laser

Genital surgery preparation for trans people

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Since the inclusion of coverage for SRS/GRS/GCS genital surgery for trans people, the number of people seeking surgery has increased immensely.

In a recent discussion between an international group of professional electrologists, including our own Keri and Natalie, we have become concerned that many surgeons are telling their patients NOT to bother with hair removal or that they only need three months worth of removal before surgery, because we’re seeing an uptick in post-operative clients seeking hair removal. Particularly for trans women seeking vaginoplasty using the penile inversion technique, postoperative hair can be quite challenging for the electrologist and very distressing for the client, since the hair is now inside of the body and pointed at an angle away from the surface.

Hair concerns for trans women after genital surgery:

Imagine someone laying on a bed as we look down from an overhead view, imagining being able to see through the pubis and into the neo-vagina:

Anterior view of neo-vagina with hair growing inside after genital surgery
Anterior view of neo-vagina with hair growing inside after genital surgery

What we see here, is the skin that was used to make the vagina now has hair growing, pointing inward. This hair can cause pain during vaginal penetration (including dilation), bleeding, infections, etc. Sometimes, depending on the angle and length of the hair, it can also grow to hang out of the vaginal opening, increasing dysphoria. Because the hair is now inside the vagina, removal requires the use of a speculum to spread open the vagina, specially angled lighting just to try to see the hair, probes bent back upon themselves to try to insert at a proper angle, and a lot of patience on the part of the electrologist and client as they attempt to treat the hair. Because of the difficulty involved, most electrologists are not capable of doing the work and most surgeons will tell their patients that it is simply unfortunate and that nothing can be done about it.

Why does this happen? For starters, while surgeons may be quite knowledgeable and skilled in the practice of surgery, most don’t really understand the process of hair removal that well. A mechanic may know how to rebuild your engine, but that doesn’t mean they will do a good job painting your car. Even if a surgeon DOES fully understand the process, many of them fail to effectively communicate with their patients, giving misleading or ambiguous preoperative instructions (advice on how many sessions, how early to start, illustrations of what areas to cover, etc are often poor). Because of their failure to convey good information, many MTF surgeons see poor outcomes with patients that had some removal, so some surgeons now instruct their clients not to bother with any hair removal at all before surgery, promising they’ll either scrape or cauterize all of the hair during surgery. The reality, is that nobody is 100% perfect and there is only so much time available during surgery to remove hair, and often hair ends up being left behind to grow.

Here’s the bottom line: to ensure that no hairs are left dormant and untreated, it takes approximately 10-14 months for all of the hair in the genital area to go through a full dormancy cycle. This means that, at a minimum, you should give your electrologist at least a year, preferably two years, to remove all of your hair prior to your surgical date. Yes, we understand that you want surgery as soon as possible and some surgeon you’ve contacted can get you in six months from now… but you really should wait, so that your hair can be properly removed, if you want to be sure that you don’t end up with postoperative internal hair. Also, laser is NOT approved for permanent REMOVAL of hair, only for “permanent REDUCTION” of hair. We frequently see hair that grows back after laser, sometimes years later. Five or ten years from now, laser can put you in the same situation as if you did no hair removal at all.

If you want to be absolutely certain that you will not have hair in your vagina, it is imperative that you start electrolysis, and only electrolysis, at least a year before your intended surgery date.

 

Hair concerns for trans men after genital surgery:

Phalloplasty usually involves taking skin and tissue from the forearm or thigh and then using it to make a penis. Often, it is not possible to extend the urethra through the penis without also making an urethra from the skin as well. Hair on the penis can generally be worked on after healing, since the skin is still at the surface, however, the skin being used for the urethra should be perfectly hairless before surgery. Like in the case of trans women above, once it is inside the body, it is tremendously difficult to work on internal hair and it can cause very similar problems – discomfort, bleeding, infection, stricture, etc. To our knowledge, nobody is even attempting to removal hair from the urethra after surgery, but fortunately, FTM surgeons seem to be much better in understanding, illustrating, and communicating pre-surgical needs.

Thus, the best plan of action is to come in at least one year, preferably two years, before your intended surgical date.

How long and how much?

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These are the two questions that, as electrologists, we hear the most.

The simple truth is, it is nearly impossible to give a specific estimate as to how long it will take to completely remove your hair since there are just too many factors. These factors include your individual pain tolerance, how dense your hair is, how large the area is, whether or not you stick to the treatment schedule, how long your sessions are, fluctuations in your hormones, whether you have treated the hair below the surface in other ways (waxing, threading, plucking, laser/IPL), etc.

