Sara J. Bernstein, MD

I am so sorry that this happened to you. Hopefully you will be able to get your situation resolved quickly and your insurance company will be willing to help as well.

In general, every insurance company has their own method of determining coverage. For an issue such as you describe; a hole in your labia left from a repair of a labial tear during childbirth, many insurances may cover part or all of the procedure to fix your problem.

The gotcha here is "part or all". Your insurance company may decide (don't shoot the messenger):

1. The issue is cosmetic and thus not covered.
2. Closure of the hole is covered, but no other improvement would be covered.
3. Full repair of the issue is covered.

As already mentioned, you have a few options:

• Botox/Dysport/Xeomin will provide a temporary reduction that lasts 3-4 months.
• Radiofrequency (such as Exilis or Pelleve) or Ultherapy (Ultrasound) can provide a longer term solution.
• Invasive techniques such as Precision SmartLipo or Vaser can also provide a longer term solution.

As you have already gone through 2 prior procedures and have still not achieved a result that you are satisfied with, I would caution you to re-evaluate your desires and expectations. Sometimes a patient's desires do not match up with their anatomy. When this happens, no amount of surgical procedures will correct the situation. Without any current pictures (as well as original before pictures), it is impossible to provide any direct advice.

I would like to suggest some internal reflection. Ask yourself ...
- Why you are doing this?
- What is your goal?
- Are you truly unhappy with your appearance or is there a deeper reason for your desires?

If you are truly serious about trying again, I would recommend getting the opinion of a respected cosmetic surgeon that specializes in cosmetic gynecology ... one that has a reputation for turning away patients who are NOT good candidates (as Dr. Goodman has already advised)

Good luck and I hope you find the inner acceptance that you are looking for.

I am sorry to hear that your boyfriend has made you self-conscious about your body. Ultimately, you must be the one who is happy with your body, not your boyfriend.
As an Ob/Gyn, I have seen literally thousands of vaginas in my career and the pictures that you sent are well within the range of what I would call typical.
Are there women who have smaller labia, yes.
Are there women who have larger labia, yes.
Can surgery be performed to reduce the appearance of your labia, yes.
Would I perform this procedure on you based upon your question, probably not.
As mentioned by others, self-motivation is the best reason for cosmetic surgery - not a judgmental boyfriend.

I have been treating patients with the MonaLisa Touch system since January of 2015 (just 1 month after FDA approval).

You should not expect to see a 100% reduction in symptoms, but you should expect a drastic reduction. In my experience, the more severe the atrophy, the more drastic the improvement.

The protocol is for 3 treatments spaced 6 weeks apart. The full regimen takes approximately 12 weeks (with treatments at weeks 0, 6, and 12).

After the initial 3 treatment, you should expect to receive annual maintenance treatments to prevent symptoms from returning.

I cannot stress enough how much this has helped my patients.