Susan Mikaelian, MD

Hi Britp, a labiaplasty surgery (without a vaginoplasty as well) should not cause vaginal dryness or changes in orgasm intensity, as those areas are not part of the surgery. If you have scarring or pain in the labial area then this will certainly affect enjoyment of intercourse, but otherwise I am wondering if perhaps it is just the natural progression of hormonal decline with aging or a hormonal imbalance leading to your symptoms.

Hello anon318501, it sounds like there are a few issues going on here. If you are leaking urine throughout the day you will need a urodynamic evaluation and consultation with an expert in surgical treatment for incontinence. This is not a plastic surgeon (they do not have gynecology training) but a urogynecologist or general gynecologist that specializes in these surgeries. If there is prolapse or weakening in one area of the vagina (below the bladder) then there is most likely prolapse in other areas, including the posterior wall or apex of the vagina. Correcting one without correcting the other can lead to issues in the future, and doing a repair of only the posterior wall (such as in a vaginoplasty procedure to tighten the vagina) will not address these other issues. Your surgery would most likely be covered by insurance. I recommend finding an experienced, skilled urogynecologist in your area.

It is hard to answer this question well without a labia majora picture, but based on the attached photo I would recommend liposuction of the mons as the fullness appears above the labia. Hope this helps.

Hi Elizabeth, it looks like your doctor performed a wedge-technique labiaplasty. Unfortunately these can have up to a 20% complication rate and breakdown. There are other labiaplasty techniques with lower complication rates. Nonetheless I would highly recommend waiting at least 3 months before you do anything else, as the tissue needs to fully heal if you are going to operate on this area again.

Hi Graceful607065, from the results I have seen I feel that Thermiva is the best non-surgical option for tightening the vagina and labia majora. While it may reduce the labia minora some it is less likely to have dramatic effect there. Patients report tightening of the vaginal canal, increased sensation, and increased vaginal moisture with Thermiva treatments. Radiofrequency seems as effective if not moreso than lasers for vaginal rejuvenation, and lasers do not treat the labia as well, only the vagina internally.