What we can say, is typically, you should see a significant reduction within 6 months if you stay on your treatment schedule and that, in 12-18 months, your hair should mostly be gone, with only maybe one or two touchups per year if there is some new, previously untreated hair growing in that you are concerned about. Why does it take so long? Quite simply because you have more hair than what you currently see growing. Hairs will cycle through a dormant resting phase, typically lasting about 6 months, only to re-emerge again later and each hair is on its own, individual timer.

Hair that isn’t there cannot be treated until it starts growing.

If you pluck/wax/thread a hair out, if it remains in the growth phase, it will typically take about 6 weeks to emerge again. If you have done laser or IPL treatment, your hair that wasn’t destroyed may go dormant for as long as two years before it emerges again. These hairs cannot be treated until they are available for your electrologist to remove and the situation was not caused by the electrologist. Unfortunately, the ability of laser to permanently reduce hair is over-promised in advertising and consultations. The FDA declares “permanent” as a year of no regrowth and, again, let me reemphasize that laser is about reduction, not removal, despite the slick marketing.

Ok, so let’s talk numbers. These are not guarantees, but typical lengths of treatment.
Arms/legs: 20 hours
Underams: 10 hours
Bikini: 10 hours
Eyebrows: 3 hours

At Emancipated Electrolysis LLC, we offer reasonably priced sessions as short as 15 minutes long up to 8 hours long, with discounts for longer sessions. For more information about permanent hair removal or to book an appointment, contact us at hairinfo@EmancipatedElectrolysis.com or call us at 585-270-5230 and finally be freed from unwanted hair.

Transgender beard removal

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Perhaps the most difficult job in electrolysis, is the removal of an androgenic beard, whether caused by PCOS in cisgender females, or the testosterone in a trans person or cisgender male.

Unlike menopausal facial hair growth that many women experience, a true beard is very resilient, with a firm follicle structure and coarse, dense hair.

Proper settings and insertions are vitally critical in such a situation, and androgenic beards are best handled by people that already have experience in doing them. They simply aren’t the same as when grandma wants to have a few hairs on her chin removed and you aren’t going to get very far if the electrologist treats them as such. Many electrologists simply aren’t aggressive enough in their treatment and are content to routinely treat the same hair over and over again, becoming comfortable with the idea that their job is some sort of ongoing maintenance, rather than something to finish. Most electrologists don’t like to work longer sessions as the dirty little secret is, they make more money off shorter ones.

Many people seek to have laser first, and that is fine, if all you are looking to do is reduce your hair. Sometimes, it is recommended to start with laser and then finish with electrolysis as a means of saving money. At best, that approach may save some time, but it isn’t likely to save much money, as the remaining hair will be thinner and more frail, with a deeper and more traumatized follicle that takes a longer time to individually treat than if laser had never been done. We feel that, given the price of laser and the costly contracts many salons try to hook people on, we can help people more effectively for less than what it would cost to have laser first and then finish with electrolysis.

At Emancipated Electrolysis LLC, the proper treatment of androgenic beard hair is so important to us, it is what we specialize in. Yes, we are more than happy to work on grandma too, but we get the most enjoyment out of helping those with the most serious hair removal needs. While most electrologists shy away from such projects, we thrive on them. Whether you are trans, have PCOS, or are a cisgender male, we are your safe, supportive, private resource to put a permanent end to your beard problems.

Email us at HairInfo@EmancipatedElectrolysis.com or call us at 585-270-5230 to schedule a free consultation, and finally be freed from your unwanted hair.

Correcting misinformation from laser spas

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Did you know that the FDA only allows laser to claim that it can cause “permanent reduction” of hair and that is almost completely useless on light colored hair (white, gray, light blonde or light red) since it works because of the pigment absorbing the intense light to create heat? Electrolysis is the only method that is able to claim permanent removal of hair and it works on all hair colors and skin types.

What most laser removal places don’t tell you, is that after 6-8 treatments, which should be spread at least 4 weeks apart – another one of those things they often neglect to mention, laser begins having severely diminished returns. They often neglect to mention that laser can even cause new hair to grow (paradoxical laser hypertrichosis). Some go so far as to claim that electrolysis doesn’t work at all, even though electrolysis works well in conjunction with laser to treat the lighter hairs or even the darker hair that the laser failed to treat and excels at finishing laser treated areas once laser has reached the point of diminishing returns. Unfortunately, making money off their clients is often more important than being honest with them. Sadly, the technicians may not even know these things themselves, since there are absolutely no training or licensing requirements to do laser hair removal in New York.

Give us a call at 585-270-5230 to schedule a free consultation for a permanent solution to your unwanted hair.