Sigma-Lead, Peri-Sanctuary, and Cosmetic SRS/GCS

Best Transgender Surgeon

It is the ultimate dream for most transgender women to have that wonderful female genitals in all of its beauty, glory and function:
a vulva and a vagina that are “like the real thing”.

Come on – is that really possible to have SRS/GCS surgery with a result exactly like a natural vulva and vagina, like so many say?

Honestly, if you think you can have an exact replica of what nature does when a female genital gets developed in a female child – the answer is no.

No surgeon can compare to the genius and unique exquisite design of what nature creates when a vulva and vagina get developed in a human fetus. If you want everything to be like the “real thing” you will end up disappointed and disillusioned after having SRS/GCS surgery.

This is why we want your expectations to be valid and according to what Dr. Kaushik will achieve for you.

So let’s first look at a natural vulva.


Natural Vulva


If my result is not like “the real thing”, is it even worth the surgery?

That depends very much on your expectations.

Dr. Kaushik literally performs hundreds of revision surgeries of SRS/GCS gone wrong elsewhere in the world every year. These clients are very happy with the revision surgery results they get – patient satisfaction is comparatively easy to achieve contrasting the before-and-after results of this kind of revision surgery.

But if you have your initial surgery with Dr. Kaushik, your vulva and vagina result will be as close as possible to “the real thing” as plastic surgery can get it nowadays
Dr. Kaushik will create a vulva and a vagina for you, that will come close to what nature manages to create every day. If Dr. Kaushik’s results are close enough for you and your expectations so you will be happy with your results is a question only you can answer. This is why we have a vast collection of results for you to look at.

If you are happy with one of our Before and After results, then we are a great choice for you. Choose the result picture you like best and show it to Dr. Kaushik during your consultation with him, so he knows which kind of vulva aspects are important to you. Explain to him which vulva aspects you want:
larger or smaller outer labia, small and delicate or large and prominent labia minora, a rather large or a rather small clitoris, which clitoris shape you prefer, and any special requests for the general appearance of your vulva that you have.
Please keep in mind though, that Dr. Kaushik cannot guarantee a certain outcome. He will strive to get as close to your desired result as possible using his surgical skills. Achieving a desired result is not solely in Dr. Kaushik’s hands – it is also dependent and limited by the patient:

  • The body’s nerve and blood supply of the tissues relevant for the surgery
  • The individual healing capacity and tissue healing abilities of the patient’s body
  • The patient’s genetic disposition in terms of body shape, tissue quality, and helpful/ limiting fat distribution
  • The mental readiness, preparedness, and positive-outcome-focus of the patient

Will I be able to pee like a woman after Olmec GCS/SRS?

Yes, nearly all of our patients do. Since peeing like a female is a very central aspect of a any proper GCS/SRS, Dr. Kaushik developed his TrueShape Urethra Shortening procedure which includes creation of urethra opening in a unique fashion. This special TrueShape surgery detail usually allows for a proper female-like stream when urine passes the urethral opening – resulting in the adequate spray of urine and the proper female sound while peeing. All TrueShape GCS/SRS surgeries include this feature, so you can go to any bathroom with confidence – knowing everything will sound just right.

Another important aspect of Dr. Kaushik’s TrueShape vulvaplasty is, that only few of GCS/SRS surgeries need a cosmetic touch-up procedure after the initial GCS/SRS to achieve a beautiful and pleasing aesthetic of your new vulva. This is part of the surgical approach that Dr. Kaushik has. He will use the best possible blood supply and nerve supply available – and that usually means to leave more tissue in your vulva region. This surplus tissue will then be removed during touch-up to create the best possible cosmetic result.

Dr. Kaushik offers three main SRS/GCS surgeries at Olmec

1) Cosmetic SRS/GCS Surgery (Vulvaplasty) with or without penile inversion

As the name implies, this SRS is about appearance – that is the vulva – only. The appearance of your vulva will be like with our full SRS/GCS surgeries. With vaginal part there are there are three options-

  • You can choose zero depth vaginoplasty, there will be no vagina present
  • You can choose very limited depth vaginoplasty- where a vaginal entrance of 1-3 inches (2,5 – 7 cm) of depth will be created and
  • Limited depth vaginoplasty-akin to standard penile inversion where a depth of 3 to 6 inches will be created depending on the available skin.

Please keep in mind and be aware of this fact: Your vulva result will be suboptimal if you are circumcised.

Unfortunately, circumcision cuts off the much needed and highly sensitive foreskin of the male genital, which is essential to create the labia minora in the best possible way
If the foreskin is missing, the result of circumcised patients will always lack in appearance compared to circumcision-free patients. Dr. Kaushik usually still achieves to create labia minora for circumcised patients, but their size will be smaller, their color will be darker, and sensate potential of the tissues used will be minimized due to the scarring created by circumcision.


