Author Topic: Long recovery after stage 1 vaginoplasty (things they don’t tell you)  (Read 780 times)

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Offline SaraSerenity

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I opted for two-stage vaginoplasty at the Meltzer clinic. In stage 1 (the actual vaginoplasty) they form the vagina, clitoris, and outer labia and reposition the urethral opening. That’s the major, invasive part. Stage 2 (labiaplasty) is when they form the inner labia and clitoral hood and do any needed revisions, and is done after the swelling from stage 1 is gone, often 4-5 months later.  To have the necessary tissue needed for stage 2, they have to leave extra tissue in the outer labia during stage 1, so in between, you have very large outer labia.

I had stage 1 in January this year (2022). Recovery went well for a while, but then in April, a small dehiscence I had was exacerbated and enlarged when I tried moving up to the size 3 dilator. I was on the post op schedule they gave me, but my body was not ready for that. I am in my 50s, and my skin doesn’t heal as quickly or have the elasticity it used to. Dilation started feeling debilitating. I went back down to size 2, and did some research on post op instructions. It turns out there’s a wide range of schedules surgeons use for moving up in dilator size, and the Meltzer & Bower clinics use the most aggressive one, changing size after three weeks. Several other surgeons have you change size only after two months at each size! Anyway, I managed to get a video visit with Dr. Meltzer and he approved me staying at size two.

My dehiscence is a small wound at the very bottom of my vaginal opening where the suture lines from my outer labia meet. So it’s right where I sit, which means I feel it every time I sit down or stand up. Even sitting on a donut ring I can only take so long. I started feeling sore all the time. Dilation is necessary but also keeps the dehiscence open. It’s likely the dehiscence won’t fully heal until my dilation frequency goes down to once a day. :( They tell you that it heals on its own, but not how long it can take. And fully half the patients who have vaginoplasty suffer a dehiscence.

Meanwhile, the clear, slightly yellow, or sometimes milky white discharge from my healing skin, which they say may last “up to 8 weeks”, is still occurring at four months. So outside the house I have to wear underwear. (They never mentioned that this discharge could last for months.) I used to wear panty liners but often I now just wear cheap cotton panties & wash them frequently.

Either way, there’s a third problem: they left so much tissue in my outer labia (for use in stage 2) that they protrude nearly half an inch from my body! I look down and instead of a smooth appearance, there are these two bulbs of scrotal tissue attached to my body. These are still tender, and wearing underwear compresses them and makes them sore. (They didn’t warn me about that either.) So at home I just go without. I’ve had to work from home and apply for an extension of leave benefits so I can work less while focusing on recovery.

I did find that a poultice of crushed mallow flowers & water in gauze has been very soothing and helps the healing process.

I dearly hope that the stage 2 labiaplasty in June will result in normal size labia so that I can wear underwear comfortably after that, and that the reduction in the amount of tissue that has to heal will enable it to heal faster. This recovery has been hard due to the persistent dehiscence and the oversize tender labia.

I chose Meltzer clinic because they keep you in the recovery center for 9 nights instead of just 4, and being alone, I wanted that extra time with professional care immediately after surgery. If I could have known I would have to deal with labia the size of orange segments until stage 2, I might have opted for a single stage, all-at-once operation like most other surgeons do. (The surgeon at Denver Health is new but was trained by Marci Bowers.) The staff at the recovery center are fantastic, but in my particular case, I think I ended up choosing the harder option for recovery.

Offline Karen_A

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I chose Meltzer clinic because they keep you in the recovery center for 9 nights instead of just 4, and being alone, I wanted that extra time with professional care immediately after surgery. If I could have known I would have to deal with labia the size of orange segments until stage 2, I might have opted for a single stage, all-at-once operation like most other surgeons do.

Sounds like the technique may have ckaged with time...

I has SRS with Meltzer, but it was back in 1998 (I was 43) when he was in Portland OR and used the now defunct Eastmorland hospital.

He was doing a two stage procedure back then (second stage was about 2 months later IIRC) ... I don't recall having issues with over large labia after the first step back then... the issue I had was different from your... I had significant clitoral necrosis unfortunately ...

But other than that I had no issues.

Back then you did your entire stay in the hospital through an arrangement Meltzer had with the hospital (different status). I don't recall exactly how long I stayed in Eastmorland  after SRS, but it was at least a week.


Online Jessica_Rose

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Sara, sorry to hear that you are having issues with recovery. After going through so much to finally have surgery, post surgical problems can feel overwhelming. It will get better.

I also had a dehiscence. In retrospect, driving 800 miles over two days was not a great idea only ten days after my Stage I surgery with Dr. Ley (she worked with Dr. Meltzer at the time). By the time I got home and saw what had happened, I was really depressed. I sent photos to the clinic and was told to keep putting Bacitracin on it once or twice a day and make sure the dilator was going into the correct opening -- not into the dehiscence. The next few months were rough, having to look at the open wound every time I dilated. The area did slowly heal, and now there is no evidence of the issue.

The extra tissue is obviously uncomfortable, and the surgical area doesn't look at all like one would expect. The Stage 2 surgery does make everything look as it should. Apparently they saved less of the tissue for me, so my inner labia are quite small. This is not something I usually offer, but I could send you some photos I took throughout my recovery period. If you are interested, send me a PM and we can discuss it.

It will get better Sara, but it never happens as quickly as we like. I wish you all the best.

Love always -- Jessica Rose


Offline SaraSerenity

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Thank you, Jessica.

Offline davina61

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7 months in and my scars are still sore, the one between vagina and anus gets very tender sometimes and still getting nerve zaps.
a long time coming (out) HRT 12 2017


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Offline RandiL

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A friend (in her early 40s) had surgery a month ago with Dr. Hyer at Denver Health (single stage) and she is just now getting to where she can sit and start to feel decent.

So recovery is going to vary a lot between individuals. Good luck Sara!

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