What causes skin separation after a labiaplasty using the trim method?

It’s really two things - Doctor factors and patient factors. Doctor factors might include burning off the edge with laser or hot cautery causing healing problems, not suturing the area sufficiently, or excess bleeding. Bleeding could be the beginning of a patient factor or could be a patient and Doctor factor if bleeding is not controlled at the time of surgery. Activity that is started too early could cause separation from too much movement or returning to work too quickly could also be a problem leading to healing issues after labiaplasty. I recommend the patients have about 72 hours bed rest after the labiaplasty with a Reduction, and this is a perfect time for your body to heal decrease as a chance for bleeding and gives excellent results.

Thank you for your questionThere are two pair of inner labia: a lower pair that inserts into the clitoris and an upper pair, called prepuce, that forms the hood and can insert into and even overwhelm the lower pair. The trim method is designed to reduce the lower pair. If the prepuce is not addressed or reduced properly, it can separate from the trim of the lower pair. In addition, the lower pair labia are like lamina: an inner skin surface, outer skin surface , and a central elastic tissue containing nerves and vessels. With the trim method, all layers are cut so that the remaining edges are free and need to be sutures together creating a new edge. If the sutures break down or come out, these layers can separate.

Scars separate if there is too much tension on them. This can happen if the stitches are too tight, or if fluid builds up under a scar or if unexpected force is applied to a scar during the healing phase. Cigarette smoking also increase the risk for scar separations. It's unclear what you mean by a separated top edge.

Thank you for sharing your question. Many factors go into the healing process including suture technique, suture redundancy, patient compliance during recovery, etc. In most cases of a trim, any separation that may develop is likely small and can heal well on its own.

Wound dehiscence can be caused by too much tension, not enough wound factors to heal (ie low protein or hemoglobin), friction, too much activity after surgery, etc. Please visit with a board-certified plastic surgeon for your surgery. Good luck!

There are 2 methods to performing a linear labiaplasty when the clitoral hood is also to be modified. One is a labial edge resection with separate kayak-shaped bilateral hood reduction. The other is what I have for years called the "Straight Shot," whereby the labia and hood are reduced utilizing one incision line from labum to prepucial fold.

Each method can come apart near the "top" of the labia if not performed meticulously, and if the patient is not very careful in her recovery.

If a "separate LP/ hood" method comes apart it is usually because the hood incision was either "T'd" into the LP line, or placed too close (less than1/4 inch) to that line & eroded into the LP line. If a "straight shot comes apart it is usually because the frenular fold "slipped" from its attachment to the newly reduced labial edge.

The more experienced the surgeon, the more careful you are, the better you will do.

You're in the U.K? See Dr. Alaxandros Bader on Harley St. in London. He is the best in the area (...tell him "Dr. Goodman sent you!")

Cheers,

Michael P Goodman, MD, FACOG, IF, AAACS
Davis, CA, USA

Dear patient,thank you for your question.The trim technique can be performed as vertically as horizontally, it doesn't matter