Is this a botched Labiaplasty?

I got labiaplasty surgery done last friday so I'm 6 says post op. I'm in such intense pain I can't sit, stand, walk, wear pants, etc. The whole thing looks botched to me, like she completely removed any labia halfway down the vagina and just stitched it that way or something! It looks very top heavy and so painful I can't even touch it, which sucks because I was given lidocaine to numb the area but can't if it's untouchable. Please let me know what you think!! I get more worried as it heals!

Doctor Answers 11

Why does it hurt so much? What will it look like when I'm healed? WAS I "BOTCHED?!"

First, to answer your question as best as possible, understanding you are in your first post-op week, what Dr. Pelosi calls the "Frankenstein Phase" of healing. It swells. It is "black & blue" all aver. It looks positively AWFUL! It will get better. The pain will dissipate, the swelling recede, the suture line less "bumpy." It will do what it will do, given the agreeably poor surgical technique. (I'll BET you were operated on by a general gynecologist, perhaps your "...regular trusted Gyn..." This unfortunately was a mistake.) It WILL look better, but......


WHY does it look irregular? WHY are you still in so much pain after the first 2-3 days. It is RARE that, if the incisions are placed properly, if the suture material and placement (deep and superficial) is proper, that a patient should be in any sort of significant discomfort after the first 1-3 days.


Your present pain is due to the fact that your surgeon was untrained in the "rules" for successful labial reduction, took too much off from some areas (labia), not enough from others (clitoral hood). The reason you are in so much pain, the reason it is so irregular, and unfortunately the reason that, when you are completely healed, your final appearance will be less than ideal, is that your surgeon used too large caliber sutures and placed them too tightly; they will not dissolve early enough not to leave grooved scars.


...Nothing you can do now other than stay off your feet, elevate your pelvis, take pain pills, and wait for it to heal. If you are not satisfied with the results you see after 6 weeks or so, please send us another photo and we will comment. THE TAKE-HOME MESSAGE? See an expert! You get what you pay for!! Anyone who lets their general Gyn, untrained in the RULES and "fineries" of plastic technique, operate on them is playing Russian Roulette with their genitals. The weblink below speaks to the reasons for, and who "produces" the mutilations that you and other women present with after making the wrong choice of surgeon either because they wished to save money ("...under insurance!) or didn't do research, let their general gyn do it, and ended up worse appearing than when they started...

Is this a botched Labiaplasty?

Thank you for sharing and i am sorry you have to go through this.

Although you are still very swollen and the overall look will be better as this heals.  The reality is you are going to need a revision.

I would recommend waiting 4 to 6 months before even attempting a revision and I would encourage you to research very carefully someone who has experience performing revisions and doing labiaplasties.  

Keep us posted

Is this a botched labiaplasty?

I reviewed your photos. It appears that most of your labia minora were removed. You had a trimming labiaplasty, and it appears botched with removal of most of your labia minora. However, no attempt to revise your labia should be done until you are at least five months after your past procedure as your appearance will improve, and the swelling will be less. You need to control your anxiety and wait. 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 two years ago. You may need various reconstructive techniques to give you a good appearance, but this won't be known until all the swelling is gone. I probably would recommend clitoral hood flaps to reconstruct your labia if your surgeon left enough remaining clitoral hood. I invented this procedure about 10 years ago and have done it about 75 times with excellent success. Fortunately, your surgeon appears to have left a lot of your hood, so it will probably be able to be done.  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

Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 20 reviews

Once the procedure is done

all you can do is focus on healing and hope that everything starts looking like what you desired when you chose to have this procedure.  Without knowing your discussion with your surgeon and what the agreed upon outcome was, it wouldn't be fair to your surgeon to judge results.  But being objective, it appears from your photos that too much labia was removed.  The swelling on top in the hood area is 'normal' and dog ears are expected after trim methods (which you had).  Focus on healing, keeping your surgeon informed of your concerns, and when considered healed, critique your results then and find out from your surgeon how things can be made better.  

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Is this a botched labiaplasty?

Dear Mickey,

Thank you for writing in with your concerns and sharing your photos.

First of all, there are things you can do for comfort care.  Extra strength Tylenol works very well (believe it or not) along with cool packs, SItz baths twice a day, and get some over-the-counter numbing and antiseptic spray they give women to use after childbirth called Dermaplast.  Buy the one with the red cap not the blue cap, which is only for numbing.  You can also purchase a donut cushion to sit on.  In another 1-2 weeks you should feel a lot better.  Lastly, get a perineal squirt bottle and squirt lukewarm water on the incision edges when you urinate so the urine doesn't burn the incision edges.  Blot dry only. You can also use it in the shower to help wash the area.

Second, yes, the person who operated on you is not trained in labia minora labiaplasty techniques and did not do a good job on you.  However, it will look a lot different in a couple of weeks when the swelling and bruising are much less and then the results can be better assessed.  It is likely in 6 months from now you may want a revision, but nothing can be done while you are at this stage of healing.  At 2 weeks, if it is possible, have the sutures removed.  The sutures cause an inflammatory response under the skin and by 10-14 days they will itch and feel irritated.  Once they are removed, the area will feel much better.  If you don't, use Benedryl by mouth, and Oatmeal soaks (Aveeno brand) and/or moist chamomile tea bags (soothing) to deal with the discomfort.

