What is labiaplasty like under local anesthesia and oral sedation?

This is my first surgery ever and I'm quite nervous to be awake for it for what could be up to 2 hours. What will I feel and what will it be like? Will I fall asleep? Do I just feel some tugging and pulling? I know the local anesthetic injections will hurt (I'm hoping for a numbing cream) and I'm not worried about the healing process, just the actual cutting/snipping. I believe Ill be sedated with valium. Any experiences or help is much appreciated!

Doctor Answers 11

Labiaplasty

Its quite common for a Labiaplasty to be done with local anesthesia and some high dose valium.  For the most part my patients seem relatively calm and sometimes chose not to take the Valium. I would recommend it cause sleepiness and  most patients fall to sleep during the procedure. You shouldnt feel any pain after the local anesthesia is injected.  Be sure to go to a Board Certified Plastic Surgeon with extensive experience in this procedure for your Labiaplasty. 

What is labiaplasty like under local anesthesia and oral sedation

Thank you for your question. A labiaplasty can be performed with local anesthesiaand PO valium.  It is normal to have anxiety before any surgery.  After a local anesthetic is injected, you should not feel pain.  Discuss your concerns with your plastic surgeon. Best wishes.

Try to relax- this is commonly done with local

Hello there! You are only human, so nervous about your procedure, but you should know that this is the usual way it is done... by that I mean with local anesthesia and some valium by mouth. The tissues are easily numbed this way, and it is much safer than deeper forms of anesthesia I think.

Be sure to go over your concerns with your plastic surgeon!


Anne Taylor, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 34 reviews

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The Labiaplasty experience

Your story and concerns are in good company with almost ever other patient that undergoes labiaplasty and/or clitoral hood reduction (aka hoodectomy) and experiences a major boost in (sexual) self-confidence and pleasure thereafter. 

Labiaplasty, which most commonly involves surgical reduction of the labia minora (inner/thinner lips) but not infrequently trimming or tucking of the labia majora (outer/thicker lips), has become a relatively common procedure over the last ten and even more so last five years.  Most commonly it is done under light sedation (aka twighlight sleep) with local anesthesia, in which case the patient should feel no pain during the operation.  Whether the surgery is done using a laser, scalpel, or scissors does not really matter but what does matter is "symmetry".  Symmetry is the most important aspect to the final aesthetic result.  Most women, just like yourself, prefer to have as much of the darker pigmented edges removed as possible.  Also, it's not how much tissue is removed but how much is left remaining because a certain amount is necessary to maintain proper form and function - typically ~10 mm or so of the dry part of the labia.  To achieve these three most important elements, I have found that the "Trim Method" satisfies best.  It is extremely important to consult with a board certified plastic surgeon that specializes in this operation (does at least 1 - 2 per week).  It may cost you a bit more but it is this type of result you will want to live with for the rest of your life.  Typical (all inclusive) fee at my office/surgery center is $4500.
Although there is no guarantee, women frequently do seek clitoral hood reduction (Hoodectomy) to improve exposure of the clitoris and hence better stimulation during sexual activity. By removing some of the excess &/or redundant skin concealing the clitoris, it becomes more readily exposed to sexual stimulation and hence a heightened sexual experience/orgasm is possible.  Sometimes I recommend adding hoodectomy to labiaplasty to better harmonize the aesthetic outcome.  Again, the key is seek consultation with a board certified plastic surgeon or gynecologist who performs this procedure regularly (>2-3 x/month) so that just the right amount of tissue is removed and just the right amount remains such that the clitoris is not constantly exposed and rubbing on clothing, etc... Typical fee for a hoodectomy is ~$3000 but reduced to about half that price if done along with a labiaplasty.
Now for recovery, because the labia tissue is so robust with blood supply it has an amazing ability to heal relatively quickly.  Most patients are sore for 4-5 days before things start to get a lot better from there.  Some patients can resume work before this time depending upon their occupation.  No exercise for two weeks, no baths/jacuzzi or swimming for 3 weeks, and no sexual activity for typically 4 weeks.  My patients are given an oral pain medication such as Vicodin or Percocet but icing the area for the first 48 hours and applying some custom  made take-home topical local anesthetic cream seems to work the best.  Glad to help.

