Failed vaginal rejuvenation. Is a further reduction more risky than the original op?

The labia minora can be reduced, but they can't be thinned out too much. The discomfort issues need to be clarified. Any concerns regarding the tightness of the canal would require an exam in person to assess the quality of the muscles and the vaginal supports. Some women who undergo tightening of the vaginal canal have damaged muscles and they simply will not achieve a major tightening effect.

Hi MissyMe2. This surgery did not necessarily fail. Did you and your surgeon discuss how much labia to remove? Did he draw a picture on your own pre-op pictures to review what he recommends to remove? Did you discuss excising the sub-frenulum folds? - The folds directly under the clitoral hood that merge with your labia? The good thing about this operative result is that you have labial tissue remaining that can be reshaped and sculpted to what you might be happier with. Many patients that have botched labiaplasties do not have enough tissue remaining to revise the surgery. The risk of the surgery should be no different than the original risk assuming you don't have any new medical issues or problems.

After seeing the pictures. You should have your labiaplasty revised to achieve your desired results. You can achieve satisfactory results by reducing the labia minora in addition to some clitoral hood reduction. Make sure to consult a skilled urogynocologist or cosmetic gynecologist for an assessment and advice of the operations required in the vaginal canal.

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​. You had a trimming labiaplasty which resulted in continued fullness, excess clitoral hood, and scalloping. 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 ten years ago. You can have a much better appearance by a very skilled reconstructive labiaplasty surgery. Approximately 40% of the surgeries I perform are revisions of other surgeons' labiaplasties.

I would do a central wedge excision on each side to reduce your labia and eliminate most of your scallops. Another trim may leave you with further scallops and the length of your labia may still be redundant. It can be done very safely as I have invented this procedure and have done it thousands of times.

Your clitoral hood is thick, wide, and protuberant. It can be decreased somewhat by reducing the sides. I invented a clitoropexy with clitoral hood reduction in which the clitoris is pushed closer to the pubic bone and the width, thickness, length, and protuberance of the clitoral hood can be drastically decreased. I have done it over 400 times with excellent results. I have not published this technique, so no one does it like me.

Your vaginal canal can be furthered tightened at the same time.

No matter the technique, an inexperienced or unskilled surgeon can lead to a high rate of complications, chronic scar discomfort, labial deformities, and further surgery. About 40% of my labia cases are reconstructions of other surgeons' labiaplasties. 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, NY

Hello, a second operation can be performed when unsuccessful or unwanted results occur. It is not a more risky operation. The procedure to be performed in the pre-operative examination should be discussed with the patient correctly and then it should be done in the direction desired by the patient. In your case, as can be seen from the picture, the inner lips can be smaller, and you will be happier if the vaginal canal is narrowed throughout.

Hello MissyMe2,
You are a candidate for a revision surgery to further reduce your labia and clitoral hood. You need a clitoral hood lifting as well since it is drooping.
If you are still feeling as loose as beofre perhaps you have vaginal prolpase that wasn't addressed at the time of your vaginoplasty.
Go to the link below to see hundreds of before and after photos where you will find many examples that are similar to you. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. Women from all over the world travel to my Center for their reconstructive and cosmetic vaginal surgery.
Best of luck,

Based on your submitted photos it appears you are a candidate for a revision to your procedures. It is important to discuss with your surgeon what you are wanting in terms of results. It's equally important to understand from your surgeon what you can realistically expect. I encourage you to discuss your concerns with your surgeon. Hopefully the situation can be rectified if the issue was a lack of communication.

Hi MisseyMe2, looking at the pictures you submitted you will be a candidate for second reduction surgery. Reduction of the labia minora or the inner lips will give you satisfactory results along with some clitoral hood reduction. You will need a proper examination to see if you need vaginal canal tightening as well or if there is a pelvic organ prolapse which needs to be addresses. Second surgery done at least 3-6 months after the first one is a safe procedure and there are no additional risk associated with it.

You had a conservative surgeon. That is not bad: better to be conservative than too radical; while more can be removed, it's impossible to "...add back!

I see you're in Mississippi. I have trained a more than competent cosmetic urogynecologist in Madison and Flowood, Dr. Robert Harris (@ Southeast UroGyn). You might consult with him (tell him I referred you...) Of course, you can do a virtual consult with me out here in CA.

Bottom line- YES- more can be done. Your hood was not reduced, your labia may still be more bulky than you'd like, and these can be aesthetically reduced to your specifications by an experienced surgeon facile in revisions. Re: additional tightening, your vaginal canal may be further "tightened" via a carefully performed levatorplasty (aka"vaginoplasty"), preferably performed under a "local" anesthesia (not asleep...) That way your surgeon can get things tighter as you are able to give feedback during surgery. Additionally, if your "perineal body" (the muscular tissue at the lower opening of your vagina) was not rebuilt as strongly as it might have, it can be rebuilt. While I and several other experienced cosmetic gynecologists give "virtual consultations," in the end it will take a hands-on evaluation to give you clear expectations.

Very best,

Michaël P. Goodman, MD, FACOG, IF, AAACS
Primary and Revision Cosmetic Gynecologist
Sacramento, CA, USA