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Why is Local Anesthesia over General More Common for Labiaplasty? Is It a 'Shortcut' Per Se?

Doing research first.. I read on a doctor's page: "The reason why we do not use local anesthesia for vaginal surgery is that the injection of the fluid into the tissue makes the tissue swell dramatically. If the tissue is swollen it is very difficult to artistically shape the labia because now you are no longer operating on the original labia. What you are operating on is a swollen version of the labia thus making it quite difficult to shape the labia with great confidence." Is this agreeable??

Doctor Answers (12)

Anesthesia for Labiaplasty

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Labiaplasty can be safely performed under local, IV sedation or general anesthesia depending on the patient's preference, the surgeon's comfort and the cost considerations.  I prefer to perform labiaplasty under deep IV sedation.  This allows the patient to be completely comfortable before, during and after the surgery.  There is some added cost to performing labiaplasty this way, but the decrease in pain compared to local anesthesia only and the decrease in post-operative nausea and vomiting compared to general anesthesia outweigh the added cost in most cases.  However, if a patient really wants to do it under local only, we are not opposed.  The type of anesthesia should be discussed with your surgeon and find out his/her reasons for that type of anesthesia before deciding on what is best for you.


Naples Plastic Surgeon
5.0 out of 5 stars 32 reviews

Labiaplasty and Local Anesthesia

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Dear nycgirl2011,  Labiaplasty can be performed under general or local anesthesia depending on the patient's and surgeon's preference.  When local anesthesia is used, the planned resection and incisions are marked before injecting the tissues to avoid the concerns you voiced.  The three biggest advantages for performing a labiaplasty under local anesthesia are: 1-the labia minora and adjacent tissues usually are relatively easy to numb with local. 2-There is a significant cost savings for the patient when compared to general anesthesia. 3-For many women, this is a very private procedure that if it can be performed in an office setting can allow them to drive themselves to and from the office.  The latter is dependent upon the patients not receiving any oral or IV medications for sedation but just using straight local anesthesia.

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.0 out of 5 stars 18 reviews

Labiaplasty under Local Anesthesia

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There is nothing wrong with doing labiaplasty under local anesthesia as long as the surgeon and patient are comfortable with this approach.Tissue swelling should not be an issue as long as the labia are not overinjected.
 

Joseph Fata, MD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 62 reviews

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Labiaplasty under local or general anesthesia

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Most labiaplasty experts will perform the procedure using either general or local anesthesia. Both are appropriate for labial contouring. Raffy Karamanoukian, Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 53 reviews

Local anesthesia versus general anesthesia for labiaplasty

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Hi,

I prefer to use local anesthesia for labiaplasty. It saves the patient around $1500 and is much safer when compared to a general anesthetic.When the procedure is complete the patient can get up and leave right away and expect to be completely pain free for several more hours. Even when the patient is put to sleep under a general (for instance when I am doing a combined procedure) I instill local anesthetics into the labia tissue to limit intra-operative bleeding and immediate post-op pain. Does the local cause swelling of the tissue? Yes? Does this prevent me from doing a good job? No. By carefully examining and marking the tissue prior to local instillation, I am able to effectively remove the excess tissue and close the incisions. I hope this helps.

All my best,

Daniel A. Medalie, MD

Daniel A. Medalie, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 14 reviews

Local anesthesia labiaplasty

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I perform labiaplasty with either local anesthesia or general anesthesia, depending on patient preference.  Because it is a small area, local anesthesia may be very effective.  For extensive procedures, I typically prefer general anesthesia.

David Stoker, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 19 reviews

Why is Local Anesthesia over General More Common for Labiaplasty? Is It a 'Shortcut' Per Se?

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   General anesthesia allows for the patient to be completely comfortable during the procedure.  I perform local with sedation upon patient request, but I prefer general for patient comfort.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 238 reviews

Local anesthesia with labiaplasty

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The choice of local versus sedation or general anesthesia is determined by the surgeon and patient.  I perform the central wedge technique, often with extensive clitoral hood surgery.  This procedure can take up to two hours which can be difficult for patients with local anesthesia in stirrups, so I usually use general anesthesia or sedation.   Markings are always done prior to the injections since the injections can certainly cause swelling and deformities.  Occasionally, a patient can be very restless and uncomfortable while under local anesthesia, so an anesthesiologist is very helpful to give sedation or general anesthesia. 

Sincerely,

Dr. Gary Alter

 

Gary J. Alter, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 9 reviews

Labiaplasty Anesthesia

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There is some swelling that happens with injection of local anesthesia but most all physicians are used to working in this type of environment and get get a good result despite the swelling. The local anesthesia also makes it more comfortable for you in the post op period. In my practice we use oral sedation (Xanax and Vicodin generally) and then apply a local numbing cream to the vaginal area. This eliminates the pain of injection. The pills help the patient to relax while up in stirrups which is disconcerting for most women. The music playing in the background or in their headphones along with the medications make it an almost pleasant experience.

William LoVerme, MD
Boston Plastic Surgeon
4.0 out of 5 stars 22 reviews

Is general anesthesia needed for labiaplasty?

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Absolutely NOT.  It only adds cost to the procedure as well as risks from general anesthesia.  Pre-marking before infiltrating is mandatory.  In addition, bleeding is much less when using epinephrine.  Granted, an injection can be painful but when my patients think about how much they are saving, its often forgotten very quickly.  Plus you cannot beat the privacy when done in the office.  And I believe my website photos support the notion of doing this under local.

If costs are no concern and you wish to experience no pain or have any memory of the procedure, it can certainly be done under general anesthesia but your labia will still be infiltrated with local prior to cutting.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 17 reviews

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.