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Hair Removal Before Bottom Surgery

Medically reviewed by Jennifer Richman on February 16, 2024.

Permanent hair removal is an essential part of the pre-operative process for vaginoplasty and certain phalloplasty patients. This step is not a requirement for patients who are seeking vulvoplasty (a “zero-depth vaginoplasty), labiaplasty, and clitoroplasty. 

Hair removal can be achieved through laser hair removal or electrolysis. There are risks and benefits to either type of hair removal. Laser hair removal treatments are considered to be faster, less frequent, and less painful than electrolysis treatments. However, electrolysis treatments are able to give permanent results as compared to laser treatments which generally can only slow hair growth. For more information about the hair removal options we offer in our office, visit our hair removal page here.

For Vaginoplasty Patients

For a penile-inversion vaginoplasty procedure, skin from hair-bearing areas such as the scrotum and perineum may be used to line the new vagina. Therefore, hair removal is crucial to avoid hair growth inside of the new vaginal canal, as well as potential complications such as infection, hairballs, and dyspareunia (pain during sexual intercourse).

Prior to vaginoplasty, hair removal must be completed along the scrotum, perineum, shaft of penis, and base of penis as shown in the diagram below:

For Phalloplasty Patients

On the other hand, phalloplasty patients are required to undergo permanent hair removal of the skin that will be used to extend the urethra. This must be finished 6 weeks prior to your surgery date. Most commonly, this is a 2” by 7” segment of the forearm. If hair grows inside of the urethra, a variety of complications like infections and stone formations can occur. However, removing the hair on the skin that will be used to construct the penis is not required. Doing so is a decision we leave up to the patient based on their aesthetic preferences.

Hair Removal Timeline

Laser Hair Removal

Laser hair removal (LHR) uses a concentrated beam of light (laser) that is converted to heat energy that damages the hair follicles to slow hair growth. In general, we recommend 9-10 laser treatments total before your bottom surgery. Keep in mind that the treatments must be spaced out by 4-6 weeks. Overall, your laser hair removal treatments may take 9-12 months.

Electrolysis

Electrolysis hair removal (EHR) uses a thin metal probe that is inserted into the hair follicles followed by a low-level electrical current that passes through the skin to permanently destroy the hair follicles and stop hair growth. Each electrolysis treatment spanning a full area can sometimes be referred to as a “clearing.” We recommend 3 full clearings, and each clearing can take 3 months if you come in for weekly treatments, in usually 1-2 hour sessions. Overall, electrolysis hair removal may take 9-12 months.

Combination

Combining LHR and EHR is advisable because it reduces the amount of electrolysis needed (since EHR can be painful for patients). We recommend one full course of laser treatment plus one full clearing of electrolysis before your bottom surgery. This will take 9-12 months for the laser treatment plus an additional 3 months for electrolysis for a total of 12-15 months.

It is important to note that the course of laser hair removal or electrolysis for vaginoplasty must be finished 2 weeks prior to your surgery date. When planning for your hair removal, remember that each person’s body is unique. For some, it might take more or less than the usual 9-12 months. Individuals who started hormone blockers in adolescence may have less hair resulting in a slightly shorter timeline. Careful planning and continued communication with your surgeon and healthcare providers are important to determine if hair removal for the donor site is adequate and ready prior to surgery.