Ryan Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 103 reviews

What is labiaplasty like under local and oral sedation?

Thank you for sharing your question and congratulations on your upcoming surgery.  Though anxiety prior to any procedure is a common feeling I would recommend speaking with your surgeon so that they may provide you with appropriate reassurance as well as review with you your anesthetic options.  Typically with local anesthesia patients will only feel generalized pressure and pulling sensations of the tissues after the initial stinging sensation of the injections.  This is improved with the use of Valium or other oral sedative. Though labiaplasty procedures can be performed with only local and oral sedation it is in your best interest to be as comfortable as possible so if you need a stronger form of anesthesia this can be supplied.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

What is labiaplasty like under local anesthesia and oral sedation?

If your surgeon has not gone over and answered each and every one of these questions, FIND ANOTHER SURGEON. These are items that (s)he should automatically review with you pre-op. I do. I have performed > 650 labiaplasties, most all in my office under local + oral sedation. If a patient is freaked about "local," we do it in a Surgicenter under deep sedation or General anesthesia.Yes, the "local" really stings (!), but it takes literally only 30-60 seconds and you are immediately numb. In our office, patients have their own nurse to chat with & comfort thenm, we play music or patients listen to their own, or text, etc. Procedures take ~ 1-2 hours and, after the anesthetic, there is no pain. Much cheaper, easier recovery (the local I use lasts ~ 4-5 hours...) But, ask your own doc!


Regards,


Michael P Goodman, MD


Davis, CA, USA

Labiaplasty under local anaesthetic

Hello,

Most of my patients have the operation under local anaesthetic without sedation. You will feel two little needle pricks and some swelling, but the remaining operation should be pain free. If you feel something you can tell your surgeon to give you more. You will feel pulling or pressure but no discomfort. My experience is that most women relax as soon as they realise that the anaesthetic works which is usually less than a minute. I haven't seen anybody being unsettled throughout the procedure and when asked everybody said that they had preferred this to a general anaesthetic.

One important factor to realise is that you have some influence on how you experience pain (from the injection). Try not to think about it when it happens and focus on some nice thoughts (last holiday?) instead and you will see that the pain is much less threatening than it seems.

Hagen Schumacher, MD, PhD, FRCS(Plast)
London Plastic Surgeon
5.0 out of 5 stars 3 reviews

Labiaplasty under local anesthesia

We do labiaplasty under local in the office all the time.  Some patients will choose to take valium ahead of time (we give you a prescription) but most don't even take that.  We use numbing cream so that some patients don't even feel the needle poke.  Once the local anesthesia is in place all you will feel is pulling and tugging, nothing sharp.  The patients really love being able to do this in the privacy of our office under only local anesthesia.  Best wishes!

Maida Parkins, MD
Milwaukee Plastic Surgeon
5.0 out of 5 stars 34 reviews

Labiaplasty

Thank you for your question.

It is important to discuss you questions and concerns with your plastic surgeon so you are both on the same page and feeling comfortable proceeding with the procedure. The only pain you may experience would be the initial sting of the local anesthetic being injected. Topical numbing cream can be applied prior to the injections to make them more comfortable. After the local anesthesia has kicked in, you should be completely numb in that area and only feel a slight pressure if anything. The Valium should sedate you enough that you are calm and relaxed during the procedure and some patients even fall asleep. It affects every patient differently. Labiaplasty has a short recovery period and most of my patients even return back to work within a day or two. Best of luck.

Sincerely,

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 66 reviews

What does labiaplasty under valium and local feel like?

Hopefully being awake was a choice you made and not the only option offered by your surgeon. I always offer my patients the choice of being awake completely (no sedation), with oral sedation (minimal sedation), or asleep with IV drugs and an anesthesiologist (moderate/deep) sedation. However, I operate in AAAHC-accredited facility and can offer this luxury to all of my patients. Most patients select your approach and are quite comfortable through the entire process. The key to comfort is expertise in the preparation and administration of local anesthesia. When properly administered, in my experience, the numbing injections are painless, but I can only speak for myself. Creams tend to cause a burning sensation, are useless and completely unnecessary; if they were useful, I would apply them on every case.

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.