Hair Removal before Penile Inversion Vaginoplasty

Do I need hair removal before my vaginoplasty?

Yes! Often with penile inversion vaginoplasty, skin from the scrotal or pelvic area is used to create the new vagina.  Some of this area, however, contains hair which can continue to grow even after the skin is used to create the new vagina.  In addition to being unsightly, the vaginal hair can create an odor, mucous, even stones inside the vagina.  Once it has formed it is difficulty to permanently remove hair once it grows inside the vagina. For this reason, preoperative permanent hair removal is critical for having a good postoperative outcome. 

What area needs to have hair removed before my penile inversion vaginoplasty?

For penile inversion vaginoplasty we use the following template for where the hair should be removed.

Generally, I advise patients to leave some hair above the phallus as this will leaves aesthetically appropriate hair in the mons region above the vagina after penile inversion vaginoplasty.  If you don’t want that pubic hair you can always have it easily removed after surgery. 

How can hair be removed?

Shaving, tweezing or waxing the hair helps to remove hair in the short run but the hair tends to grow back.  There are two methods of permanent hair removal that are commonly used: electrolysis and laser.

What are the advantages and disadvantages of electrolysis before vaginoplasty?

Electrolysis uses electrical energy to destroy the root of the hair and, unlike Laser treatments, it has the same effect on patients regardless of skin or hair color. But, with electrolysis only small patches of hair can be removed at once and patients typically require multiple visits for complete hair removal.

What are the advantages and disadvantages of laser hair removal before vaginoplasty?

Laser hair removal uses a laser to destroy the roots of the hair. Because it targets darker pigment, it is generally best for patients with light skin and coarse, dark hair – the laser can sometimes burn darker colored skin and leave the skin with patchy lighter colored areas. The advantage of laser hair removal is that it permits large areas of hair removal at once and can be quicker to remove large areas of hair prior to surgery.  If hair does come back, it tends to come back a little lighter than before.

Where can I get the hair removal done and does insurance cover it?

We are fortunate to have a laser available at Mount Sinai for our patients undergoing gender affirmation surgery.  Health insurance generally does not cover hair removal, we have had some success getting coverage for laser hair removal when it is done at Mount Sinai. If your insurance does not cover hair removal, electrolysis is generally cheaper than laser hair removal – although costs can vary greatly.

When should I start the process of hair removal if I am considering getting a vaginoplasty done?
Immediately! Hair removal can take time to schedule and I always tell my patients to start the process as soon as possible after their initial visit with me.  It is sometimes the step that delays getting your vaginoplasty completed. If you do not live close to New York City hair removal can be done locally to speed up the process.