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Common Issues Post-op 

In the postoperative period, there are many common issues that arise as part of the healing process. Usually incision care and time will work to let your body heal without any additional surgery. Included here are pictures of the most common types of conditions.

Separation

Swelling

Healing

These pictures are from the same person. She had separation at her 2nd post operative week due to swelling. The middle picture is at 3 months postoperatively. Her separation healed with time. The last picture is at 1 year. Her swelling decreased.

Post-op separation
Post-op swelling
Post-op healing

Bleeding Concerns

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  • Immediately Post Operatively: in the first two weeks, oozing is expected onto the hygiene pads that cover the wound vacuum or bolster.

  • First 3 months: Intermittent bleeding can occur postoperatively as part of healing within the first 3 months after surgery. Please make sure you are dilating the vagina and not the urethra. Also check for signs of a bladder infection ( see FAQs and Videos on Bladder Health/ Gyn 101)

  • Within the first year after surgery, occasional bleeding or dark brown discharge can be seen on pads. This is usually due to granulation tissue which commonly occurs within the first year after surgery. While scary, it's benign bleeding. This will be taken care of on your post-operative visits at 3, 6, 9, and 12 months. If unable to return to our office, please see a local provider like a gynecologist. Again, please make sure you are not accidentally dilating your urethra and also check for signs of a bladder infection ( see FAQs and Videos on Bladder Health/ Gyn 101)

Granulation Tissue

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  • Common in 1st year postoperative

  • Pink/red painless scar tissue which bleeds.

  • Easy to treat in office with chemical cautery- painless.

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Residual Erectile Tissue

Pre- Revision Surgery
Residual erectile tissue
Post- Revision Surgery
Residual erectile tissue

This patient was referred for 4 reasons from her prior surgery done out of the country.  

  • Excessive erectile tissue

  • Covered clitoris

  • Hollow groove on mons

  • No clitoral hood

Yellow Discharge

Yellow Discharge, Swelling, Separation W
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​The patient is 14 days out of surgery & the patient on the right is 20 days:

swelling, bruising, separation, as well as, yellow discharge.

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  • All of these are common and expected.

  • Yellow Discharge common post op on incision sites

  • Proteinaceous by-product of healing (not pus)

  • Goes away once incisions heal

Swelling
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Both patients are 2 weeks post surgery. On left is extreme swelling and on right is mild swelling. Most patients are somewhere in between with their swelling.

Swelling and Separation

Top Row: Operating Room,1st week, 2nd week before cleaning and after cleaning

Bottom Row: 3rd post op week, home photos x3 over next 2.5 months, Complete closure of separation occurred at 3 mos. Last Photos are 9 then 12 months without surgical intervention.

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9 then 12 months without surgical intervention.

Following Post-op Swelling, Separation and Healing with time & without intervention

Pictures in order:OR, Post Op 1 week, 2 weeks, 3 weeks, 3 months

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Not So Common: Severe Separation, Labia Necrosis
This patient experienced necrosis of her labia minora, retraction and severe separation during her first month postoperatively. She healed well over the first 3 months and as of the last pictures mid 4th month, her separation is resolved and has granulation tissue that is being treated.
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Same patient at 5 months below

9 months below
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Absorbable staple

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Absorbable staple that was removed in the office.

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Typically staples do not need to be removed as your body will absorb them or "spit" them out. If 
you notice a staple do not be alarmed, your vagina is not growing teeth! 

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Exposed clitoris needing clitoral hood revision, more defined labia minora:
Preop, OR and 3 months later

A more prominent clitoris: this result can be from request or the the amount or tightness of tissue requires less coverage to preserve blood supply to clitoris, top of labia minora and/or clitoral hood. Some patients desire a more prominent clitoris/more exposed for their post op euphoria. If the clitoris is too sensitive and/or exposed, a revision is easier to make it smaller and covered vs a revision to make clitoris larger and more exposed if covered by the clitoral hood.
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Inadequate hair removal prior to surgery can result in hair growth within the vaginal canal.
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