Medical Information GRS

WARNING: The following is information regarding Medical Gender Reassignment Surgery.

Transgender Information for Female to Male & Male to Female below

Female to Male:

Hair Removal for Phalloplasty

Before you have phalloplasty, you will need to undergo hair removal at the donor site (typically the arm). All hair should be removed from the crease of the wrist to a minimum of 15 cm up the arm, Ideally 18 cm of hair or more will be removed.

On the underside of your arm: The hair in this area should be removed by ELECTROLYSIS rather then Laser to ensure full hair removal This hair should be in a strip that is 4cm at the base and 5.5 cm at the top. This section of your arm will be used to create a urethra, and hair increases the risk of complications.

On the remainder of the forearm: hair in this area can be removed with laser, electrolysis or a combination.

*****Although, laser hair removal is an option, we strongly advise you to use electrolysis. Lasers have not been proven to be permanent, and since hair removal can often not be redone after the SRS operation, there is no room for experimenting with unproven technology. As you can’t afford to risk your time, money, or the quality of your surgical outcome on unproven technology, you should invest in the only proven permanent option for hair removal: electrolysis.

Caution: Many surgeons use a “scrape” technique during surgery, where they scrape away the hair follicles, but results indicate this is not effective and complicates recovery (eg ingrown hairs). We recommend you rely on electrolysis.

Male to Female:

Genital electrolysis

Electrolysis hair removal is mainly used to remove facial hair, but it is effective on your whole body, including your genital region. Most surgeons who perform Surgical Reassignment Surgery (SRS) strongly advise having genital electrolysis before SRS.

How much hair needs to be removed from the genital zone before a Sex Reassignment Surgery (SRS)?

Why genital electrolysis prior to SRS? Can’t I have my SRS without it?

Genital electrolysis is performed prior to SRS to avoid any problems with hair in your new vagina. In most patients, the area between the anus up to a part of the scrotum is going to be used to create the back wall of the vagina. The area from the scrotum up towards the base of the penis, will also be used to build up the vagina. For most patients that require skin grafts for vaginoplasty, scrotal tissue is transplanted during SRS.

The most important reason to have the hair in that area removed, is that there is a high risk of infection of the hair follicles. This risk may be higher even due to the friction that you will experience against that skin during dilation but also during intercourse, for example. And since the skin is no longer exposed after surgery, it’s too late to remove the hair later on.

Many SRS surgeons emphasize that patients should have genital hair removal prior to SRS since it strongly influences the operation and its outcome. Some may not want to perform SRS if you still have hair in the area used for your neo-vagina.

Laser or electrolysis for your genital hair removal?

We strongly advise you to use genital electrolysis. Lasers have not been proven to be permanent, and since genital hair removal can often not be redone after the SRS operation, there is no room for experimenting with unproven technology. As you can’t afford to risk your time, money, or the quality of your surgical outcome on unproven technology, you should invest in the only proven permanent option for hair removal: genital electrolysis.

How much hair needs to be removed from the genital zone before a Sex Reassignment Surgery (SRS)?

Vaginoplasty, using Penile Inversion, is the most common MTF genital surgery.

This utilizes the penile skin to line the vagina, and the scrotal skin to create the labia.
Some SRS surgeons use a perineal skin flap at the posterior end of the vagina, it is best to have electrolysis on this area.
It is suggested to remove the hair around the base of the penis and the hair on the midline 7 inches forward from the anus.
If you plan to do genital electrolysis, please do consult with your surgeon as to his or her preferences.

Practical: timeframe of genital electrolysis

You should plan for genital electrolysis to take about a year, although some get it done sooner (7 months minimum). All parties should keep in mind that electrolysis is a gradual process, and that it can take a year or more to completely clear an area.
As the complete hair growth cycle of genital hair is between 5-7 months, you will need at least this timeframe to completely clear all hair.
In the resting phase (telogen phase) of the hair cycle, killing the hair is less effective as it is not connected to the growth center of the hair (papilla). Unlike your facial hair, where about 30 percent of your hair is in resting phase, in your pubic area this is 70 percent. This means electrolysis in this area is less ‘effective’ and takes a longer timeframe to completely clear the area.

ONCE THE MAIN area has been accomplished we recommend rest, then come by every week for 15 min of genital electrolysis to remove the hairs that still pop up if necessary

On average the total timeframe to clear the genital area with electrolysis is around 1 year.

Preparation for genital electrolysis

Shave the genital region 4-5 days prior to your genital electrolysis. Because after all the hairs are shaved, only active hair follicles will grow back, which in turn allows us to be more effective (Most Electrologists, don’t electrolyze the hairs that can not be killed in this stage, although in our office the Specialized Electrologist is in the habit of doing all hairs present).
Iso-betadine soap—Hygiene before and after treatment is paramount, as there is a high risk of skin infections from genital electrolysis. We advise using Betadine liquid soap in the shower the morning of your genital electrolysis. Also the days after genital electrolysis this can be useful. You must be scrupulous about hygiene when getting genital electrolysis, especially if getting it performed close to your surgery date.

Your genital electrolysis

It is normal to feel nervous and embarrassed prior to your first genital electrolysis session. Know that for us this a routine treatment and The Specialist at Your Everlasting Solution, will try to make it as comfortable as possible for you.
We can use the machine’s highest settings for genital electrolysis if necessary. You want a high kill rate, and any scarring will never be seen. Unlike your face, it doesn’t matter if you overdo it a bit and mark the skin slightly, after all the only person who will ever see it after vaginoplasty is your gynecologist! Although Cherie is highly successful in treatment & leaving the skin in better condition then when the hair was there.
The skin itself is soft, wrinkled and rubbery in texture, and the follicles can be very ‘tight’ in some clients. Careful attention to stretching the skin around the follicle being treated is essential, and sometimes the electrologists finds a relatively stiff needle, such as some of the one-piece designs, helpful as it may be necessary to push the needle into the follicle considerably more forcefully than with any other site on the body, and a highly flexible two-piece needle may be prone to bending. Cherie at Your everlasting Solution is very experienced she has never encountered having to be forceful.
Removing genital hair tends to be more painful than facial hair removal. Pain can be reduced significantly. You may need to take additional steps to alleviate pain. Some have reported adequate pain relief with painkillers and/or EMLA.
Meticulous post-treatment skin care is very important to avoid infection and aid healing.

Recovery of your genital electrolysis

After treatment, skin may be red and even slightly swollen. This varies from patient to patient.
It is extremely important to take care of hygiene when you get genital electrolysis, particularly if treatment is close to your operation date.
Skin is more prone to infection after electrolysis. We’ll provide lotion to avoid this and help healing your skin after treatment. Antibiotics should also be taken while having treatments. *only when having genital electrolysis for SRS surgery.
Scrotal tissue may heal slower from electrolysis than other parts of your body.