What to Expect With Penile-Preserving Vaginoplasty

Penile-preserving vaginoplasty is a gender-affirming surgery for transgender and non-binary individuals who want vaginoplasty surgery but would also like to keep parts of their original genitalia. Also known as phallus-preserving vaginoplasty, this option for non-binary bottom surgery can be suitable for those who wish to keep the functionality and aesthetic appearance of the penis while undergoing vaginoplasty. It’s a way for individuals to align their bodies with their gender identity in a way that feels right.

Understanding Penile-Preserving Vaginoplasty

Penile-preserving vaginoplasty aims to create a new vagina, called a neovagina, using tissue from the penis and scrotum. This surgery is personalized to help individuals affirm their gender identity. During the surgery, your surgical team will use the skin from your penis to create the inside of a new vagina (neovagina), and the scrotal tissue will be used to give extra support. You can anticipate a detailed process that takes into account your goals and needs to make you feel more comfortable with your gender.

After the surgery, there will be a recovery period with post-op care and check-ups to make sure everything is healing well. It's important to understand that the results can be different for everyone. It depends on how your body is built and how the surgery is done. Talking openly with your surgical team, and following all care instructions after surgery will help make sure you get the best result possible. The ultimate goal is to achieve a result that aligns with your desired gender identity and that everything works as it should.

Preparing for Penile-Preserving Vaginoplasty

Before having penile-preserving vaginoplasty, there is a careful pre-surgery process. You’ll have meetings with your surgical team, where you talk about your goals, what  to expect, and your medical history. They’ll do thorough check-ups to make sure the surgery is right for you. You should openly communicate your desires and concerns, ensuring a clear understanding of the expected results.

Before surgery, check in with yourself. Are you feeling okay? Are you ready for gender affirmation surgery? Mental health is an important part of the process. We recommend following up with a mental health provider before the operation, as well as, post-operatively. Sometimes, your doctor might suggest hormonal therapy to make sure the genital tissues are soft and flexible. You may also be required to remove the hair in the area before surgery. It’s a good idea to stop smoking and avoid certain medications that may interfere with the surgery and recovery process. Taking these steps helps make sure everything goes well, and you have the best chance at the results you want.

Before surgery, it’s important to stay healthy by eating well and exercising. Your doctor will give you clear instructions on what to eat, and when to stop eating before your procedure. It’s a good idea to have emotional support too, and some individuals find it helpful to talk with others in support groups or through counseling.

What to Expect During PPV Surgery

In penile-preserving vaginoplasty, your surgeon will use skin from the penis and scrotum to make a new vagina (neovagina) while keeping it sensitive and functional. The surgery happens while you’re asleep under general anesthesia. The surgeon separates and uses these tissues to make the neovagina look natural. The skin for the vaginal canal comes from the base of the penis and scrotal tissue. 

The surgery will last several hours and may require a short stay in the hospital.

Post-Op Care and Expectations of Phallus-Preserving Vaginoplasty

After the surgery, your doctor will give you clear instructions on how to take care of yourself. You might feel a bit uncomfortable and swollen, but the doctor will give you medicine to help with that. You might expect to have a temporary tube to help you pee at first. Any swelling or bruising will go away as you heal. 

After you leave the hospital, taking care of yourself at home is important. You’ll get instructions from your doctor and healthcare team about how to care for the surgical  area. For the first 1-2 months it’s a good idea to avoid things like intense exercise, lifting heavy stuff, and any kind of sexual activity. As you start to feel better, you can slowly get back to your usual activities if your doctor says it’s okay. Besides taking care of your body, having people around who support you emotionally is also really helpful. Recovery can bring up different feelings, and having a support system makes it easier.

After surgery, you’ll have follow-up appointments to make sure everything is healing well and to talk about any worries you might have. In these appointments, the doctors may adjust your hormone therapy and give you instructions on how to take care of any scars.  Follow postoperative care instructions closely, and communicate openly with your healthcare providers about any concerns or questions during recovery. They’re there to help you every step of the way.

Exploring Positive Outcomes of Non-Binary Bottom Surgery

Non-binary bottom surgery can have a lot of positive effects for those looking for gender-affirming surgery. Individuals choose this surgery to match their body with their gender identity, making them feel more like themselves.


Non-binary bottom surgery may create a more positive body image, reducing feelings of gender dysphoria and enhancing overall mental health. The surgery can give you the confidence to embrace your gender identity leading to a happier outlook on life. Taking control of one’s body can lead to better relationships, both with oneself and with others. 

Besides that, non-binary surgery can make intimate relationships better because individuals feel more at ease and satisfied. The surgery lets someone express their gender identity more truthfully, leading to healthier connections and an all-around better life. The good things from this surgery aren’t just about the changes to the body; they affect how someone feels emotionally, their confidence, and how genuinely they engage with life.

Common Questions About Phallus-Preserving Vaginoplasty

As you think about phallus-preserving vaginoplasty, you might have some questions about the procedure. Individuals often want to know if health insurance covers the surgery, trying to figure out if it’s something they can afford. Another common question is about who can have the surgery. Individuals also ask about who the best candidates are for phallus-preserving vaginoplasty, wondering if it’s the right choice for them and their goals. 

At ART Surgical, our team is here to help you get ready for your phallus-preserving vaginoplasty surgery. We will give you all the information you need, and answer any questions or concerns you may have.

Mental Health and Support for Non-Binary Individuals

Taking care of mental health and offering support to non-binary and transgender individuals is vital for creating a positive and affirming atmosphere. Many individuals may face challenges like gender dysphoria, so having access to mental health resources is essential. Support for mental health often includes addressing gender dysphoria by talking to a counselor, going to therapy, or joining support groups.

Building a support network is important, and friends, family, or support groups can provide understanding and empathy. Professional counseling or therapy is also helpful in guiding individuals to navigate their gender identity and cope with their emotions. Therapists who specialize in gender-affirming care can offer useful advice and coping strategies.

Online communities are also valuable for support. Social networks, forums, and advocacy organizations connect people with similar experiences, reducing feelings of isolation. Helplines and mental health hotlines are also available for immediate support in times of distress.

Life Beyond PPV Surgery: Embracing the New You

Life after penile-preserving vaginoplasty is a journey of self-discovery. You are embracing your true identity. This transformative surgery helps you align your appearance with who you truly are, making life more genuine and satisfying. 

Accepting who you are is more than just looking at your physical changes, it is about embracing yourself and feeling more confident. Lots of individuals feel better about themselves and their bodies, which can improve their overall mental health. 

You might find empowerment in expressing your gender identity openly. This could mean exploring new things, following your passions, and doing activities that feel true to yourself.

In the end, life after penile-preserving vaginoplasty is about embracing the positive changes from the surgery and living as your authentic self.

Book a consultation to learn more about penile-preserving vaginoplasty and how renowned gender-affirming surgeon Dr. Angela Rodriguez and her team at ART Surgical in San Francisco will guide you through the process.

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