Vaginoplasty

• You will be scheduled for a pre-operative appointment before your surgery to determine if you are a candidate for the procedure and to clear you for anesthesia.
• You must meet the World Professional Association for Transgender Health (WPATH) guidelines and WPATH support letters must be obtained before booking your procedure.
• You must demonstrate you can safely proceed with surgery and recovery, both physically and psychologically.
• Before surgery, you need to have the hair permanently removed in the following areas: scrotum, under the penis base, between thigh creases, and perineum (area between scrotum and anus).
• Follow provider instructions regarding medications before and after surgery.
• After midnight on the night before surgery, you may not eat any solid foods, including candy, chewing gum, cough drops or mints.

• At your pre-operative appointment, you will discuss the procedure with your surgeon to determine the best method of care for you. Your wellbeing and goals are important to us.
• Vaginoplasty usually takes 5-7 hours. You will be put under anesthesia, which means you will be deeply asleep and will not feel anything during the procedure.
• The operation is performed through incisions in the perineum.
• Plan for support during recovery in the weeks following surgery.

• You will receive post-operative instructions from your surgeon to follow at home, after a typically 5-day hospital day.
• Your catheter, drains, vaginal packing, and other surgical dressings will be removed 5-7 days after surgery.
• You will be instructed on how to perform dilation. It is important for the dilator and vaginal area to be clean.
• You will be on bed rest until day 5 after surgery. Avoid strenuous activity and heavy lifting for 6 weeks after surgery.
• Increase fluid intake and eat fiber-filled foods to prevent straining during bowel movements.
• You should plan to be out of work for at least 6 weeks following surgery.
• Follow the instructions of your medical team for restarting supplements such as estrogen.
• Refrain from vaginal and anal sex for 3 months.

Is a vaginoplasty reversible?

No, a vaginoplasty is not a reversible procedure. Speak with your surgeon to ensure this is the right procedure for you.

How do I make sure hair removal before surgery is permanent and how long does this take? Can this be done after the vaginoplasty?

To make sure necessary hair is removed and will not grow back, hair removal can be done via laser hair removal (uses heat and light) or electrolysis (uses electricity). Plan accordingly as completion of hair removal may take longer than 1 year and should be finished at least 4 weeks before your vaginoplasty. Hair inside the vaginal cavity (inside your body) cannot be removed after your vaginoplasty.

How often do I perform dilation?

Dilations should be performed as soon as vaginal packing is removed (5-7 days after vaginoplasty). You should then continue to dilate 3 times a day for 3 months. For the next 6 months, dilations are recommended 2 times a day. You should then perform ongoing dilations every day. Consistency is important to prevent narrowing of the vaginal canal. Dilation is a lifelong necessity, and sex is not a substitute for dilation.

What are the risks of surgery?

There is a small risk of bleeding and infection from the operation, as with any procedure. Specific risks for vaginoplasty include wound separation, vaginal stenosis (vaginal canal narrowing), hematoma (significant bruising), and rectovaginal fistula (atypical connection between rectum and anus).