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Vaginoplasty (constructing a mtf vagina) with Dr. Gallagher

During my visit with Dr. Gallagher, she took me through the presentation she shares with patients who are considering a surgery to create a mtf vagina.  In this post, I will share with you some answers to commonly asked questions when shopping around for a surgeon to perform your vaginoplasty.

General Vaginoplasty Procedure

  • The first step of this procedure usually starts with an orchiectomy (testicle removal).
  • For most patients, Dr. Gallagher states she uses a penile inversion procedure.  This involves using both the penile skin and usually the scrotal skin to line and deepen the new vagina.
  • The new clitoris is then created from the glans (head of the penis) and the labia is shaped using the remaining tissue.
  • Another option offered by Dr. Gallagher is a “zero depth” procedure where the penis/ testicles/ scrotum is removed and a new clitoris formed without a passage for the new mtf vagina.
  • Vaginoplasty with Dr. Gallagher is considered a “single stage procedure.”  This means, every effort is made to complete the procedure during the first visit.

Labiaplasty

As state above, Dr. Gallagher’s goal is to perform vaginoplasty surgery in a single stage procedure, in an effort to prevent the need for additional surgery.  Some people, however, wish to pursue a labiaplasty.  If desired, Dr. Gallagher will perform a labiaplasty once everything is healed. When asked what is involved in a labiaplasty, Dr. Gallagher stated, “It usually involves a ‘nip tick’ to bring the labia majora together in the midline.”

Vaginoplasty Surgery Requirements

  • Dr. Gallagher states that she adheres to the Standards of Care, Version 7.
  • Three letters of referral are required for surgery. Two from mental health professionals and one from your hormone prescriber.  I am able to provide most clients with a letter of referral after one 85 minute session if you’ve been living FT for at least 5-6 months. This is true for folks outside of Indiana, too, if you live in a state that recognizes my license and allows telehealth – online sessions.  Email me for more information.
  • Patients need to be physically fit, which means your BMI is best suited for surgery when it is under 35.
  • Genital hair removal by either laser or electrolysis is required before surgery.
  • HRT is stopped for 2 weeks prior to surgery to prevent blood clots.

 

Procedure and Recovery Time for Vaginoplasty

When asked about the length of time surgery will take, Dr.Gallagher stated, “Depending on the patient, the procedure takes 4-6 hours.”  The average hospital stay is 3-7 days.

Vaginal packing stays in for 7 days and the catheter (tube in the bladder) stays for about 14 days. Once the packing comes out of the new vagina, the next step is to teach the patient how to dilate the new vagina. Dilation is necessary a few times a day during the initial healing process, then it decreases to 3 times a week once healed. Penetrative intercourse counts as dilation also.

The typical time required off of work for this procedure is roughly 4 weeks.  According to Dr. Gallagher, this varies from person to person.  Swelling can remain for a few months, thus you may not see the final results for quite some time after surgery.

Post Vaginoplasty Orgasmic Capabilities

A very common question about creating a mtf vagina is whether or not it is possible to continue having an orgasm after surgery.  I asked Dr. Gallagher what she estimates the odds are for a patient to resume orgasmic capabilities after surgery and she stated, “about 80-90% of women can resume orgasmic capabilities after surgery.”

She said that she is, “very carefully preserve the nerves to the new clitoris, which for most trans women will be the center of sexual pleasure.”  She did clarify, however, “After surgery there will be a lot of swelling so most women do not have their first orgasm for several weeks afterward.”  As for penetrative sex, Dr. Gallagher estimates that the typical patient can consider penetrative sex 8 weeks after normal healing from the procedure.

mtf vagina, vaginoplasty, mtf surgeon