In 2022, I underwent labiaplasty surgery in London. As swelling reduced, it became clear the top edge had been cut into an unnatural right angle before the clitoral area, almost as if it should have been sewn down rather than left sticking out. I sent photos to the clinic, but they insisted it was “healing perfectly” and said full results could take 6–12 months. However, this area now sticks out, is extremely sensitive, and causes daily discomfort in clothing—which was one of the main reasons I sought the procedure in the first place. I also noticed stitching that was so tight it caused extra scarring, creating a kind of Frankenstein appearance. In other spots, the tissue didn’t fully knit together, leaving stretched scars along mismatched edges. I feel anxious and devastated. I need revision surgery for both physical and emotional reasons. But the original surgeon has been struck off the GMC for negligence, is uncontactable, and reportedly fled the country. I tried to pursue legal action, but was told he was likely uninsured—others had similar cases but couldn’t claim damages. The clinic has offered revision, but I don’t trust them, and I suspect I now need a real specialist. Can anyone advise what may have gone wrong in the original surgery, what I should look for in a revision specialist, and roughly what the costs might be?
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Hello Shepnut, You were correct in your initial concerns that things weren't right. It is not unusual for the appearance to look abnormal at first but once the swelling goes down you should have a good idea as to your final outcome. You should seek out the expertise of an experience cosmetic vaginal surgeon to perform your revision. There is hope and you are a candidate for revision labiaplasty. Go to the link below to see hundreds of before and after photos where you will find many examples that are similar to you. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. Women from all over the world travel to my Center for their Intimate Makeover. Best of luck,
Dr. Oscar A. Aguirre, MD, FPMRS
Board Certified Plastic Surgeon
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Labiaplasty with hood reduction is a technical procedure. I think of it like origami. Parts need to be cut, released, and folded into place to create symmetry and a natural appearance. Not every surgeon is equally skilled and even more importantly, equally thoughtful/patient/fastidious about their results. In patients who have a trim labiaplasty with scissors, the labia can have a “scalloped” appearance: too little removed at the bottom and top (the frenulum) and too much removed in the middle. The frenulum is very sensitive at baseline because it is the wishbone-like structure that extends from the bottom portion of the clitoris. This needs to be tailored smoothly so that there are no angles to the remaining tissue. When closing the labia, I use a running subcuticular suture. The suture is dissolvable and is completely buried under the surface of the skin so there are no track marks ridges or suture marks that can leave uneven and irregular scarring. It’s important to find a very delicate surgeon in the process of a Labiaplasty. As I tell my patients, they have only one worry: to find the right doctor. after that the worrying is mine.
Dr. Adam J. Oppenheimer, MD, FACS
Board Certified Plastic Surgeon
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As the inventor and innovator of the wedge technique in 1994, I reconstruct many women who have had labia reductions by other surgeons, both wedge and trimming techniques. You had a trimming labiaplasty which resulted in asymmetry, excess clitoral hood, and scalloping. The reconstruction is much more difficult than a primary labiaplasty and should be done by a plastic surgeon with extensive experience in labia reconstruction. I published the first and most extensive paper on labia reconstruction in the prestigious journal "Plastic and Reconstructive Surgery" about 15 years ago. You will need various reconstructive techniques to give you a good appearance. Fortunately, you have adequate clitoral hood to reconstruct your labia minora with clitoral hood flaps, which I invented and published in that journal article. In this surgery, I take the remaining tissue of your clitoral hood and transfer it downward to create labia minora. I have done this surgery about 100 times with excellent results. The surgery takes about 3+ hours so it is not a simple office procedure. If any surgeon reduces more of your clitoral hood, you will be ineligible for this repair. Approximately 50% of the surgeries I perform are revisions of other surgeons' labiaplasties. You only get one good chance to reconstruct you, so be patient and ask a lot of questions. Gary J. Alter, M.D. Beverly Hills, CA - Manhattan, NY
Dr. Gary J. Alter, MD
Board Certified Plastic Surgeon
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The photo doesn't show the complete extent of the damage. Trying uploading a second photo without pulling on the labia. The distortion doesn't allow for a complete assessment of how much tissue is remaining beyond the "right angle". Your condition can certainly be improved. What to do next? Schedule a virtual consultation. Traveling to USA and back is not necessary to get this conversation started if you're able to share more photos - privately if you prefer.
Dr. Marco A. Pelosi III, MD, FACOG, FACS
Board Certified Plastic Surgeon
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Q: What went wrong with labioreduction? A: 1. The surgeon chose the incorrect technique (linear labia minora resection—partial amputation), which is known to carry a higher risk of complications, and the presented picture demonstrates such surgical anomalies: a) The operation did not achieve a natural appearance in adult women, altering the rounded natural shape to a straight one (as illustrated in the picture). Please refer to the recent scientific-clinical publication by Ostrzenski A. "Severe cosmetic surgical complications of the labia minora." Eur J Obstet Gynecol Reprod Biol. 2023 Dec;291:39-48. doi: 10.1016/j.ejogrb.2023.08.010. Epub 2023 Sep 22. PMID: 37820513 (Please Google the PubMed website and search using Ostrzenski A). This study showed that the current surgical techniques cause severe physical and neurological complications due to their flawed concept, and this case is an additional example. A natural labia minora appearance can be restored using labial tissue expansion. b) The surgery did not achieve labial symmetry. c) The upper part of the labia minora was not properly addressed and has become symptomatic. It needs revision as per a patient's request. d) Both labia minora are fused with the labia majora and infralabial crease. This can be corrected using a labiolysis surgical technique, described by Ostrzenski A., "Labiolysis: Corrective Surgery for Iatrogenic Labium Minus Fusion." Ann Plast Surg. 2019 Nov;83(5):558-567. doi: 10.1097/SAP.0000000000001920. PMID: 31232812. (Please Google the PubMed website and search using Ostrzenski A). e) Reducing the clitoral prepuce will enhance overall aesthetic satisfaction (please consult publication: Ostrzenski A. Clitoral prepucioplasty with anterior commissure transposition: a case report and description of a new, minimally invasive surgical technique. J Reprod Med. 2015 Mar-Apr;60(3-4):178-82. PMID: 25898485). All the best, Prof. Dr. Adam Ostrzenski USA
Dr. Adam Ostrzenski, MD, PhD
Board Certified Plastic Surgeon