What to Expect When Preparing For and Recovering From Vaginoplasty

Some people who are transgender or nonbinary may choose to have gender affirmation surgery. These procedures may help them align their physical bodies to match their gender identities.

One of these gender-affirming surgeries is called a vaginoplasty. This is when surgeons create a vulva and vagina in someone who was born with a penis. 

“We can make a vagina and female genitalia that is remarkably lifelike,” says Jess Ting, Reconstructive Surgeon with Mount Sinai’s Center for Transgender Medicine and Surgery. “It’s beautiful, it’s aesthetic, and most importantly, it’s functional.”

How do you prepare for vaginoplasty?

If you do opt to have a vaginoplasty, there are a number of ways you’ll need to prepare for surgery, including:

• Coordinating with your clinical team to make sure you have healthy blood counts and normal blood clotting

• Working toward a healthy lifestyle, including quitting smoking or losing weight if needed

• Addressing other health conditions like diabetes or high blood pressure

• Finding a support system and a safe place to help you recover from surgery

• Making sure you’re emotionally and psychologically ready for this type of major surgery and the long recovery

• Undergoing laser hair removal around the genitals prior to surgery

What’s it like to recover from vaginoplasty?

Dr. Ting explains that vaginoplasty patients will spend at least 3 or 4 days at the hospital for recovery. 

When discharged, they may go home with packing inside the vagina, a vacuum-assisted closure (VAC), wound dressing, and a catheter to drain urine. They may also have a few small drains for postoperative bleeding. All of these items are generally removed within a week at the first postoperative appointment, according to Dr. Ting.

Patients may experience pain and swelling after surgery and should expect to spend the first 2 or 3 weeks resting in bed.  For the first month after vaginoplasty, they may want to sit on a donut ring to relieve the discomfort. They generally should avoid strenuous exercise for about 6 weeks or bathing for 8 weeks. Showering is usually fine during this time, but check with your surgical team.

The most “underestimated” part of recovery, says Ting, is the need for dilation, meaning keeping the vagina from closing or forming scar tissue. Patients will have to insert a medical dilator a few times a day for the first year after surgery, for about 10 minutes at a time. 

Doing this can involve a significant amount of pain. “It’s very important that patients come in prepared for that part of the recovery,” says Dr. Ting. 

What are some common complications from vaginoplasty?

If you’re thinking about gender affirmation surgery, Dr. Ting says it’s important that you educate yourself about all of the possible outcomes, including the negative ones. These can include:

• Poor healing: Incisions may reopen, but they usually heal on their own

• Excessive bleeding

• Infection

• Scar tissue

• Pelvic floor disorders

• Fistulas: These are abnormal connections between body parts, but they’re relatively uncommon

In addition, it can sometimes take multiple tries for surgeons to get the aesthetic result you’re looking for, so it’s possible you’ll need revision surgery. 

However, Dr. Ting says that most of the vaginoplasty patients he sees say that they feel more comfortable in their own bodies, and that their gender- affirming surgeries have helped them feel like their authentic selves.

“One of the best parts of my job is seeing the patients after surgery,” he says. “The vast majority of our patients are so happy after surgery.”

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Written by:

Marisa Taylor Karas

Marisa Taylor Karas is a freelance journalist based in Brooklyn who has covered health, gender, and technology for 15 years. She previously worked at The Wall Street Journal, The Guardian, and Al Jazeera America, among other publications, and also served as managing editor of the Mellon Foundation in New York City.

Reviewed by:

Alexandra Schwarz, MD

Alexandra Schwarz, MD, is a board-eligible sleep medicine physician and a board-certified family medicine physician. She is a member of both the AASM and the ABFM.

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