Almost as important as the surgeon selected and the technique utilized is the care that a patient gives herself in the weeks after genital plastic surgery. Here is some straight-forward information about what you can expect on your short- and long-term recovery.
Recovering From Labiaplasty / Clitoral Hood Revision / Hymenoplasty
Your surgeon is operating on loose, thin tissue with little or no muscular or fibrous support. This is traumatic to the tissue, and the immediate response is for the tissue to swell (sometimes significantly) and turn black and blue, especially in the first 4-7 days after surgery. The area may swell to 3-4 times its size and look positively awful, to the point where you may become seriously concerned and wondered “Oh my god! What did they do to me?!”
But be stout of heart. This generalized swelling, sometimes more on one side than the other, is normal and dissipates rapidly beginning on day 5 or 6 after surgery. It is also normal to leak a modest amount of blood from the incision lines in the first 24 hours after surgery. Without fail, the more movement you do immediately after surgery (walking, stairs, leg activity, etc.), the more swelling and potential for poorer healing you will experience.
Danger signs include significant bleeding, significant swelling in one particular area and opening of the suture lines. Your surgeon should discuss this personally with you, ideally giving you written post-op instructions that include a detailed list of warning signs to watch out for.
Your surgeon should be available (or have a surrogate immediately available) to attend to any post-operative emergencies. This is especially important if you will be traveling away from your home area for your surgery.
What are the dos and dont’s after your labial/hood/hymenal surgery? In my years of experience, patients who are “nice” to themselves and their vulvas in the weeks after surgery have better outcomes. After all, you are paying a lot of money for this surgery; do not cheat on post-operative care.
General Post-Operative Protocol
Most of my patients tell me the whole surgery and recovery process was “not as bad as they thought.” With the exception of the local anesthesia injection (which should take no more than 20-60 seconds on each side, producing almost immediate numbness), there is little discomfort during the procedure itself.
I personally provide either Vicodin™ or Norco™ to my patients after surgery. Most use several during the first 3-4 days post-op. Many patients tell me they used Ibuprofen or Naprosyn for most of their recovery.
2. First Week
We recommend you mainly “hang out” around the house for the first week after your procedure. Sure, you can climb stairs, but slowly, one at a time, and greatly limit your up-and-down trips. You can go for occasional car trips, but no stick shift, be careful getting in and out, and don’t go too often. Yes, you can walk around your house/apartment, but keep it limited.
The best general position for you in this time is recumbent, with your legs up, whenever possible. Wear loose cotton undergarments. Avoid the “rub/rub, swish/swish” of walking whenever possible!
Also be sure ice the area with a soft ice pack for 20 minutes every 2-4 hours while awake, and do a gentle cleanse/soak in a shallow bath, shower (hand-held is best, if available) or nozzle-directed spray bottle twice a day. Dry gently with a soft towel and/or blow dryer (set for low heat/high blow).
3. Second Week
You can be up and around more in your second week of recovery. If you have a relatively sedentary job, you may return to work/school, although the surgical area may still be a little tender. Try to limit walking whenever possible.
If friends or coworkers inquire as to why you seem to be moving gingerly, just tell them you “had a little cyst ‘down there’” that had to be removed. You may return to more vigorous work activities 10-14 days after surgery.
4. Third and Fourth Weeks
You may resume full general activities during these weeks, but still no vaginal intercourse or bike riding at this time. Patients can typically return to an exercise regimen or return to the pool.
5. Sex, Bike Riding, Swimming, Etc.
Your surgeon will instruct you specifically, but usual guidelines allow patients to return to the water in 2-3 weeks. Gentle swimming and non-penetrative vulvar area sexual play can occur in 3-4 weeks. Swimming and full gym activities can resume in 4 weeks. Penetrative sex and bike riding can resume 4-6 weeks after surgery.
Exact recovery protocols differ for each individual depending on age, estrogen levels, healing capacity, skill of the surgeon and the type and extent of procedure performed. Large, extensive procedures take more time to heal. V-wedge, for instance, takes a bit longer than linear dissection.
These are all general protocols; stay tuned for my next blog post for a look at the specific “Post-Op Instruction Sheet” we give patients in our office.