Vaginoplasty: How to Prepare

A Type of Gender-Affirming Surgery

In This Article

A vaginoplasty, also called transfeminine bottom surgery, is a major operation that requires careful preparation. A few months prior to surgery, you will be instructed on various pre-operative lifestyle changes, like undergoing permanent hair removal and smoking cessation.

As your surgery date gets closer, you will be given additional instructions on various logistics—including what medications to continue or stop, and what to bring with you to the hospital.

Location

A vaginoplasty is performed under general anesthesia in the surgical unit of a hospital. Most surgeries take between seven to 10 hours.

Once you arrive at the hospital, you will first be taken to a preoperative room where you can expect to change into a hospital gown.

A nurse may then take your vitals and place a peripheral IV. Fluids, anesthesia medication, and oftentimes, an antibiotic, will be administered through this peripheral IV during the surgery.

While waiting in the preoperative room, you will also:

  • See your surgeon and any other doctors or nurses who are assisting with the surgery
  • Sign surgery and anesthesia consent forms, which address potential risks (e.g., bleeding or infection) associated with the operation

Once the surgery is ready to begin, you will be wheeled on a hospital bed into the operating room. Here you will be attached to various monitoring devices. Inflatable sleeve-like compression devices may also be placed on your legs to prevent blood clots. You will then be given anesthesia medications to put you to sleep.

What to Wear

Your surgeon may advise you to take a bath or shower before you arrive for surgery. Since you will be changing into a hospital gown, it's best to wear comfortable, loose-fitting clothing.

Leave jewelry, including wedding rings, and other valuables at home. Additionally, it's important to not wear the following items on the day of your surgery:

  • Contact lenses
  • Makeup
  • Perfume
  • Deodorant
  • Lotion or creams

Also, do not wear nail polish, as the anesthesiologist will need to attach a device that monitors your oxygen level (called a pulse oximeter) onto your fingertip.

Your clothes and other personal belongings will be placed in a plastic bag and given to you after the surgery (or to a loved one in the waiting room).

Food and Drink

You will likely be advised to begin a clear-liquid diet two days prior to surgery.

Examples of clear liquids include:

  • Water
  • Apple, white grape, or white cranberry juice
  • Black tea or coffee
  • Clear broth
  • Jell-O

Medications

About one to four weeks before your vaginoplasty, you will have an appointment with your surgeon. During this appointment, your surgeon and his team will review all instructions regarding preparing for and recovering from the surgery.

To ensure a good outcome and to optimize healing from the surgery, it's important to follow these instructions carefully. Do not hesitate to ask questions or address any concerns you have.

One of the instructions provided may be to start a bowel cleansing preparation. An example regimen may be to drink four liters of a prescription bowel cleansing liquid called Co-Lyte starting two days prior to your surgery.

Besides an appointment with your surgical team, you will also have an appointment or telephone call with an anesthesia nurse. The nurse will review your medications and give you specific instructions about whether you need to stop any of your medications before the operation.

Be sure to tell your surgeon and the anesthesia nurse all of the medications you are taking. These may include:

  • Prescription drugs
  • Over-the-counter drugs
  • Dietary supplements, vitamins, and herbal products
  • Recreational drugs

For example, the following instructions may be given to you:

  • About two weeks prior to surgery—to lower your risk for blood clots—you may be advised to stop estrogen supplements.
  • About 10 days prior to surgery—to lower your risk for bleeding—you may be advised to stop any nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, Motrin (ibuprofen), or Aleve (naproxen).

What to Bring

You can expect to stay in the hospital for around five to seven days. To prepare for this extended stay, you should bring these items with you on the day of your surgery:

  • Your insurance card
  • Your driver's license
  • Comfortable clothes to leave the hospital in
  • Your personal toiletries, such as toothbrush and comb

Pre-Op Lifestyle Changes

During your pre-operative appointment, your surgeon will instruct you on the following pre-operative lifestyle changes:

Permanent Hair Removal

Starting three to six months before your procedure, you will need to undergo permanent hair removal—either electrolysis or laser hair removal. The purpose of this hair removal is to prevent hair from growing inside the new vagina. This can cause problems like increased vaginal discharge and/or odor and discomfort with sex or dilation.

Hair removal usually needs to occur in the following areas:

  • The perineum (the space between the scrotum and the anus)
  • The shaft of the penis
  • Center part of the scrotum
  • The ring of skin around the base of the penis

Smoking Cessation

Your surgeon will advise you to stop smoking, vaping, chewing tobacco, or using any nicotine products (e.g., nicotine patches) for at least three months prior to the surgical date. This is because nicotine decreases blood flow to the genital area, and increases the risk for poor wound healing and other complications during surgery.

Weight Loss

Excessive adipose (fat) tissue may negatively impact the outcome of the surgery and have safety implications. Depending on your case, you may be advised to lose a certain amount of weight prior to your surgery.

A Word From Verywell

Preparing for your vaginoplasty requires ample time and diligent attention to your surgeon's instructions. While it's normal to feel a bit apprehensive during this preparatory process, be sure to reach out to your surgeon if you are feeling overly anxious.

Do not hesitate, as well, to reach out if you need to re-review aspects of the surgery (e.g., potential complications, the technique that will be used, and your expected outcome).

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Article Sources
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  1. Johns Hopkins. FAQ: Vaginoplasty.

  2. Bratzler et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195-283. doi:10.2146/ajhp120568

  3. Schechter LS. Gender confirmation surgery: An update for the primary care provider. Transgend Health. 2016;1(1): 32–40. doi:10.1089/trgh.2015.0006

  4. Kaiser Permanente Medical Group. Preparing for vaginoplasty and other feminizing genital surgeries. 2020.

  5. Chen ML, Reyblat P, Poh MM, Chi AC. Overview of surgical techniques in gender-affirming genital surgery. Transl Androl Urol. 2019;8(3):191–208. doi:10.21037/tau.2019.06.19

  6. Kaiser Permanente Medical Group. Recovering from vaginoplasty and other feminizing genital surgeries. 2020.

  7. University of Utah. Transfeminine bottom surgery: Vaginoplasty

Additional Reading