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Appearance and body image after a vulvectomy | CION Cancer Clinics
After a vulvectomy the vulva looks different, and how different depends on how much tissue was removed. A small excision may leave only a scar, while a radical operation leaves the area flat and smooth. Nothing shows through clothes, and your womb and ovaries are not touched. This page explains what changes, how to prepare for the first look, and where to find help. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Will the vulva look different after a vulvectomy?
- What does each kind of operation usually change?
- How can you prepare to look for the first time?
- Is it normal to feel upset about how you look?
- What do women fear about their appearance that is not true?
- What changes, and what usually stays the same?
- What can this page not tell you?
- Common questions about appearance after a vulvectomy
The short answer
Will the vulva look different after a vulvectomy?
Yes, the vulva will look different after a vulvectomy, and how different depends on how much tissue was removed. A small operation may leave little visible change once healed, while a larger one leaves the area flatter and smoother, with a scar.
Why it matters to talk about this
Many women are not told clearly what to expect, and see the change for the first time alone in a bathroom mirror. Others never look at all. Both are understandable. Knowing in advance, in plain words, usually makes the first look less of a shock.
The look changes as you heal
In the first weeks the area is swollen, bruised and stitched, and it looks far worse than it will later. Swelling goes down slowly. The colour of the scar fades from red or dark towards the colour of the skin around it. Judge the appearance once healing is well along, not in the first days.
Before surgery, you can ask your surgeon to describe or sketch what will be removed. Many women find this helps.By type of operation
What does each kind of operation usually change?
These are general descriptions. Your own result depends on where the cancer was and how much the surgeon had to take.
Wide local excision
A small area of skin is removed with a rim of healthy tissue. Once healed, many women see only a scar and a slight change in shape on one side.
Partial vulvectomy
Part of the vulva is removed, often one side. The area may look uneven, with one side flatter than the other.
You may notice
- Less of the inner or outer lip on one side
- A scar line that feels firm
Radical vulvectomy
Most or all of the inner and outer lips are removed, and often the clitoris. The area looks flat and smooth, and the openings of the vagina and urethra are more visible.
Groin and flap scars
If glands were removed from the groin, there will be scars in the skin creases. If a flap was used to close the wound, the new skin may differ in colour or hair from the skin around it.
Not sure whether this applies to you?
Ask an oncologistWhen you feel ready
How can you prepare to look for the first time?
Choose your moment
There is no right time. Some women look in hospital with a nurse beside them. Others wait until they are home. Pick a time when you are not rushed or tired.
Decide who is with you
You may want to be alone, or have your nurse, a sister or a close friend nearby. It is your choice, and it can change later.
Look in small steps
Use a hand mirror in good light. Look briefly, then again another day. Some women start by touching the area with a washcloth before looking.
Say how it felt
Tell someone, even a single sentence. Shock, sadness or relief are all common first reactions.
How women feel
Is it normal to feel upset about how you look?
It is very normal. The vulva is private, and it is tied up with how many women feel about being a woman, a wife and a partner. Losing part of it can bring grief, even when you are relieved the cancer has been removed.
Feelings that often come up
Women describe feeling less feminine, embarrassed, or worried that a husband will notice or turn away. Some feel angry that nobody warned them. In many families this part of the body is never discussed, so these feelings are carried alone. Saying them to one trusted person often takes away some of their weight.
What tends to help
Time helps most women. So does knowing that the change is private and cannot be seen through clothes. Talking to your surgeon, your nurse or a counsellor who works with women after gynaecological cancer can help you sort out which worries are about appearance and which are about sex, closeness or the fear of the cancer returning.
If low mood lasts for weeks, stops you sleeping or eating, or you feel hopeless, tell your team. That is treatable.Leave a number, we will call you
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Commonly believed
What do women fear about their appearance that is not true?
"People will be able to tell."
The change cannot be seen through clothes, including a sari, salwar or trousers. Nobody knows unless you choose to tell them. Groin scars sit in the skin creases and are covered by underwear.
"I am not a whole woman any more."
A vulvectomy removes skin and tissue on the outside. It does not remove your womb or ovaries, and it does not change your hormones. Being a woman is not measured by the shape of the vulva.
"It is better never to look."
Not looking is a choice some women make for a while, and that is fine. But checking the area helps you notice healing problems and later changes that need a doctor. Many women find the reality less frightening than what they imagined.
"My husband will not want to be close to me."
Many partners are far more worried about losing you than about how you look. Closeness often returns once couples talk openly. When talking is hard, a counsellor can help both of you.
Side by side
What changes, and what usually stays the same?
What may change
What usually stays the same
The shape of the lips of the vulva
The vagina, womb and ovaries are left in place
Feeling and numbness in the skin
Your hormones and your periods or menopause
Pubic hair where skin was removed
How you look in clothes
The direction of the urine stream
Your ability to pass urine and open your bowels
Being straight with you
What can this page not tell you?
This page cannot show you what your own vulva will look like. The result depends on where the cancer was, how much healthy tissue had to be taken around it, whether the wound was closed directly or with a flap, and how your skin heals.
Who may find this harder
Younger women, women who are single or newly married, and women who had a radical operation often find the change harder. So do women who had no chance to talk about it beforehand. None of this means you are coping badly.
Questions worth asking
Ask your surgeon what exactly was removed, whether the clitoris was involved, and whether reconstruction could change the appearance later.
Questions we are asked
Common questions about appearance after a vulvectomy
What does the vulva look like after a vulvectomy?
It depends on the operation. After a small excision there may be only a scar and slight change in shape. After a radical vulvectomy the lips are gone and the area looks flat and smooth, with the vaginal and urinary openings more visible. Swelling in the first weeks makes it look worse than it will later.
Can I see pictures before the operation?
You can ask. Some surgeons prefer to draw a simple sketch or describe what will be removed, because photos of other women may not match your own operation. Ask what will be taken, what will be left, and how the wound will be closed.
Will my pubic hair grow back?
Hair does not grow back where the hair-bearing skin was removed. Hair on the skin that is left keeps growing as before. If a flap of skin from another area was used, it may have more or less hair than you are used to.
Will my husband notice the difference?
If you are intimate, he may. Many women find it easier to talk about the change before that moment rather than hoping he will not notice. Your nurse or a counsellor can suggest words to use. Many couples find the conversation matters more than the appearance.
Can reconstruction make it look like before?
Reconstruction mostly helps a large wound close and heal. It can improve comfort and shape, but it cannot recreate the vulva as it was. Ask your surgeon whether it is suitable for you and what realistic results look like.
I cry every time I think about it. Is something wrong with me?
No. Grief after losing part of your body is a normal reaction. It often eases over time. If the sadness is constant, stops you sleeping or eating, or you feel hopeless, tell your team. Help from a counsellor or doctor is available and it works.
Can I wear the same clothes as before?
Yes, once healed. Nothing shows through clothes. While you heal, loose cotton is kinder to the wound than tight jeans or leggings. If you have swelling in the legs after groin surgery, you may need looser trousers for a while.
Who can I talk to if I feel embarrassed to raise this?
Your nurse is often the easiest place to start, and has heard these worries many times. You can also ask for a counsellor. Writing your question on a slip of paper and handing it over at your appointment is perfectly fine, and many women do.
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Sources
- Macmillan Cancer Support — Vulval cancer
- Cancer Research UK — Vulval cancer
- NHS — Vulval cancer
- Cancer.Net — Vulvar cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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