I'll go through them below, if you have any other questions feel free to ask ❤️

How many vaginoplasties have you done?

Dr. Purohit didn't recall the exact number, but it was over 300, which I felt was a pretty good amount.

Complication rates

Fistulas and stenosis were around 1% or less, while wound dehiscence and granulation were very common, which is true for most surgeons. I seem to have had no or very little dehiscence and no granulation that I'm aware of.

Who did you train under?

Dr. Purohit trained under Dr. Bowers

Of the techniques that you offer, which do you prefer, and why?

Dr. Purohit offered standard Penile Inversion, Peritoneal Flap/Pull-Through, Sigmoid/colon vaginoplasty, and minimal depth. He didn't have a particular favorite, and was willing to do any of those as a first surgery. Generally you should probably keep colon for revisions in my opinion, but regardless, that's not what I went with. I was borderline for needing peritoneal due to my rather small size pre-op, so that's what I went with.

What are the benefits and drawbacks of that technique?

As said previously, he didn't have one technique that he preferred over any others. Generally, though, PI is simpler than PPT or colon, while PPT and colon might give you more self-lubrication. PPT and colon are a bit tougher to recover from since they go into your tummy with a robot.

If skin grafts are used, where are they harvested from?

Typically just a scrotal graft is used.

Are revisions covered by insurance?

If medically necessary, yes. Unfortunately insurance typically won't pay for an aesthetic revision.

Should I stop HRT prior to surgery, and why?

Dr. Purohit does not have his vaginoplasty patients stop HRT before surgery. From my understanding, the science behind stopping is outdated and the studies were done with patients on Premarin, a conjugated estrogen, which isn't a common form of HRT anymore. Bioidentical estradiol poses no increased risk of clots during and after surgeries than what a cis woman would face, assuming your levels aren't super high for some reason. I believe the other surgeons at Mt. Sinai also allow you to continue your HRT leading up to surgery.

How long will I be in the hospital?

Dr. Purohit's patients are typically in the hospital for three days, and that's how long I was in the hospital. If there are any complications, though, he's not gonna kick you out. He'll keep you there as long as necessary.

How long should I stay nearby after surgery?

He wants patients in NYC for at least two weeks post-op. I opted for three. I didn't need to stay that extra week, but tbh I just really like NYC.

What after-care products will I need? What will be provided to me?

He did not go too much into this, but I felt I was prepared regardless. Big things I personally would recommend: Unscented baby wipes for cleaning yourself, unscented soap for cleaning your dilators, a donut pillow (or a waffle pillow, I've seen lots of folks here recommend those over donuts), doggy pee pads for dilation and just general bleeding and discharge in bed, normal human pads (like for your underwear), a hand mirror, and a wedge pillow. As for what's provided, it's basically just the dilators, specifically the SoulSource set with the big orange one.

Do you have any specific recommendations for post-op care?

He did not have any particular recommendations, and my caregiver sat in on my consult so I didn't have to remember much to specifically tell her at the time. I personally don't have any specific recommendations beyond the typical stuff: Rest as much as you can, drink lots of water, especially in the hospital , that kind of stuff.

When can I return to school/work?

Dr. Purohit (rightly) said that it's different for everyone and depends on what your work is. Typically at the least, 1.5 months off work, preferably more if you can manage it. School is the same story, so I just took the semester off. Personally, I can not imagine working right now. I worked as a tech in an ophthalmology practice with pretty low patient volume, and I would not be able to go back right now. Standing and walking still gets me tired pretty quick, and showering completely drains my energy.

What info should I share with my post-op caregiver?

As I said previously, my caregiver sat in on the consult. If you can have the same happen, do it.

Do I need to stop my other medications before surgery?

For my meds, no, just don't take them the day of, and continue after. This you 100% need to ask your surgeon, especially if you take things like aspirin or medications for hypertension.

Will you construct both labia majora and minora?

Dr. Purohit said yes, and my verdict is yes. There's pictures on my profile if you're curious. The minora are a bit hard to see in the more recent photos, but in the photo taken at the end of the surgery, you can see the minora quite clearly. Just gotta wait for the swelling to go down.

How long is the expected wait until my surgical date?

He didn't know off-hand, which I expected. The surgical coordinator got me in for about 6 months after my consult. It might have been sooner had I not opted for PPT, as they need time with the robot and the surgeon who uses said robot.

Which dilator is used to construct the vaginal canal?

The big orange SoulSource dilator

How long does the surgery take?

Typically you're under general anesthesia for about six hours. I was under for an extra two hours because a needle broke off inside me. They got it out and all was fine, but hospital policy required that they do an x-ray, which took a while.