together and further expand the perineal navicular fossa to form a “vagina” that extends outward, suitable for patients with large labia minora. What about patients with small labia minora? Gynecologists have thought of using the labia majora or even the inner thigh skin instead. The advantage is that the procedure is short, but the disadvantage is that the urine is easily left in the “vagina”, and the farther the material is taken from the center, the more traumatic it is, and the greater the difference from the natural vagina. In particular, the difference from a normal vagina is difficult for the patient and her partner to accept.