How much hair do I need removed in the areas indicated for hair removal on the guides?

• We ask that 95% of the hair be removed from the areas shown on the hair removal guides. On average, it takes 6-12 months to achieve 95% hair removal.  Please know that these guides are slightly different for each type of vaginoplasty. penile inversion (PIV) vs peritoneal pull-through (PPT) vs penile preservation peritoneal pull-through (PPPPT) vs minimal depth.

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What should I do if I’m undecided on which type of procedure I want performed?

• It’s always a good idea to remove more hair rather than less hair especially if you are unsure of your next steps. We would recommend you use the penile inversion vaginoplasty hair removal guide as this is the most in depth and will allow you the most options moving forward.

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How close to my surgery date am I allowed to complete my last hair removal session?

• We ask that your last hair removal session is at least 1 week prior to your date of surgery.

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Should I get laser or electrolysis done?

• Short answer - either is fine.  Sometimes electrolysis works better than laser depending on a few factors like hair color, skin color, and follicle resilience. We encourage you to see what works best for you and your goals.

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Should I shave before surgery?

• No. Please do not shave the surgical site the week prior to procedure. We will shave the necessary areas in the operating room.

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Do you remove any hair during the surgical procedure?

• Yes! We do perform follicle scrapping on the scrotal skin prior to using the graft to line the vaginal canal for penile inversion vaginoplasty procedures. This is a good way to get rid of any remaining hair follicles we see, however, is not a sufficient method for hair removal in general and will hopefully take care of the remaining 5% of persistent hair follicles. There are always a few dormant or resilient follicles that may survive and grow fine hair later.

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What do I do if hair grows after surgery?

• It depends on where the hair growth occurs.

• Outside on labia majora or minora – You are allowed to receive laser or electrolysis treatments 3 months post operatively on any areas accessible to your technician after surgery.

• Inside the vaginal canal – This is a little bit tricki er and usually only pertains to our PIV patients. If you move forward with the procedure after suboptimal hair removal, you may find hair growth inside the vaginal canal. Small amounts of hair can be plucked at your follow up visits or by your local gynecologist. Larger amounts of hair may need quarterly topical hair removal with diluted depilatory products (ie Nair mixed with water) followed immediately with douching. Please note that large amounts of hair inside that vaginal canal can lead to an increase in bacterial infections and dysphoria. We advise strongly against moving forward with a planned PIV procedure prior to proper hair removal.

• Even in optimally treated patients, a few fine hairs may grow from resilient or dormant follicles. While this may be a source of dysphoria, they are usually difficult to feel and do not cause any gyn issues like infection. They may be plucked by your gynecologist if seen in office but most women and their partners do not notice the hair.

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I’m confused by the hair removal guides! Can you explain in further detail?

• PIV - Remove all hair (95%) from penile shaft, 1 inch around base of penis (360 degrees), all hair from scrotum (graft used to line vaginal canal), and hair from the perineum (bottom of scrotum to anus).

• PPT – Remove all hair (95%) from penile shaft, 1 inch around base of penis (360 degrees), and hair from the perineum (bottom of scrotum to anus). Hair from the scrotum itself does not need to be removed. This does not change based on the type of labia created.

• PPPPT – Remove hair from the perineum (bottom of the scrotum to anus). IF there is only going to be vaginal canal created, no further hair removal needed. ANY external tissue work: external skin, vulvar, labial construction will then have a recommendation of hair removal from the scrotum and 1 inch around base of penis (360 degrees).

• Minimal Depth - Remove all hair (95%) from penile shaft, 1 inch around base of penis (360 degrees), and hair from the perineum (bottom of scrotum to anus). In general, hair from the scrotum itself does not need to be removed. However, IF you are opting for 5-7 cm depth option AND you have very little shaft skin, then we recommend all hair from scrotum be removed as a small graft may be used to line vaginal dimple.