Marshall T. Partington, MD, FACS

Combining Labiaplasty and liposuction at the same time is very reasonable. Be aware that post operative swelling in the vaginal area may be more pronounced, especially if liposuction of the abdomen has been performed. When indicated, I often combine labiaplasty and liposuction of the mons pubis to enhance results. 

Judging from your before and after photos, it looks like you have had a wedge procedure without attention to clitoral hood reduction. Other than swelling, I would not expect you to have post surgical exposure issues with the clitoris.

It sounds like you may be experiencing local irritation from outside absorbable sutures. Besides soaking and analgesics, it might be worthwhile to ask your surgeon if he/she might trim excess suture material at the external knots which may be causing chafing and consequent inflammation. It is this inflammation more likely than infection that causes the pain. Often Epsom salt soaks can help relieve swelling and discomfort.

I’m sorry you're uncomfortable . I hope this helps. 

Dr. Partington

Sorry to hear you are having those problems. Whenever there is a post operative problem, it is the doctor’s responsibility to diagnose what went wrong before setting out a plan to fix it. 

LABIAPLAST REVISION often involves reexcision of the opened wound edges and resuturing. One concern is that presumably the perfect amount of tissue was removed the first time and additional tissue excision to reclose the wounds may represent an over resection and over tightening of the labia. Ask your surgeon about this prior to the revision surgery.

The holes you have noted may well be from a reaction to the particular suture material used in the initial repair. It may be advisable to use a different suture material... again , ask your surgeon. 

I hope this helps. Dr Partington

Judging from your photo, it looks as if you have undergone a trim technique of both labia minors. This technique is associated with heightened swelling, discomfort and scarring. 

I purposely avoid this technique in favor of the WEDGE TECHNIQUE WHICH MINIMIZES SCARRING, SWELLING AND RECOVERY TIME.

I would recommend you discussing Epsom salt soaks with your surgeon and monitor closely for infection and local suture irritation. 

Hope this helps. Dr Partington

We currently charge $600 per vial. Often times a treatment involves one to two vials. Unfortunately your pictures do not show your neck. Some people benefit from two or more treatments depending on the volume of fat in their neck.

One of the beauties of micro-needling is that there are essentially no side effects. It is perhaps one of the most effective treatments for acne scarring. It is important to not perform the procedure if there is active acne as this could result in infection. You can expect your face to look mildly sunburned for a day or two after the procedure. Deeper needling, which we term medical needling involves topical anesthetic and will create a longer-lasting sunburn look. It also is more affected for deeper scars.

In looking at the limited views from your pictures I would say definitely liposuction and not tummy tuck. You should be able to get nice smooth contouring of your abdominal skin as well as tightening your waist and hip line which will accentuate the roundness of your buttocks. Avoid abdominoplasty at this point I suggest.

Your photographs does not show the full anatomy. However from what I can see you are a very reasonable candidate for a wedge procedure. The clitoral hood appears normal and I would recommend that that is not operated on. Scars from the Wedge procedure are generally excellent and well-hidden. Loss of sensation is a rare problem. However, clitoral hood reduction is more likely to be complicated by sensation changes.

Unlike fillers which we commonly use to address wrinkles, creases and contour irregularities, the effects of needling are permanent. This is because needling creates new collagen and elastin. Micro-needling generally refers to needles that are .1 mm long. This indeed can be performed without topical anesthesia. It creates small holes in the stratum corneum, the topmost layer of the skin and allows for better absorption of cosmeceuticals such as Vitamin A, C and E. I prefer the term medical needling for longer needles which are generally performed in the office under topical anesthesia. These needles are usually a millimeter long. These puncture the full layer of the skin and create micro bleeding underneath the skin. It is the release of this blood under the skin that triggers a natural healing reaction to call fibroblasts into the region which create collagen, especially type 1 collagen which promotes scarless healing. Longer needles such as 3 mm can be used as surgical needling. This requires regional anesthesia and may be combined with surgical procedures for optimal skin tightening.