"Vaginal plastic surgery" is an umbrella term for several methods, and vaginoplasty is the surgery among them that adjusts and sutures lax vaginal tissue. It works differently from laser or filler, so if you are curious about how the methods differ, you may want to read the differences between vaginal laser, vaginal plastic surgery, and vaginal filler first.
Once the surgery is over, the questions change. They become questions tied to daily life: how long the discharge will last, whether it is okay to bear down on the toilet, and when you can exercise or have sex again. With labia minora surgery you can see the wound from the outside, but with vaginoplasty most of the wound is inside the vagina, so it is harder to judge for yourself how far you have healed. That is why the signals your body sends and your follow-up visits matter even more.
What changes are common early in recovery from vaginal plastic surgery?
For the first few days the inside of the vagina may ache with a dull, heavy pain and feel swollen, and blood-tinged discharge sometimes continues for several weeks. How strong these changes are and how long they last depend on the extent of the surgery and how quickly each person heals.
Patient information from medical institutions abroad shows changes they have in common. The American Society of Plastic Surgeons (ASPS) explains that after vaginoplasty you may feel a deep, dull ache for the first few days. For a surgery that sutures the back wall of the vagina in a similar way, Cleveland Clinic in the US notes that blood-tinged discharge may last from a few days to a few weeks, discharge may continue for a few weeks or so, and vaginal pain settles within 4 to 6 weeks.
- Discharge: It is often red or brown at first and gradually becomes lighter. Use a pad or liner and change it often.
- Dissolving stitches: According to information from the British Society of Urogynaecology (BSUG), stitch knots come away onto your pad at around 2 weeks, and a little bleeding may appear again at that time.
- Bowel sensation: The back wall of the vagina lies against the rectum, so you may feel heaviness down below or feel as if you need to have a bowel movement.
- Urine: For a few days right after surgery, it may feel as though your urine does not come out freely.
- Tiredness: You may tire easily for a while after surgery, so take breaks during the day as well.
How should I manage washing, bowel movements, and urination?
The basics are to keep the outside clean and dry without rinsing inside the vagina, and not to strain hard during bowel movements. For how to wash, prescribed medicines, and your next appointment, follow the guidance of the medical institution that performed your surgery.
- Wash only the outside in the shower You can usually start showering early, but do not rinse inside the vagina or aim a bidet stream directly at the vagina. After washing, pat yourself dry with a soft towel.
- Sitz baths only after you have been advised Some clinics recommend sitz baths, while others tell you to avoid them and keep the wound dry. Check with the place that performed your surgery whether to take them, and if so from when and for how many minutes.
- Use pads instead of tampons Until the wound has healed, do not use products that go inside the vagina, such as tampons or menstrual cups.
- Prevent constipation in advance Drink plenty of water and eat fiber such as vegetables and fruit. If your stools become hard, do not hold them in or strain; talk with your medical team about whether you need a stool softener.
- Do not hold in urine Urinate often to empty your bladder, and if urine does not come out well or it hurts, contact your clinic without waiting.
- Do not lift heavy things Anything that puts strain on your abdomen can pull on the stitched area. For a while, it is better to get help with chores that involve weight, such as grocery shopping.
- Walk a little at a time Rather than only lying down, walking slowly around the house or nearby helps recovery and helps prevent blood clots in the legs.
Choosing clothes that do not squeeze down below, such as roomy underwear and loose trousers or skirts, makes sitting and moving much more comfortable.
When can I return to exercise, baths, and sex?
When to start again is decided after the medical team has checked that the wound inside the vagina has healed. Light activities such as walking come first, and the more an activity involves putting something into the vagina or straining the abdomen, the later it comes.
The periods given in overseas guidance differ slightly from source to source. ASPS explains that after vaginoplasty you may need about 1 to 2 weeks of downtime, and that tampons and sex should be avoided for 8 weeks. Guidance from an NHS hospital in the UK on surgery that sutures the vaginal wall says to take about 2 to 4 weeks off work and to avoid sex, strenuous exercise, and heavy lifting for 6 weeks. Cleveland Clinic explains that most people are fully recovered within 3 months.
| Activity | What to check before starting |
|---|---|
| Walking, light housework | Usually started early; cut back if you feel pulling down below or the bleeding increases |
| Work, school | Whether you stand for long periods or lift heavy things, and how far your commute is |
| Running, strength training, yoga | Whether there are movements that strain the abdomen and pull on the area below the pelvis |
| Cycling, indoor cycling | Whether the saddle presses directly on the perineum |
| Bathtub soaks, swimming, sauna | Whether the bleeding has stopped and the wound has healed |
| Tampons, menstrual cups | Whether you have been told the wound inside the vagina has healed |
| Sex | Whether you have confirmed at a follow-up visit that penetration is okay |
The first time you have sex again
At first you may feel pulling or stinging. Do not rush; take enough time to get ready and go slowly, and if you feel dry, a lubricant may help. If the pain is severe or does not get better after a few times, do not put up with it; please mention it at your visit. Painful sex can sometimes occur because of scarring or a narrowed area, so it needs to be checked.
Which symptoms mean I should contact the clinic right away?
If bleeding or pain increases instead of easing, if you have a fever, or if your discharge smells bad, do not wait for your next appointment; contact the medical institution where you had surgery. Discharge for a few weeks is common, but an increase in amount or a change in smell can be a sign of infection.
Are there problems that can occur, even if rarely?
Most people recover over time, but bleeding, infection, or the wound opening can occur, and rarely, injury to nearby organs or long-lasting pain during sex. During recovery, recalling the risks you heard about in your pre-surgery consultation makes it easier to notice warning signs.
- Bleeding, hematoma: If blood collects inside the wound or bleeding continues, treatment may be needed.
- Infection: If an infection develops in the wound, vagina, or urinary tract, treatment such as antibiotics is needed.
- Wound problems: Stitches may loosen and let the wound open, or on the other hand pull tight and cause discomfort.
- Nearby organs: Injury to the rectum or bladder, which lie against the vagina, is rare, but if it happens, further treatment is needed.
- Changes in urination or bowel movements: Urinating or having bowel movements may be difficult for a while, or constipation may get worse.
- Painful sex, changes in sensation: If the vagina becomes too narrow or scarring forms, painful sex can continue, and some people feel that sensation during sex has changed.
Vaginoplasty is a surgery that adjusts the width and shape of the lax areas identified during the examination. It is not a surgery that can promise improvements in sensation, sexual satisfaction, or urinary incontinence, and results and recovery differ from person to person.
What should I ask at follow-up visits?
Ask specifically how far your wound has healed now and which activities you can start again next. Your schedule may change depending on how quickly you recover, so it is a good idea to check again at every visit.
At LILEAP, we decide on the area to operate on and the tissue to preserve through an examination, and during recovery we explain how to wash the wound, how to use prescribed medicines, and when your next appointment is. Exercise and sexual activity are resumed after checking your recovery. What to check before surgery is covered in the guide to vaginoplasty within vaginal plastic surgery, and what to organize when you first consult about a looser feeling after childbirth is covered in our article on the vagina feeling looser after childbirth.