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Objective To evaluate the effect of a scar-free surgical approach, the modified McIndoe technique, in cases of vaginal agenesis. Materials and Methods Seven patients with Mayer-Rokitansky-Kuster-Hauser syndrome underwent vaginoplasty with the modified McIndoe technique. Mucosa grafts harvested from the vulva were minced into small particles and transplanted to the neovagina. Results Epithelization in the neovagina is approximately 20 times in size than that in the mucosa harvested from the donor site. An adequate vaginal length was obtained in all cases, with a minimal change in genital appearance and invisible scars. All 4 sex-active patients reported satisfactory sexual experiences, with spontaneous lubrication during intercourse. Conclusion With the modified McIndoe technique, using an autologous micromucosa graft harvested from the vulva and the buccal cavity, we can physiologically reconstruct a new mucosa-lined vagina with minimal sacrifice.