Moving through the process of completing a gender-confirming surgery can be emotionally and physically draining. Fortunately, as the community has grown and more people have access to surgical options, their experiences allow us to be better informed and more prepared heading into MtF bottom surgery.
It takes at least a year to completely recover from a full vaginoplasty. The scars will take that long to mature and need to be dilated regularly for a year. And the rate at which the dilation schedule ramps up adds to the intensity. With most grueling portions of the recovery being the first 2 months, when patients are not allowed to sit for at least 4 to 6 weeks. Patients are advised to engage in lots of walking. With vaginoplasty alone, you are welcome to lay on your back and sides.
How to prepare for surgery?
First and foremost when beginning this process, a strong community of your therapist and supporters will be one of your strongest assets. Recovery can be frustrating and uncomfortable, but the months leading up to your procedure can be stressful as well. Stay engaged in self-care and your community as you prepare for your bottom surgery.
We discuss in consultation that surgery and recovery is like rigorous exercise. It is another opportunity to go over the plan for surgery and recovery.
Dr. Keelee MacPhee
Following consultation, your GRS surgery is scheduled for roughly 4 to 6 months out depending on the scheduling available at the facilities being used. Be mindful, due to rising COVID numbers, some surgeries have been delayed throughout the community and there is always the possibility this could continue. Delays in scheduling is one of the many reasons community is important to your pre-op planning. Those with existing health issues or complicated medical backgrounds should submit their medical records and labs from any primary care or specialists to their doctor.
If you’re able to use insurance for your confirming surgery, you’ll want to gather your letters of support as early in the process as possible. This allows the performing physician to submit them to your insurance provider in a timely fashion. Each insurance plan often has different requirements. Additionally, some may be very picky about every single detail of the qualifications being met before they approve you to have surgery. Typical requirements are 1 to 2 letters of support from mental health providers, including at least 1 year of full-time life experience in your new identity.
Mental fitness isn’t the only schedule you’ll need to stick to prior to your bottom surgery — physical fitness can help a lot in the post-op recovery process. Patients in their best shape physically and mentally at pre-op will do better and heal faster. It helps to strengthen core and pelvic muscles, plus have mobility and cardiopulmonary strength preop.
Shopping list for MtF bottom surgery recovery
First and foremost, buy multiple pairs of compression garments so that you can change your clothes regularly. Compression garments need to be strong and snug so that they hold everything well. If you can pull on your garments so that they stretch over 6” away from your skin, then they are likely not strong enough and not going to help enough. Aim for something with at least 6% Spandex in its fiber content. You’ll keep two compression layers on during post-op except for showers or dilation.
Ice packs are integral to the recovery process from MtF bottom surgery. Ziplock baggies can be used as disposable ice packs between the two layers of your compression garments to target the labial area. Or you can use a more sustainable, reusable cold compress. If available, you can use a Polar Care ice machine that people have after joint surgery to continuously chill your perineum/vulva. Keeping these areas cool will be helpful to prevent discomfort as you recover. Polar Care machines, as well as reusable ice packs and compression garments, are available on Amazon, and someone in your family may already have a Polar Care machine to borrow.
A donut cushion will assist you immensely during the weeks in which you are avoiding pressure on your incisions, and provide you the option to sit down. While movement during this time is important to a healthy recovery and it’s very important not to spend too much time in bed, or over-exercise.
Other items to consider for GRS Recovery
Zinc cream, baby wipes and maxi pads are all necessary for your post-op success. Compression and ice will keep swelling down and make for easy cleaning with baby wipes. Zinc cream is also the best way to protect that area when it is newly postop. However, zinc cream is not easy to wash off, but will wear off in time. Additionally, be sure to change maxi pads every few hours. Check at least every four if you’re experiencing heavy draining, is best to keep it clean.
Other items you’ll want to have on hand for your MtF bottom surgery recovery are:
- a douche bottle
- a homemade douche solution
- 1:3 ratio of vinegar to clean water
- 2 cups per treatment
- a homemade douche solution
- KY jelly or your favorite lubricant jelly
- a handheld mirror
- your prescriptions
- puppy pee pads
- peri bottle
- baby powder and,
- A&D ointment, for later in your recovery process.
I always warn everyone this is going to be difficult. It is hard to anticipate for anyone just how challenging it will be physically, technically, and emotionally.
Dr. Keelee MacPhee
Managing discomfort after bottom surgery
With their new anatomy, many people may feel confusion or panic about what to touch and clean. As a result, many patients are most uncomfortable when they are swollen. Every surgery can cause temporary swelling. The body will recover from that swelling in a few days, by redirecting the tissue fluid back into the blood vessels. Ice is best immediately after surgery. Dr. Keelee recommends that everyone do intensive icing the first 2 weeks to minimize the pain.
The first initial days are tough for some as they manage the potential discomfort of vaginal packing. However, with pain control, ice, and lots of stool softening (fiber, stool softener, water), you’re sure to survive! It’s bird baths only that week; no showering. It’s important that the 100 miles of packing doesn’t get wet. It serves to support your new vaginal lining as blood vessels develop.
Walking is greatly encouraged, but please don’t do more than that too early in your recovery. Your restrictions on biking and partnered sexual activities are meant to protect you from getting hurt.
Vaginal packing removal
What’s next in my bottom surgery recovery?
At this point, it’s about consistency in your recovery program. Continue to keep your bowel movements soft as your body continues to heal. Be sure to follow the dilation schedule as laid out in your appointments. For some, this may only be one step in their confirmation with more procedures ahead, and for others, it may be the light at the end of a very long tunnel. Whatever comes next, Dr. MacPhee and her devoted staff are available to provide consultation and services throughout the trans community. Contact our office today if you have any questions or use the form below to reach us today.
