How long will it take me to recover from Vaginoplasty?

After three days in the hospital, you will need to stay in the Philadelphia area for about another 12 days.  When available, most patients stay at one of the studio apartments above our office which rent for only $50/night; you can bring a companion at no additional charge and you can be seen daily.

When can I go back to work after Vaginoplasty?

Most people return to work after vaginoplasty in about 4-6 weeks.  You can resume strenous work and exercise in 6-8 weeks.

How often do I dilate?

 

Our recommended dilation schedule is as follows:

Week 1 –   Week 3       4 times a day

Week 4 –   Week 6       3 times a day

Week 7 –   Week 9       2 times a day

Week 10 – Week 12     1 times a day

Week 13 forward  - Dilation or intercourse a minimum of once or twice a week for the rest of your life.

Our full dilation instructions can be found here

What about orgasm?

Most if not all of our patients are able to have orgasm following MTF surgery/vaginoplasty.    Some people experience orgasm within seveeral months to a year and a half.

What do the dilators look like?

The dilators have a shape similar to a candle but they come in different sizes from small to large.  When dilating, you should use the largest dilator which fits comfortably in the vagina.  (See picture).  You can use any other type of dilator, dildo, or vibrator as long as it fits comfortably into the vaginal and does not cause pain or injury to the tissues.

Do I need to douche?

Following removal of vaginal packing, 1 week after surgery, we recommend douching every other day for the first three weeks, and then once or twice weekly in order to keep the vagina fresh and free of abnormal bacteria.  Remember that the lining of the vagina is normal skin and this has a different PH and different natural bacterial flora than natal vaginal mucosa.  

How long will it take for my scars to go away?

Scars never disappear.  All scars are permanent.  It takes about one year for scars to heal completely and during the first few months they are usually pink or reddish and sometimes tender and raised, but between six months and a year they usually become flat, white and soft and are barely visible by 8-12 months after surgery.

What does the fee for SRS cover?

The total fees for male-to-female SRS are $19,150 and include the surgery fee, the operating room and anesthesia fees, and three days in the hospital.   The only other costs you will incur will be transportation to and from Philadelphia and food and lodging while you are recuperating.  You will need to be in the Philadelphia area about two weeks following surgery.  Our studio apartments cost only $50/night (which is much less than a hotel) and Dr. Leis can see you daily.

What other costs are involved for surgery?

The only other costs you will incur will be for your transportation to and from Philadelphia and for food and lodging during your recuperation.

How long do I need to stay in Philadelphia?

Patients who come from out of town (more than about 1 hour drive from Philadelphia) should remain in the Philadelphia area for about 2 weeks after gender reassignment surgery and about 8-9 days following facial feminization or breast augmentation.  You can stay in a local hotel or, when available, most patients prefer to stay in one of the studio apartments above our office which rent for $50/night.  You can bring a companion at no additional charge, and Dr. Leis can see you daily.

If you don’t have accommodations, what are your recommended hotels?

If our apartments have already been reserved, there are several hotels within a short distance.  The Hilton on City Avenue, the Crowne Plaza on City Avenue, and the Marriott Four Falls in Conshohocken.

What weight do I have to be to have surgery?

We don't require any specific weight but strongly recommend that you be as close to your ideal weight as is reasonably possible.  It is recommended that your body mass index (BMI) is below 27.  You can check your body mass index here http://www.nhibisupport.com/bmi/

Being close to your correct body weight will help keep the risks of complications low and will improve your chances for an excellent cosmetic result.   

What’s required if I smoke?

It is important that you stop smoking for several weeks before and after surgery (at least two weeks) or you risk complications associated with non-healing.  Smoking causes long-term constriction of blood vessels which will decrease the amount of blood required to heal your incisions.  There is a significant increase in complications such as wound break down, infection, bad scarring, etc. in people who smoke.  

What hair removal is required or necessary?

Hair removal from the scrotum prior to MTF is preferable.   The scrotal skin is used to add to the length of penile skin to increase depth of the vagina.  If hair is left on the scrotal skin, it can continue growing inside the vagina and it will be more difficult to keep the vagina clean.  Normal skin shedding can accumulate on the hairs and bacteria can also accumulate eventually causing possible inflammation and infection.  Also, with dilations and intercourse, some of the hairs can break off and wind up high up into the apex of the vagina, occasionally causing formation of a "hair ball" which can result in chronic irritation and infection.  For this reason, it is always good to have at least one or two speculum vaginal examinations by your doctor, gynecologist, or surgeon each year to make sure the vagina is healthy and free of hair balls.  We recommend starting hair removal several months prior to surgery.  Laser hair removal works well on hair that is dark with skin that is light.   However, if the hair is light or the skin is dark, then electrolysis is recommended.  Treatments should occur every 4-6 weeks for about 4-6 months prior to surgery.  

Does my insurance cover this?

In regards to insurance coverage, when an insurance company says it will "cover" a procedure, it does not mean that it will pay for the surgeon's fee in full.  It means it will pay some amount of money it has assigned to that specific surgery, less any copay or deductible associated with the individual's policy.  Because of this, patients pay Dr. Leis' fee in full about 4 week prior to surgery, we file all the necessary forms with your provider and you will be reimbursed in accordance with the terms of your policy.   If the hospital and anesthesia provider are both participating with the insurance company, you will not have to pay them (except for deductibles and co-pays).  We would determine if they are participating with the insurer before the surgery is performed.  In the event that the surgery is not covered, we work with some financing companies that extend loans for medical procedures if you, or a friend/family member, have decent credit.  Let us know if you would like the contact information.

Do I have to be on hormones for FFS or Breast augmentation?

Patients who desire either FFS (facial feminization surgery) or chest reconstruction (breast augmentation), do not have to be on hormones or have letters from mental health specialists.  However, in the case of breast augmentation, we feel it is beneficial for a patient to be on hormones for about 6 months to see what amount of breast development results from hormone therapy before having breast augmentation. 

What about revisions and cost of revisions?

We do not charge a surgery fee for revisions that occur within the first year after surgery.  Small revisions can often be done in our office operating room at little or no charge for the facility.  If the revision needs to be performed in a surgery center or hospital, the patient is responsible for their associated operating room and anesthesia fees.