Treatments for chronic pain, I can't stand this anymore. 8 years post op trim method labiaplasty. What can I do?

Thank you for your questionI believe that the treatment parameters for your problem can only be determined with a careful examinations they will depend on the specific locations, positioning and types of scars. My recommendation is to do an extensive search for surgeons who are experienced at correcting botched labiaplasties, do in person consultions, review their work and compare what they say.It would be inappropriate to give recommendations without seeing the specific issues.

Pain following labiaplasty is uncommon and can occur following both the wedge or trim technique. Typically pain occurs when tissues are placed under tension. Recommended reatments depend on what your examination is like.
PRP injections work very well in some situations, but surgical correction may be necessary.
If you follow the link below you'll see dozens of B/A photos demonstrating results of revision labiaplasty. You will likely identify some examples that are similar to you. From that link you can schedule a virtual consult via phone or zoom, at which time we can discuss in depth your concerns

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. The reconstruction is 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 ten years ago, and about 40% of my female genital surgeries are reconstructions of botched labiaplasties. Frequently, removing the tender, painful tissue and replacement with healthy tissue eliminates the pain. You may need various reconstructive techniques to help you. I need to see photos outlining your area of discomfort and to determine where I can get healthy tissue. Also platelet rich plasma or stem cell treatment may help. 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, NYC

I mentioned it while answering your previous question. I need to see the photo. If you send a photo I can help you better.

Q: How to manage post labioreduction chronic pain?
A: Your description the type of pain and its location strongly suggests that your presumptive diagnosis is post-labioreduction neuropathy due to palpable scar compression on the nerve ending.
Unfortunately, there is no well-known therapy for the over-resected labia minora by trimming. Although, one of the advisors here claimed: “As you may be aware, I am a specialist in post-labiaplasty pain and revision labiaplasty.” The RealSelf audience needs to understand that neither such specialization in “post-labioplasty” and “revision labioplasty” nor a “specialist” exists in the USA. However, as an academician and a practitioner, I feel very offended by such deceptive marketing by one of the physicians that it compelled me to bring to your and other readers of RealSelf attention. I do not use the RealSelf forum for marketing my practice, and I’m doing it exclusively to help women. Your option is corrective surgery with scar resection to relieve nerve compression with labia minora tissue expansion. I have just concluded my clinical research phase-I on this topic and still doing phase-II – the 3-year follow-up. The initial results of this study are encouraging that I like to mention such a surgical method being on the horizon.
Conservative medical therapy for this surgically induced neuropathy by trim labioreduction has not been studied; however, some practitioners offer not proven therapeutic agents (off label), and none of my patients who looking for my opinion benefited from such an approach.
Your problem is directly related to selecting the surgeon for labia minora labioreduction (you called it trimming labioplasty). Any woman about to choose a surgeon for labia minora labioreduction must eliminate a surgeon who offers a trimming technique for labioreduction. A labial trimming technique for labia minora labioreduction is simple amputation of a healthy structure that changes the natural look of the labia minora completely. It creates an unacceptable appearance of the labia, and medically, it partially or totally amputates the healthy structure (medical body harm). For example, imagine that a surgeon reduces the size of the ears by partial amputation of the ears (to some extent, the ears and the labia minora have a similar rounded natural appearance). Please cover your free edge of the ear, take a picture or look at the mirror reflection of the uncovered part of the ear. It does not look natural! Similar outcomes of surgery on the labia minora done by trimming (amputation) can be identified, as observed on the ear. Therefore, it will be the outcome of the labia minora look to some degree. Additionally, labioreduction by trimming leads to over-resection and associated neuropathy (pain at the incision site) or neuralgia (referred pain in different areas away from the original surgical site).
With regards,
Prof. Dr. Adam OstrzenskiUSA,

Im sorry you are having issue post labiaplasty procedure. Please consult a labiaplasty revision specialist to discuss your options. Be sure to choose a board-certified plastic surgeon that specializes in this procedure and is well known for their work.

This may interest you and others experiencing pain after labiaplasty. Our office, in cooperation with Dr. Charles Runels, a PRP expert, is presently recruiting patients for a study evaluating the effects of PRP when added to a protocol of topical neuroleptic medication (gabapentin). All treatments are free of charge. Much work is done virtually, but each patient must come to our office in Davis CA twice for injections of PRP or sham injection (both groups will be treated with topical neuroleptic medication). As you may be aware, I am a specialist in post-labiaplasty pain and revision labiaplasty. Interested women should contact our office or read additional information on RealSelf's Web reference below. Again, if accepted for the study, there are absolutely no charges for treatment, and patients randomized to the "Control Group" will have the option of receiving free PRP injections after data collection is completed. Best wishes, Michael P Goodman, MD, FACOG, IF, AAACS. Davis, CA, USA