Not just that, they also use a part of your colon to make the actual fake vag.. So these new "women" are running around with false Vs that literally squirted shit out for most of their lives. Because of the time issues with something like that and other things, you can never truly get rid of a lot of the bacteria responsible for most of the shit smells. Then combine that with a lack of natural systems to clean and wash out the deepest area, and lack of immune responses etc. Leading to dark, warm area loving bacteria, like above, to thrive. Which is why fake vag's will always smell like shit. No joke.
Then you get (even worse) horror stories. Them failing to clean the tissue off properly leading to massive infections and literal dangerous fecal and lower digestive track bacteria taking up almost permanent residence. Some poor underaged teen over in europe died a year or so ago from a massive infection. His whole lower half, all the skin and soft tissue became hopelessly infected. They had to essentially skin him from the ~mid-waist down all the way to his lower legs in order to try and save him.. it didn't work. :/
There are also horror stories about them not properly preparing the local tissue before turning an outie into an innie, leading to pubic hair growing deep in the new fake vag, beyond the reach of anything.. As well as other horrors beyond imagination.