Prior to Gender Reassignment Surgery GRS

As surgical techniques in respect of reassignment have moved forward over recent years, as have our expectations and the desire to attain the best possible results, after all you only have one chance to get the Surgery right. The quest to achieve the optimum outcome now includes the choice of having hair removed from the genitalia prior to surgery.

What are the options?

Surgeons in Thailand have perfected a technique to scrape the hair follicles from the scrotal tissue prior to reconstruction, although this procedure is not available in this country.


Electrolysis is very dependent on the skill of the therapist conducting the treatment. For correct needle insertion the skin must be stretched between the index and second finger, thus opening the entrance to the hair follicle in order to slide a fine needle into the follicle following the direction of the hair growth. The nature of the scrotal skin simply does not lend itself to being stretched in this manner. This means that correct needle insertion is almost impossible. If the needle is inserted incorrectly the current will be discharged into the wrong place. The resulting destruction to the dermis can disrupt the blood supply and result in tissue, which is too damaged for reconstruction.


Laser treatment works by selective absorption of the laser light by the melanin or colour in the hair. This inevitably means treatment is only successful where the hair contains dark pigment and the skin is fair allowing the light to pass through the skin leaving it untouched. As has been proven time and again there are many different lasers on the market, not all of them remove hair successfully. It is worth noting here that IPL systems are different technology altogether to laser and may result in absorption of light in the skin tissue. It is of the utmost importance that you choose a proven system as after surgery no further treatment can be carried out.

Chris Hart from Cristianos Laser Clinics was one of the pioneers of the use of laser for this procedure and is monitoring the success of treatment carried out at her clinics in Manchester, London, Bury, Liverpool and Leeds. Chris had this to say ‘Treatment of the Perineal area in preparation for Gender Reassignment Surgery for transwomen continues to receive positive feedback from both clients and from surgeons. Clients have not reported any difficulties with hair regrowth but we are obviously restricted in assessment of the area post surgery. Clients have been receiving an average of 6 to 8 treatments. It is my personal view that the probability of incorrect needle insertion is too high even for the most experienced therapist and therefore would never recommend any client to have electrolysis on the genitalia prior to Surgery even in circumstances where the hair or skin is unsuitable for laser treatment’

Chris’s commitment to the procedure included at trip into theatre to observe a M2F reassignment, taking dedication a step too far maybe! Recalling the experience Chris determined ‘It was a necessary evil to appreciate first hand the tissue, which needs to be treated and as importantly the tissue that does not require hair removal. Both vitally important in achieving the most natural results’

Perineal Hair Removal

More and more surgeons are requesting Cristianos at Leeds, London, Altrincham, Liverpool and Bury that hair is removed from the Perineal area prior to Male to Female reassignment surgery. The skin tissue used to create the vaginal cavity is naturally hair bearing. Whilst it is not essential from a surgical point of view to have hair removed it can result in complications for the patient after surgery if the area is not hair free. Removal of the hair from the genitalia by means of electrolysis, prior to reassignment surgery and in order to prevent the presence of hair inside the new vaginal cavity, was considered particularly difficult. The nature of the tissue meant that correct insertion of the needle was difficult leading to the possibility of tissue damage. Many surgeons advised that the hair be left. The advent of laser removed the danger of tissue damage and several surgeons are now advising their patients to consider laser treatment.

Although we do not have the opportunity to scope the new vaginal cavity for the presence of regrowth the clients who have received treatment with us have reported a high degree of satisfaction and have not reported any experience with problematic regrowth. After consulting with leading surgeon Mr Phil Thomas we can recommend approximately 8-10 laser treatments on the Perineal area and, as no treatment can be carried out after surgery, the ideal time to start treatment is 12-18 months prior to surgery, giving ample time to address any regrowth.