After male-to-female (MTF) bottom surgery, also known as vaginoplasty, there are several post-operative considerations and stages of recovery to be aware of:
- Immediate Post-Operative Phase:
- Hospital Stay: The patient typically stays in the hospital for several days.
- Pain Management: Pain is expected but can be managed with medications.
- Dilation: The neo-vagina needs to be dilated with special dilators to prevent the vaginal canal from narrowing. This is an essential aspect of post-operative care and typically begins within a day or two of surgery.
- Catheter: A urinary catheter may be in place for about a week to allow for bladder emptying since there will be initial swelling around the surgical site.
- Short-Term Recovery:
- Activity Restrictions: Patients are often advised to avoid heavy lifting, vigorous activity, and sexual activity for 6-8 weeks.
- Dilation: Dilation continues multiple times daily and gradually reduces in frequency over time. It’s a long-term commitment to maintain vaginal depth and width.
- Hygiene: Proper care of the surgical site is essential to prevent infections. This may include cleaning and bathing guidelines.
- Long-Term Recovery:
- Sensation: The neo-vagina and surrounding area may be numb initially. Sensation typically returns over weeks to months but can vary widely among individuals.
- Sexual Activity: Once healed, many individuals can engage in penetrative sexual activity, but it’s essential to consult with the surgeon about when it’s safe to resume.
- Continued Dilation: Depending on the surgical technique used and individual factors, dilation may need to continue long-term, though often with reduced frequency.
- Potential Complications:
- Granulation tissue: Overgrowth of tissue in the vaginal canal, which may require treatment.
- Stenosis: Narrowing of the vaginal opening or canal, underscoring the importance of regular dilation.
- Fistulas: A rare complication where an abnormal connection forms between the vagina and the bladder or rectum.
- Scarring: Some individuals may experience excessive scarring or keloid formation.
- Emotional and Psychological Aspects:
- While many individuals feel relief and happiness after surgery, it’s also common to undergo emotional ups and downs. Continued support from mental health professionals, friends, and family can be beneficial.
- Hormone Replacement Therapy (HRT):
- Most individuals continue with a form of HRT after surgery, but dosages may change, especially if the testes are removed during surgery, as they are a significant source of testosterone.
- Routine Medical Care:
- It’s essential to have regular check-ups with the surgeon, especially in the first year post-op, to ensure proper healing and address any complications.
- Routine gynecological care, like any other woman, may also be necessary, though without the need for Pap smears since the neo-vagina lacks cervical tissue.
It’s crucial for individuals considering or undergoing MTF bottom surgery to maintain close communication with their medical and mental health professionals, ensure they understand post-operative care requirements, and seek out support as needed.