Pain 1 year after Labiaplasty & Hood Reduction

Your history does sound consistent with nerve-related pain. I recommend an in-person evaluation by a board-certified or board-eligible plastic surgeon to confirm the diagnosis and further discuss treatment options.

Q: What can be done about the labial neuropathic pain?

A: Yes, it is possible to cure your postsurgical neuropathy condition!!!
It is a typical description of nerve entrapment manifesting by "excruciating" pain in multiple structures on the right side of the external genitalia. You presented the location of pain, the quote: "just below the clitoral hood." It may indicate the involvement of the right clitoral frenulum.
You also described: "The pain began two weeks after surgery." It indicates that the nerve entrapment became symptomatic with increasing inflammation associated with a healing process. After 1-year postoperatively, the newly formed scar compressed even more than inflammation, leading to numbness. Please take pictures of your genitalia and send them to me (aostrzen@fiu.edu) to view what can be done in your case. However, you need to see a physician in person who knows enough how to decompress the affected nerve.

My research and publications on this very topic may help you understand your situation better:

1. Ostrzenski A. Labiolysis, Corrective Surgery for Iatrogenic Labium Minus Fusion. Ann Plast Surg. 2019 Nov;83(5):558-567. doi: 10.1097/SAP.0000000000001920.),

2. 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.).
You may find my articles on the PubMed website.


With regards,
Prof. Dr. Adam Ostrzenski
USA

Your outcome, with a combination of pain + numbness is unusual, but most likely a result of an injury to a branch/branches of your pudendal nerve. Neither a diagnosis or recommendations for proper therapy can be made without an in-person evaluation with proper neurological testing by an expert in cosmetic gynecology and/or a pain management specialist/neurologist. Whom to see??! Since you are in the UK, I would recommend Dr. Alexandros Bader on Harley Street in London (you can tell him I referred you...) If Dr. Bader is unable to help, he would be able to recommend the proper pain management/neurological specialist. In the U.S. East Coast I'd recommend either Dr. John Hunter in NYC, or Dr. Marco Pelosi III in Northern New Jersey. Dr. Otto Placik in Chicago; Dr. John Miklos Atlanta, myself or Dr. Gary Alter in California. Your therapy may involve a neuroleptic medication, either topically or systemically, or perhaps PRP injections. First though would be a proper evaluation. It's always best to have a proper diagnosis prior to embarking on therapy (sic.)

Best wishes,

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