1. Keep your wounds dry for 24 hrs then you may shower and get your wounds wet – do not rub your incisions except with soaped fingers; do not submerge wound for weeks; you may use a Peri Bottle to spray the wound after using the bathroom (use warm water – not hot water) and blot dry

2. Watch for signs of infection (redness, increasing pain or swelling) 4-5 days after your procedure; redness @ the edge of the wounds is normal but spreading redness is not

3. Do not scrub or pull at your incisions - ok for gentle washing with soaped fingers; also blot gently after using the bathroom

4. Topical ointment (ie: Aqua-phor or Vaseline) to wounds twice a day including after showers until no crusting or drainage at wound site, then you may stop; suggest panti-liner (avoid adhering liner to panty) or gauze to keep your clothes clean; need to apply enough ointment so nothing sticks to wound – wash dressing off in shower if dressing stuck to genitals

5. No roughness to labia for 6 wks (ie: penetration sex, riding bicycle, horseback riding, etc) and be very gentle when starting up again; avoid tight jeans for a month; use hemorrhoid cushion or horse shoe neck pillows for prolonged sitting so no pressure on labia

6. Please call if you have any concerns or problems @ (530) 215-1118. If after hours, call (530) 227-8839 (my cell) or (530) 246-7308 if I don’t answer; Continue calling cell if no answer and urgent; increasing pain and swelling only on one side or bleeding that you cannot stop is urgent

7. Use Ibuprofen 200 mg 2-4 capsules/tablets every 6 hours as needed and/or Tylenol for pain; Call for Neurontin or Toradol if you wish to use that. Your local anesthetic should last for 4-5 hours from now

8. Hold mild direct pressure to your wounds if any bleeding – hold for 5 minutes minimum before checking; repeat for 10 minutes if it continues before calling doctor

9. Please return in 3 weeks for a wound check and removal of retained sutures… but you can delay til 2 months for photos if you are coming along well and have absolutely no concerns and prefer not to drive back for that

10. Please keep your stools SOFT so your don’t have to strain to have a bowel movement – it can tear stitches and lead to bleeding

11. Take your Keflex 500mg capsules at 10 pm, when you wake up, and around 1pm tomorrow (#3)

12. You can have intense itching – take antihistamines for that; if sutures still present at 3 weeks post-op, removing you sutures may help with diminishing the itch such as Benadryl, Zyrtec, Claritin, Allegra, etc.

13. Please call if any asymmetric swelling with increasing pains

14. Ice bags or frozen peas for the first 48 hours may be helpful with pain and swelling

15. If possible lay with pillow under butt to elevate slightly so at or above level of heart for a few days; when you start walking for prolonged times, if your vulva gets very swollen, you are upright for too long

16. Absolutely no pulling at your labia to get a better look… you can pull incisions apart if that is done