1 month post labiaplasty & vaginoplasty. Had anal sex. Perineum opened up & bled. (Photo)

1 month post labiaplasty & vaginaplasty. I know I shouldn't have, but my partner, who has average sized penis, was gentle.....at first. We both got excited, but after a few minutes he noticed blood. It was minimal. I took a Sitz bath and there looked to be minimal damage. Today it was more open. This pic was just after a Sitz bath. My MD is not in the same city. I'm freaked out. Advice?

Doctor Answers 10

1 month post labiaplasty & vaginoplasty. Had anal sex. Perineum opened up & bled.

Thanks for submitting your question. It appears that your perineoplasty repair has separated and this will now need to heal by secondary intention. Which means it will take more time and you will need to avoid all penetrative sexual activity for some time. 

You should see your surgeon or a local provider to determine the best course of action. 

Fredericksburg OB/GYN

Wound separations

can occur post-op but it was certainly avoidable here.  But that is water under the bridge.  Focus on good wound care as the wound appears superficial and let your surgeon know so additional instructions can be provided to you to help you achieve the best outcome possible... and of course, no more penetration sex until your surgeon clears you.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

1 month post labiaplasty & vaginoplasty. Had anal sex. Perineum opened up & bled.

Thank you for your question. It is usually best to follow instructions of your surgeon and usually after these types of procedures it is best to avoid sexual activity until released by your surgeon. But, things happen and we deal with the outcomes. It looks like you have had a small separation in your incision. You should contact your surgeon and discuss this with him or her. Likely this can be treated with local wound care and protection of the area and will go on to heal without further complication.

Good luck and be careful!

Dallas Buchanan, MD
Spokane Plastic Surgeon
5.0 out of 5 stars 30 reviews

Early sex after perineoplasty/vaginoplasty with incision split- what to do?!

No, you "shouldn't have," but we all do things we "shouldn't have..." Sex is a powerful thing! I tell my post-op perineoplasty/vaginoplasty patients to refrain from penises & toys in vagina or anus for a minimum of 6 weeks, usually 2 months (or at least until I've counselled them @ 6 weeks exam...

What to do?? Well, first send your photo to your surgeon & ask him/her! No way unfortunately to just "sew it back up..."-- won't "take." You will need to wait until it's fully healed (will take a bit longer now that it's split; probably a good month more...) before sex again. From the photo, it looks like things are held together "underneath," where it counts.  Yeah- you messed up, but not the end of the world. Worst thing is that you may have to have the local area excised & re-sewn after it all heals (wait until at least 5-6 months post-op), pay a bit more, and avoid sex again for 6-8 weeks.

Live & learn. Best wishes,

Michael P Goodman, MD
\Davis, CA, USA

Healing after Vaginoplasty

There is a small opening of your incision line. The opening appears superficial and will likely be able to be managed conservatively. You should follow up with your surgeon by phone today for their recommendation regarding an in person exam. Until you are seen, keep the area clean and dry, rinsing with water in the shower. 

George Shashoua, MD
Austin Urogynecologist
4.9 out of 5 stars 38 reviews

Wound seperation

Thank you for sharing your post in question. Unfortunately due to the fact that there is a small separation  along the incision of your perineum, I  would recommend a proper in person evaluation by your surgeon. In the interim, I would abstain from any  intercourse and would apply some triple antibiotic ointment to the area.
Best of luck!!

David Ghozland, MD
Santa Monica OB/GYN
5.0 out of 5 stars 27 reviews

1 month post labiaplasty & vaginoplasty. Had anal sex. Perineum opened up & bled.

Thank you for sharing your question and photograph. Unfortunately it appears that you have suffered a separation of your perineoplasty incision line that hopefully will not worsen with time.  You need to see your surgeon for an in-person evaluation and discussion of wound care recommendations as well as a reminder of the activities to avoid in order to not stress your repair further.  If you can not see your surgeon they may have an arrangement with someone more local to be able to lend advice.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

Post-Op Healing for Labiaplasty

Swelling after #Labiaplasty is usually present for several weeks.  It’s possible that swelling can persist for two or three months. Firmness of tissue can remain for 4-6 months, and this is something that may have been part of the bleeding you experienced. Postoperative care will usually consist of sitz baths or soaking the area in warm soapy water starting approximately 2 days after a surgery. The sutures will dissolve over the course of several weeks. This will in part depend upon the #Labiaplasty technique used, the amount of brusing and they way in which your body heals. Ice can help reduce swelling. Arnica and Bromelain may help.  Direct massage may be useful as well, but when it comes to the bleeding you experienced you may want to see your surgeon in person to make sure that the sutures are still healing properly. With your doctor in another city, you may be able to call the office and ask for advice from the answering service to make sure. Patients return to most normal activities immediately after surgery with the exception of activities that will create direct pressure on the #vaginalregion such as certain exercise equipment and #sexualactivity.  It will be necessary to refrain from these forms of physical activity, including sex, for approximately 4-6 weeks.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Sex too soon after vaginoplasty broke your scar

This will heal from the inside out and leave a scar which may need to be revised if it's too wide. Nonethless, the deeper layers appear to be intact. Anal sex is never OK after vaginoplasty until everything has healed. Keep it clean and avoid all sex until it's healed completely.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.6 out of 5 stars 24 reviews


The separation seems superficial and should not make any real difference with your final result. The perineum heals very well. Speak to your doctor and get a recommendation on the specifics.

Adam J. Oppenheimer, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 191 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.