Dr. Meltzer is a Member of the American Society of Plastic Surgeons
This is a picture of our office Toby R Meltzer MD,PC 7025 N.Scottsdale Road Suite#302 Scottsdale,AZ 85253

Office : 480.657.7006

Toll-free: 866.876.6329

E-mail: info@tmeltzer.com



7025 N. Scottsdale Road
Suite # 302

Scottsdale, AZ 85253



Toby R Meltzer MD, PC - Plastic and Reconstructive Surgery

Patient Resources - MtF

Post Operative Dilation Instructions



Your post-operative care is going to involve regular use of vaginal dilators and douches. It is absolutely critical that you continue to dilate as required. Failure to do so may result in a collapse of the vaginal vault. If this were to happen, a second operation may be required at your own expense. If at any time you have any questions or concerns, please call our office and speak with a nurse.


You will begin dilation when your packing is removed.
One of Dr. Meltzer's nurses will perform the first dilation with your participation.
This will generally be on day 6 of your postoperative recovery.

Example: If your surgery is on a Tuesday, you will be dilated the following Monday.
The first day you will be required to perform dilation 5 times (once in the middle of the night).


1)  Wash your hands and have your supplies setup including something to clean with at the end of the dilation.

2)  Start with the smallest dilator.

3)  Apply about one teaspoon of KY jelly, or any water-soluble, medical grade, lubricant
      to the dilator (do not use Vaseline); spread it around.

4) Hold the dilator with the dots on top (curving upwards).

5)  Gently insert the dilator into the entire length of the vagina and hold in place for 15 minutes,
      applying firm pressure. This should never be forceful.

6)  Slowly remove the dilator.

7)  On your last dilation for the day apply a small amount of Bacitracin to the tip of the dilator;
put the lubricant on the rest of the dilator as demonstrated and insert, turning the dilator very slightly
from side to side to distribute the ointment.
Continue this practice for 4-6 weeks.

8)  When passing the small dilator (#1) becomes easy, progress to the next size.
Generally 10 - 21 days for each size.
The fourth (largest) dilator may be used at your discretion following this period. This size may not be necessary or comfortable for everyone. Also, please let your body be your guide.
As soon as it becomes simple, progress to the next size.
Do not reduce your daily dilations if you find it is difficult.



The First Month: Four times a day. Dilations should be timed 3-5 hours apart.

The Second, Third, Fourth, and Fifth Month: Twice a day.

(Please note, if it is getting easier toward the fourth month, you may reduce your frequency to once a day. However, please contact our office and speak with a nurse before doing so).


You may have intercourse after three months.


Six months to One Year: Once a day.


After one year, you may start decreasing your frequency by a day or two between dilations.

As it becomes easier, you may further decrease your frequency.
However, we strongly recommend that you check it at least once a week for as long as needed.


Follow these general rules: As dilation becomes easier, decrease your frequency.
If dilation becomes more difficult, increase your frequency.


Remember, intercourse does not completely replace dilation.
To maintain the full depth and width of your vagina, you will need to check it from time to time.


Wash the dilators, after each use, with a nonabrasive, antibacterial soap
 in warm (not hot) water, dry thoroughly.

DO NOT place them in a dishwasher, or clean with alcohol; this may cause them to crack.


After the first month, you may switch to a commercial lubricant such as Astroglide, Wet or the lighter KY lubricants.



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