How Long Does Bottom Surgery Take to Heal?

MTF (male-to-female) bottom surgery, also known as transfeminine bottom surgery, is a life-changing procedure for trans women seeking to align their physical bodies with their gender identity. As with any major surgery, proper healing is as important to achieving satisfying results as the surgery itself. In this guide, we review the healing process after MTF bottom surgery, from the initial recovery period to long-term healing.

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Initial Recovery After Transfeminine Bottom Surgery

Before undergoing surgery, it’s important to have realistic expectations and plan as much as possible ahead of time for your recovery period. The immediate and most intense part of the MTF bottom surgery recovery process lasts approximately four to six weeks.

MTF Bottom Surgery Recovery: Week One

While the recovery process varies among patients, the following is a general breakdown of the first week following MTF bottom surgery.

• Dressings and Compression Garments: The surgical site will be bandaged, and you may need to wear compression garments to support healing and reduce swelling.
• Catheter: A catheter is placed during surgery to collect urine as the newly created vaginal canal is packed with gauze. When the gauze and catheter are removed, don’t be embarrassed by the smell. A strong, unpleasant odor is normal, and the medical staff is used to it.
• Hospital or Accommodations: Most transfeminine bottom surgery patients stay in the hospital or at special accommodations reserved for them for at least five days after surgery. Dr. John L. Whitehead and the medical personnel at Restore Medical Center will monitor your vital signs, manage your pain, and ensure the surgical area stays clean to reduce the risk of infection.

Transfeminine Bottom Surgery Recovery: Weeks Two Through Six

You can expect the next four to five weeks to involve the following:

• Swelling and Bruising: It’s normal to experience bruising and swelling, which will peak during the first two weeks and gradually improve over the following weeks.
• Vaginal Dilators: Arguably, one of the most important parts of the healing process is the use of vaginal dilators. Dilating several times per day helps train the new vaginal canal to accommodate penetration and prevents it from closing. You will receive instructions and guidance from Dr. Whitehead before being discharged.
• Limit Activities and Mobility: Avoid strenuous activities, rest as much as you can, and increase light activities gradually. Short, gentle walks are recommended, but heavy lifting and physical strain can increase the risk of complications.

Intermediate Vaginoplasty Recovery

After the first four to six weeks, MTF bottom surgery patients start to feel more comfortable and become more mobile.

MTF Bottom Surgery Recovery: Months Two to Three

Swelling subsides during the next two months, and patients may resume normal activities, but caution should be practiced.

• Swelling Reduction: There should be little to no swelling remaining after the second to third month, but some residual swelling may persist. The appearance of the surgical site will continue to improve as it heals.
• Continued Use of Dilators: Vaginal dilation remains a vital part of the healing process, and eventually, you’ll be able to reduce the frequency. Closely following Dr. Whitehead’s instructions helps prevent complications related to vaginal depth and width.
• Resuming Normal Activities: Patients can start to integrate more physical activities but should avoid putting stress on the lower abdomen or pelvic area. Most patients can go back to work by month two of recovery, depending on the physical demands of the job and their surgeon’s advice.
• Sexual Activity: Vaginal intercourse is usually not recommended until at least three months after MTF bottom surgery or until Dr. Whitehead clears you to attempt penetrative sex. Failing to follow aftercare instructions can increase the risk of complications.

Long-Term MTF Bottom Surgery Recovery

The final results of vaginoplasty often coincide with complete healing, which can take up to a year.

Transfeminine Bottom Surgery: Month Three to a Year

As trans women start to feel better about the alignment of their gender identity and physical body, they can better appreciate the following changes:

• Vaginal Shape and Appearance: The genital area will become more refined over time. It can take six months to a year for the swelling to completely resolve and the new genital area to settle into its ultimate shape.
• Dilation Frequency Decreases: Between three to six months following transfeminine bottom surgery, the need for vaginal dilation is usually reduced to once daily, though it will be part of your vaginoplasty maintenance for life. After six months, you may be able to dilate just a few times a week.
• Scarring: Scars will fade and become less noticeable over several months. The use of scar treatments like silicone gel can minimize the appearance of scars.
• Sexual Function: Between six months to a year following bottom surgery, most patients can resume sexual activity if they so desire. The new vaginal canal should now be functional, and many bottom surgery patients can enjoy a healthy and enjoyable sex life.

An Important Note About Smoking: Dr. Whitehead requires patients to abstain from all nicotine products several weeks to months before and after MTF bottom surgery.

Learn More About MTF Surgery in Miami, FL

Restore Medical Center in Miami, Florida, is a surgical practice exclusively serving transgender men and women seeking gender-affirming transitions. Dr. John L. Whitehead, a leading board-certified surgeon, and Dr. Alain Ramirez, a highly trained board-certified anesthesiologist, have extensive experience providing gender-affirming care and surgery. The entire Restore Medical Center team consists of compassionate and helpful LGBTQ+ community members and allies who will be with you every step of the way.

Our state-of-the-art AAAASF-accredited surgical center is dedicated to transmasculine and transfeminine surgery. Call 305.865.2000 to schedule your Bay Harbor Islands MTF bottom surgery consultation.