I'm considering get labiaplasty to correct my overly large labia minora. I'm not so concerned with getting rid of the pigmented skin but I'm very concerned about preserving nerve endings both for sexual sensitivity and pain afterwards. Which method is best for this?
Which Labiaplasty Method Will Preserve Sensation the Best?
Doctor Answers (13)
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Best method for labiaplasty
There are different methods for labiaplasty and different shaped enlarged labia. I don't think there's a best method. The choice of procedure depends on you surgeon's training and background. Many surgeons including gynecologists, general surgeons, urogynecologists or plastic surgeons use either the labia amputation technique or a flap technique. I personally prefer the flap technique, because this will preserve the normal labial edge with the normal color and sensitivity. This will not leave a scar at the edge like the amputation technique. Scars do shorten over time and can distort the anatomy especially if overly aggressive resection was done. There are also some reports in the literature about chronic scar itching with the amputation technique. It does not matter if the surgeon uses a scalpel or a laser to make the incision in the healing process or final outcome.The superior end of the labia as it blends with the skin over the clitoris has three folds or layers. I've seen this anatomy obliterated with the amputation technique. Sensation should be better in the normal undisturbed labial edge as opposed to a scarred edge in theory, but I'm not aware of any study to support this. You can view the flap technique on my site at bellevueplasticsurgeons.
Labiaplasty (trimming excess labia minora tissue) will always preserve sensation!
A LABIAPLASTY involves trimming redundant (excess) labia minora tissue during a minor surgical outpatient procedure.
In some women, the presence of extra skin and mucosa (genital lining tissue) in this region can cause discomfort with physical activities such as intercourse or exercise, or even walking! Other women have cosmetic concerns with the appearance of their genitalia and can feel self-conscious when becoming intimate with others.
The most common type of labiaplasty involves trimming excess labia minora tissue only. The vital nerves that provide sexual stimulation and pleasure to this region lie deep to this area in the region of the clitoris. They are protected and safe from any damage during surgery.
Occasionally, a redundant clitoral hood also plays a role in the anatomy to be treated. Clitoral hood reduction is then added to the procedure. Nerves lie directly beneath this area, but are also protected by soft tissues overlying the clitoris.
It is important that the Plastic Surgeon who performs the surgery is Board Certified, has experience in labiaplasty, and uses magnification (surgical "loupes") during the operation. This enables the very best visualization of the anatomy and ensures the best possible cosmetic result.
Keep in mind that after ANY surgical procedures, nerves in the area will "go to sleep" and the surgical site will be numb for some time. Complete numbness could last a week or two for some people, or months in others! When nerves start to "wake up", some individuals experience "pins and needles", others "electric shock"-like pains, and others, intense itching. Nerves should recover fully by 6-12 months.
Labiaplasty is a wonderful operation that significantly changes the quality of life and appearance for many women!
Karen M. Horton, M.D., M.Sc., F.R.C.S.C.
A modest degree of temporary post op pain is to be expected in any procedure. Your concern re pain is mostly related to 2 issues. The first is that that reduction stay away from the skin on the clitoris. A scar there for your stated concern is risk for little benefit. The second is regarding long term pain from your scar. All scars contract. A straight scar from an amputation reduction can be painful long term with intercourse. For this reason, I prefer what is called a "double opposing Z plasty" reduction. It is what we use to seperate fingers in children born with fused fingers.It requires more time and a meticulous technique but the attention to detail is worth it.
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Best technique for labia reduction surgery
Labiaplasty and preserving sensation
Either the trim or the wedge resection Labiaplasty usually preserves normal clitoral and vaginal sensation. Choosing one method over the other depends more on the patient's anatomy. If there is a small amount of thin, dark tissue at the edge of the labia minora, the trim method should be fine. If the tissues are bulky or thick then a more extensive wedge resection may be necessary to reduce the excessively thick tissue.
Labiaplasty - Technique, Sensation
Hi xray44 in Edmonton, AB,
Anytime you see a choice of how to do things, you can assume that neither technique is perfect - or else that's the one that everyone would be doing.
In this case there are, in fact, two main techniques - the "wedge" and the "trim." Both are good, and both can produce dramatic results with minimal complications. And I don't know of a study that has been done to indicate the difference between the two in terms of sensation (or anything else) and it would, in fact, be a difficult study to do.
However, I would say that, in general, a wedge technique involves less disruption of more of the surface of the tissue involved, and so is probably less likely to interrupt the sensory patterns. Assuming normal heal, the wedge technique leaves just one small scar visible at about the center of each labia.
In the end, though, it's the surgeon, not the technique that matters most. You may want to visit more than one surgeon so that you can get a few different opinions.
I hope that this helps and good luck,
Labiaplasty and sensation
Your concern about maintaining sensation is important. In both the trim or wedge excision your sensation should not be altered if performed properly. The overly large labia minora might even interfere with sensation and your sensation may be improved.
Labiaplasty Surgeon is More Important Than Trim vs. Wedge
If Labiaplasty is done with care and the tissue around the clitoris is not injured or traumatized, both the wedge method and trim method will both be able to preserve good sensation.
Labiaplasty of the Labia Minora Will Preserve Sensation.
Do not be concerned about your nerve endings both for sexual sensitivity and pain after wards.
Labiaplasty does not affect sensation to this area (if done correctly).
The type of surgery will not affect sensation either, as the area treated is strictly focused on the labia minora.
Dr. Carlos Cordoba
MDCM, CSPQ, FRCS, FACS
Plastic & Esthetic Surgeon
4055 Ste-Catherine O. Suite 100
Montreal, QC. Canada H3Z 3J8
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.