Concerned about Recovery (Photo)

I had this surgery done about a month ago and our doctor is great. I had the stitches remover externally at the 2 week mark. I have followed all instructions. The exterior hole is widening again. Is this normal? To correct, is it a full blown surgery with general anesthesia? Should I wait for the full healing process before possibly correcting or is it better the address the issue while in the early recovery process to limit additional down time from work and discomfort?

Doctor Answers 9

Labiaplasty

Swelling is normal.  It seems like your labia are healing quite nicely.  Its apparent that the perineal incision is spreading a bit.  This can happen and shouldn't be difficult to fix.  Be sure to keep your surgeon updated on your healing status. 

Post-Op Healing from Labiaplasty

Swelling after #Labiaplasty is usually present for several weeks.  It’s possible that swelling can persist for two or three months. Firmness of tissue can remain for 4-6 months. Postoperative care will usually consist of sitz baths or soaking the area in warm soapy water starting approximately 2 days after a surgery.  The sutures will dissolve over the course of several weeks.  This will in part depend upon the #Labiaplasty technique used, the amount of bruising and they way in which your body heals. Ice can help reduce swelling. Arnica and Bromelain may help.  Direct massage may be useful for swelling as well. Patients return to most normal activities immediately after surgery with the exception of activities that will create direct pressure on the #vaginalregion such as certain exercise equipment and #sexualactivity.  It will be necessary to refrain from these forms of physical activity, including sex, for approximately 4-6 weeks. Generally, patients are able to walk comfortably within a few days and can return to work within a week. If you find yourself concerned about healing it is good to visit your surgeon to have the area evaluated. They can determine whether there is proper healing or if any reconstruction is needed. Good luck!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Atlanta labiaplasty/perineoplasty

Thanks for sharing and it is apparent you had a linear resection with interrupted sutures for the labiaplasty and perienoplasty at the base.  The perineal area can breakdown and in my practice this occurs about 5-10% of the time and usually it will heal on its own.  I have been performing perineal surgeries for 30 years and the rule of thumb is 1) allow it to heal on its own at this point 2) adding sutures now will not help 3) most will heal from the bottom of the incision up to the surface on its own and 4) if it doesn't heal you can have a revision at 8- 12 weeks after the original surgery ( you do not need to wait 6 months).  You should really be asking you surgeon his/her thought as he/she is your surgeon.

I don't see anything major here. You should heal well without any additional work.

I assume your concern is about the small skin separation at the perineum. This usually heals on it's own from the inside out. Just keep clean and free from pressure. If it needs a revision, it can be done under local and doesn't take long.

Healing after labiaplasty

The perineal area should heal on its own, it may just take a little longer than expected given the setback. You should be able to tell how the final outcome will look at 2-3 months following surgery. A prescription topical cream such as Bactroban may be needed to promote healing. Warm water baths and keeping the area clean and dry will also improve healing time. Please consult with your surgeon for an exam and specific recommendations. 

Nothing you can do now

Hello DK,Thanks for your post with photos. I'll assume that the "exterior hole" you are referring to is your perineum. In that case those sutures will eventually dissolve and no further surgery should be done in this area till you are finished healing. At 1 month you are way outside the window of when a revision can be performed immediately postop.If you're bothered by the opening widening again, it may be more to do with the procedure you chose to have done. Looks like you may have benefited from a formal perineorrhaphy (reapproximation of your perineal musculature) rather than approximation of just your perineal skin.  You also have persistent lateral prepuce and very small, nearly absent, labia minora. Hopefully, once your healing is complete you'll be happy with your outcome. I recommend you enjoy your new vagina once you're released for sexual activity and leave things alone.  Best of luck,

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 23 reviews

Concerned about recovery

Thank you for sharing your question and photographs.  It appears that you had an asymmetrical trim labiaplasty and perineoplasty performed.  There was an aggressive amount of labia removed from the lower right labia while the perineoplasty has started to separate at the incision line.  Due to the swelling in the tissues correction should be sought at the 6 month mark from surgery to allow your tissues to mature back to normal.  Hope this helps.

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

Labiaplasty and perineoplasty

Looks like you had a trim labiaplasty with a perineoplasty.Some opening of the perineum has occurred, which is possible but not common. There is no way to go back in and fix it just now. you need to wait 6 months and see what your result will be. The good news is that it is very quick to heal and will very likely be fine. The problem is that exposed sutures can sometimes get in the way of healing... that looks like PDS suture which takes a long time to dissolve. Best to see your surgeon and be patient. Sorry this has happened.

See your surgeon

Hello,
This type surgery is not standard. We all do a bit different operation most of us tailoring it to the patient's requests using our own technique. You appear to have had more than a "usual"  labiaplasty. I would return to your surgeon and ask how his patients do with the specific procedure you had and voice your specific concerns. 
Best Regards,
John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 26 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.