Q: Is an additional surgery needed to eradicate two botched prior surgeries? A: Yes, you will need the third surgery to satisfy your genital perception look to feel comfortable with your intimate life. However, you need to understand your esthetic problem after your two surgeries. All attached pictures clearly show your problem with botched surgery, Advisors here just seeing the extra clitoral hood tissues to remove will resolve your all esthetic concerns. Your esthetic problems to satisfy your expectation can be summarized: 1. The left thin labial tissues were unnaturally brought up to the pubic bone (the commissure anterior) with the documented problem of surgical suturing technique (it is considered as “railroad track” complications), figure 3. You correctly noticed in your presentation, quote: “…still this extra tissue on my clit that looks like a 3rd labia lip almost.” This situation will require corrective surgery on the left labial tissue and not just to remove extra clitoral hood tissues, 2. On the left, the clitoral hood orifice tissues were brought down to the thin labia bifurcation and will need reconstruction, 3. The straight thin labial look after two surgeries is departure from the natural appearance of these structures. The surgeon selected the wrong surgical technique, which changed the naturally rounded shape to an unnatural straight look with the left thin labia asymmetrical and wave appearance. Furthermore, separation of the labial frenulum (left and right thin labial connection at the lowest part) need also be rebuild. To reconstruct it will require tow stages of surgery a) expend both thin labia tissues (the method that I developed; however, not yet published); b) recreate the symmetrical, rounded and without waves appearance of the thin labia. It is challenging to understand why Dr. Marco Pelosi III presented his surgical concepts, that are not related to the question here and not necessarily right one, Perineoplasty (the crotch surgery) or the hair labial surgery (the labia majora), or other unrelated surgeries to the question were presented. Anatomical presentation in his segment is also adequate. This woman who asked the question how and what what corrective surgery can cure her emotional disturbance due to unsatisfactory surgical outcomes that still created an unacceptable look followed two cosmetic surgeries on her external genitalia. This woman needs an honest clinical answer supported by clinical-scientific data and not what is the marketing intentions of advisors since she is facing the 3rd surgery for the same esthetic problems. At this moment, misleading or marketing information is the last thing that she needs. It is an advisor’s responsibility to provide adequate scientific-clinical information in addition to marketing. It is a simple reason that I do not market my practice on the RealSelf website, although I do not have any objection to those who do. With regards,Prof. Dr. Adam OstrzenskiUSA