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Recovery and Complications from Vaginoplasty, Vulvoplasty and Labiaplasty

Medically reviewed by Jennifer Richman on February 16, 2024.

Whether you are undergoing an initial vaginoplasty, vulvoplasty or labiaplasty or a revision surgery, this article provides an overview of the recovery process. We describe general instructions for your first two weeks, when you can regain physical activities, sexual activity and the vaginal dilation regimen. A more personalized recovery plan will be presented through a collaborative discussion with your surgeon during your consultation. The post-operative care, medications, and follow up appointments also vary depending on which bottom surgery you will have and these instructions will be given to you personally.

How long will I recover for?

After a vaginoplasty, you will be staying in the hospital for approximately 3 nights, but this may vary. If you are having a labiaplasty alone, you may go home after your procedure. During your stay at the hospital, you will be closely monitored to ensure you are recovering well. Patients that undergo urinary shortening will use a catheter for the first few days after surgery. Bruising and swelling will be expected around your genital area and will subside in a few weeks. 

It usually takes about 6 months for swelling to completely resolve. By this time, you may be able to see your final surgical outcome. Although in some instances, the final appearance may take longer to reveal itself.

The length of your recovery depends in part on the type of bottom surgery you will have. Some surgeries, such as the vaginoplasty, are done in stages and will require several months in between each stage for adequate healing. In some instances, full recovery may take a year or longer.

Physical Activity after Bottom Surgery

Most patients are independent in performing normal daily activities within a week or two of surgery but may take more time and experience discomfort to do daily tasks. Lifting more than 10 pounds is avoided in the first two weeks.

We recommend that our bottom surgery patients avoid doing wide leg movements when getting out of bed or getting in the car to limit the stretching of your wound.

Once two weeks have passed and when you are comfortable, you can increase to light activity such as walking and light chores. Exercise and more rigorous activity such as jogging or yard work can be introduced slowly and progressively after about 6 weeks, but go slow and proceed with caution.

Sexual Activity after Bottom Surgery

During your recovery process, the skin in your genital area, especially between the rectum and vagina, can be fragile. In general, it is advised that penetrative sex be avoided outright until your body has completely healed. We generally recommend patients wait 3 months to have penetrative sex.

Swelling around the reconstructed nerves can also impact your sensation so it can be a while for the erogenous sensation to return. Patients who undergo a clitoral reconstruction feel a return of erotic sensation 3-9 months after surgery and regain the ability to orgasm at this time. Most vaginoplasty patients experience their first orgasm before undergoing a labiaplasty 5 months after their initial operation.

It is normal to take some time to learn and rediscover your new body. Starting gently and slowly is a good approach, with open verbal communication with your partner, if one is present.

Dilation after Vaginoplasty or Vaginal Deepening Procedures

Lifelong dilation is required when a vaginal canal is created from a vaginoplasty or vaginal deepening revision surgery. You will receive guidance and support from your surgical care team as you begin dilating after surgery. The following schedule for dilation is most commonly utilized:

Post-op appointment to 1 month after surgery: Dilation 4 times a day
Months 2-6: Dilation twice a day
Months 7-12: Dilation once a day
Year 2 and on: This is an ongoing dynamic and fluid stage. The need for dilation will be anywhere between once a week to once a month.

Complications

Complications for our bottom surgery procedures can usually be treated without the need for an additional revision surgery. Undergoing surgery with an experienced, board-certified plastic surgeon, avoiding smoking and alcohol consumption prior to surgery, and carefully following recovery instructions can help you prevent complications.

Urgent Issues

The following are potential warning signs that you will need more immediate medical attention. Reach out to our on-call medical staff or a local provider if:

• Your surgical dressings are soaked with large amounts of blood, as this may be a result of excessive bleeding.
• Your pain levels are unresponsive to medications
• You cannot keep fluids down and/or experience vomiting
• You notice yellowish discharge from your incision sites accompanied by a fever, as this can be a sign of infection
• You have abnormal swelling in your groin or lower leg, as this could be a sign of blood clots
• If at any time during your recovery you feel a sudden shortness of breath, pain in your chest, lightheadedness, dizziness, or tender, swollen legs, call 911 right away. These may be signs of a rare but serious medical emergency.

Other complications

Most complications for bottom surgery are preventable and can be resolved with non-surgical treatment. Sensations that seem abnormal can be a cause for concern in recovering patients. We describe some of the more common complications in bottom surgery recovery below. In any case, we encourage you to reach out to your expert surgical care team through our secure patient portal with any questions you have. No concern is too small for us. We are committed to doing everything in our power to facilitate the ease of your recovery process and help you achieve your desired surgical results.

During the first month after surgery, we recommend patients take special precaution to not make wide-leg movements as these can reopen wounds. Even then, the frequent dilation schedule and tension around the groin can cause slight wound openings, for instance, along the perineum where your sutures are. If this happens, there is no need to worry. Simply clean with soapy water, gently pat it dry, and apply antibiotic ointment until healed.

About half of all vaginoplasty patients experience granulation, which is a red or pink healing tissue that forms on the surface of the wound. This is normal and essentially the body over-healing a wound. Granulation tissue can occur in the vaginal dimple, around the clitoris, and/or around the urethral opening. It is normal to experience bleeding or vaginal drainage until it fully heals.

Whenever urinary work is performed, there is a risk for abnormal urinary stream, blood in the urine, urinary fistulae and urinary tract infections. These problems tend to be temporary and can resolve during the first few weeks with treatment such as antibiotics. In rare cases, temporary catheterization or a revision surgery might be needed. If you experience abnormal urination––such as pain, blood or infrequent urination––contact your surgical care team for instructions on how to proceed.