  • Least invasive GCS/SRS surgery with the least risk of surgery complications
  • TrueShape vulva
  • TrueShape urethra shortening
  • No functional vagina – therefore no dilation necessary

For Indian clients:

It is also important to know that Indian clients can choose the vulva parts to be created because of oftentimes limited budgets or ideas that the patients have about the appearance of their vulva. This topic needs to be discussed in a personal consultation with Dr. Kaushik

2) Peri-Sanctuary GCS/SRS

Once again, Dr. Kaushik steps forward with a unique innovation: his version of peritoneal SRS/GCS – his Peri-Sanctuary SRS/GCS. According to Dr. Kaushik’s evaluation, regular peritoneal pull-through surgery concepts heavily manipulate the peritoneal tissue and expose it to intense pulling and pushing which affects the optimal blood supply of the sensitive peritoneal tissue – which in turn affects the healing capacity of the peritoneal neovagina as well as its resistance to more intense sexual intercourse.
This is why Dr. Kaushik created his absolutely tension-free Peri-Sanctuary peritoneum procedure. Due to that circumstance, vaginal canal shrinking is less than with the regular peritoneum GCS/SRS approaches. The constant lubrication of the mucous layer of the peritoneum will provide an appropriate vaginal lining after about 2.5 -3.5 inches (6 – 9 cm) of depth. Total functional vaginal depth of 5-7 inches (12.5 – 17.5 cm) is possible – depending on the physical prerequisites of the patient.
Peri-Sanctuary SRS/GCS is the surgery of choice for all patients who are ineligible for Sigma-Lead GCS/SRS due to age, existing illnesses, or chronic diseases.
The same creation of the vulva (vulvaplasty) as with cosmetic or Sigma-Lead SRS/GCS completes this wonderful new approach which is less invasive and bears fewer potential risks than the Olmec gold standard Sigma-Lead SRS/GCS.


  • Medium invasive level GCS/SRS surgery with medium complication risk
  • TrueShape Vulva
  • TrueShape urethra shortening
  • Sensate Peri-Sanctuary vagina with constant lubrication and a vaginal depth of 5-7 inches (12.5 – 17.5 cm)
  • Dilation post-op: 2 x 1 hour per day for 12-16 months, then 1 x 1 hour per day

3) Sigma-Lead SRS/GCS

Dr. Kaushik’s Sigma-Lead surgery has proven itself as the Olmec gold standard of SRS/GCS surgery for all of Dr. Kaushik’s patients. In his highly acclaimed and award-winning medical paper, the technical details of his Sigma-Lead SRS/GCS are explained in detail.
Currently providing the ultimate in vaginal function, sexual sensitivity, and vulva aesthetics, this Olmec flagship surgery will keep you happy with your new genital for the rest of your life. After surgery you will dilate for 15-20 minute once per day for about 4-6 months before you can enjoy sexual intercourse, which can then replace dilation. Lubrication during sexual arousal, self-cleaning vagina properties, and a genuine vagina feel for you as well as for your sexual partner will make intimacy for you and your partner another recurrent highlight in your life.
Please be sure to meet the eligibility standards to be able to undergo Sigma-Lead SRS/GCS, since otherwise the surgery can’t be performed:

  • Age limit: 50 years
  • BMI (Body Mass Index): 22 or less
  • Free from existing intestinal illnesses

The Sigma-Lead SRS/GCS is an invasive surgery which bears more potential risks than conventional skin graft SRS/GCS surgeries or peritoneal SRS/GCS surgeries.

The intestinal tract equals a mirror of your lifestyle and eating habits and reflects those in its beingness. Usually, the best Sigma Lead candidates are vegetarian or vegan lifestyle people with a harmonic work-life balance and regular physical activity. These patients usually recover the fastest and can then soon enjoy living their life with their proper genital.


  • Most invasive GCS/SRS surgery with more grave complication risks
  • GCS/SRS technique for best vaginal function and best vulva aesthetics
  • TrueShape vulva
  • TrueShape urethra shortening
  • Sigma-Lead vagina with high sensitivity, lubrication on arousal, self-cleaning properties, and vaginal depth of 6-8 inches (15-20.5cm)
  • Dilation post-op 2 x 15 minutes per day for 4-6 months, then 1 x 15 minutes per day until month 12-15, then dilation as needed

GCS/SRS Revision Surgery

Sigma-Lead, Peri-Sanctuary, as well as TrueShape Cosmetic GCS/SRS surgery are available as revision surgery also. Any kind of revision surgery is a highly complex situation and every patient’s situation is unique. This is why a personal consultation via email or Skype with Dr. Kaushik is of utmost importance. Please provide as much visual evidence of your issue as possible

For revision surgery purposes, please contact Dr. Kaushik via email at [email protected] to explain your current situation and discuss your surgical options to address your issue with Dr. Kaushik in person.

Recognised by International Institutes