I am sure this has been a traumatic experience for you and I am sorry that you are suffering.  Let me reassure you as one who has performed over 750 labiaplasties that a revision will improve your end result.  Please be sure to follow up with someone who has extensive training in labiaplasty procedures before having a second procedure.  Ask to see lots of before and after pictures and discuss how they address complications.

For more information on labiaplasty, please visit the link below.

I hope this information is helpful and wish you a speedy recovery!

Sincerely,

Troy R. Hailparn, MD, FACOG

Cosmetic Gynecology Center of San Antonio

Troy Hailparn, MD
San Antonio OB/GYN
5.0 out of 5 stars 26 reviews

Is this a botched labiaplasty?

Thank you for sharing your question and photographs.  It appears that your surgeon aggressively resected your labia minora tissues but failed to taper the removal into the tissues into your clitoral hood. As a result your clitoral hood has extensive swelling and is the source of your tenderness.  At this point you need to allow your results time to mature over 6-8 weeks before your long-term results, and the need for a revision, will be known.  Best wishes. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Recovery after labiaplasty

Your labiaplasty photos do show a lot of irritation along the suture line. You may want to try some Vasoline or an antibiotic ointment. We see labiaplasty patients 14 days after surgery and most patients who have not had some degree of very unusual swelling will look almost fully healed at that point. I suspect that you will be feeling very much better soon. I agree that the balance between the fullness on the top and lower areas does not look right at this time, but because it is so early, this is not something you can assess accurately at the moment. Balancing the clitoral hood and the labia tissue as well as not removing too much labia are all part of the very important issues that any surgeon who is well educated and experienced in labiaplasty should know. Choosing an experienced well informed board certified plastic surgeon is a must for any operation you might consider.

Angela Keen, MD
Salt Lake City Plastic Surgeon
4.7 out of 5 stars 25 reviews

Is this a botched labiaplasty?

Let me start out by saying that it takes 6-8 weeks at a minimum to heal, and a determination about your final outcome cannot be made at this point.  It does however appear that you had an aggressive, somewhat  asymmetric resection of the labia minora using the trim method.  Unfortunately with this procedure, it is important to try to get it right the first time. Revisions can be very challenging.   Try not to get discouraged at this point. There's nothing you can do but try to be positive and allow things to heal.   Once everything is healed, if it is unsatisfactory to you, you can seek a consultation from a board-certified plastic surgeon who is experienced with revision labiaplasty. The good news is that things will typically look much better after they heal and the swelling has gone down.  Best wishes to you!

Erik Miles, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 24 reviews

Botched linear resection

Dear M:

I would say your results are less then desirable but then again I don't need to tell you that as that is why you are writing.   This is not the results of your surgeon doing a linear resection versus a wedge resection but instead due to the lack of experience of your surgeon  doing the surgery.  First of all your surgeon appears to have not made the incision even and symmetrical throughout one side or compared to the other side, second he used what appears to be ia whip stitch ( similar to a baseball stitch) which goes over the edge of the labia minora for closure.  This will give the patient a scalloped appearance or like the humps on the back of a dragon.  Thirdly he didn't remove the excess lateral prepuce on each side of the clitoral hood giving that area a very wide appearance which is more notable since the labia minora have been reduced.

Granted I feel confident your results will look somewhat better after the swelling subsides but this will take weeks.  Currently the swelling is greater where the bulk of the tissue remains i.e. near the clitoral hood and near the bottom of the labia minora and this is swollen the most giving you a very skewed view,  Most of this swelling will subside and improve your results dramatically over the next 6 weeks.  But unfortunately I think you are correct that the middle section has labia almost if not completely resected and you i think you will end up with a scalloped edge Ie bumpy.  I also think you will not too much tissue around the clitoris..... 

Now what can be done at this time:  do nothing.  Do not let your surgeon do anything at this time and I would caution you not to let him/her do anything in the future.  I would suggest you wait a minimal of 12 weeks from the original surgery and then see a surgeon who has great skill, expertise, education and results in revision surgery.  This surgeon should have a website section dedicated to various procedures for the vulva including botched or revision surgeries.   Your next decision / surgeon should be very well thought out .  Your next surgery is your best chance of restoring you back to a more aesthetic states....so please, please choose a surgeon wisely.

John R Miklos  MD FPMRS, FACS, FACOG

Atlanta ~ Beverly Hills ~ Dubai

Labiaplasty: Postoperative Swelling

Thank you for your question.  Swelling is common after labiaplasty with the amount dependent in part based on the time since surgery.  The final result will be seen after several months, which at that time one can evaluate if a secondary surgery would be recommended.  I would recommend contacting the surgeon who performed the original surgery to evaluate your current condition.  If you require a secondary procedure in the future, I would recommend an experienced genital surgeon even if that requires traveling.   

Best of luck.     

Jeffrey S. Palmer, MD, FACS, FAAP (Cosmetic Urologist -- Cleveland, Ohio)

Jeffrey S. Palmer, MD, FACS, FAAP
Cleveland Urologist
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.