Heavily considering Labiaplasty - plastic surgeon or gynecologist?

Question

Hi, I am heavily considering labiaplasty and a hoodectomy to take place within the UK. Is there a difference in experience etc when booking purely with a plastic surgeon compared to a gynecologist?

Gary J. Alter, MD · Answer

If desired, your labia minora and clitoral hood can be reduced to improve the appearance. A labiaplasty with a clitoral hood reduction can reduce your hood size. However, it must be performed by a surgeon with experience. One of the two most common labiaplasty techniques is the central wedge technique, which I invented in 1995 and published in the plastic surgery textbooks. It is also known as the "V" or wedge technique. Gynecologists and most plastic surgeons perform a labiaplasty very differently. They essentially trim the labia minora (inner vaginal lips) and leave a long suture line instead of the normal labial edge. Their technique is the same whether a scalpel or a laser is used. In contrast, the central wedge removes triangles of tissue and bring the normal edges together. Thus, the normal labial edges, normal color, and normal anatomy are preserved, but the darkest labial tissue is usually removed. There is rarely a sign that the woman has had surgery.

If you have extra tissue on your clitoral hood, it can be reduced at the same time. If your clitoral hood is long and protuberant. It can be decreased somewhat by reducing the sides. I pioneered 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 decreased. With this procedure, I lift up the clitoral hood skin, move the clitoris closer to the pubic bone, thin the tissues under the clitoral hood skin, and then remove a large amount of excess skin. This results in a dramatic decrease in the length, thickness, and protuberance of the clitoral hood, so that the hood is now within the labia majora when the woman stands. I have performed this procedure over 350 times with outstanding results.   I have not published this technique, so no one does it like me.​

​Your labia majora have stretched which resulted in excess skin and lost of fat to provide fullness.  I suggest reducing the excess skin and increasing the fullness with fat injections. The technique I popularized and published in the medical literature  leaves a scar on the inside of the majora in the fold between the majora and the minora and clitoral hood. If closed with sutures under the skin and performed meticulously, the scars are difficult to see.

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.​​ Approximately 40% of the female genital surgeries that I perform are reconstructions of other women's botched labiaplasties and hood reductions.

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NYC

Amir Sadr, MD, MSc (Plast), FEBOPRAS · Answer

Dear Angeleyes_xo
Thanks for posting a great question. Labioplasty can be done by either of them. There are some points to consider though. In the UK most of plastic surgeon are trained on NHS and they get to see or perform less and less labioplasties these days as this is considered a cosmetic procedure that NHS does not cover the cost. This has resulted in many recent plastic surgeons with less experience in this field. On the other hand gynaecologists see this condition on air daily practice. so they are more familiar with the problems patients get with it.Plastic surgeons are the best surgeons in form of tissue handling, managing wounds and stitching the wound neatly. They have acquired this skills over many years of training. They also have an artistic eye for beauty, proportion and harmony as they have to use this judgment everyday. Gaynaecologists do not have much training in labioplasty unless they got specific training in female aesthetic genital surgery. There are a few gynaecologists that only do female genital cosmetic surgery and therefore they have developed the skill and experience. My personal opinion is that a plastic surgeon who has had he training and have done many labioplasties if a good option as their tissue handling and stitching quality is better than most other specialties. The best question to ask either the plastic surgeon or gynaecologist is how many labioplasties they do in a month and also request to see their before and after photos. I hope you find this explanation useful.

George Bitar, MD · Answer

I think it depends on the individual doctor. Either can be great, but it really depends on their experience and your comfort level. As a plastic surgeon, I'm a little biased though. Pick someone you feel confident with who's experienced with the procedure.

Angelica Kavouni, MD, PhD, FRCS(Eng) · Answer

Hi there , this is a good question but difficult to answer. Generally speaking plastic surgery training is very beneficial for a good cosmetic outcome. Some gynaecologists do not take into account the cosmetic elements in terms of the type of stitching, the technique or the types or sutures. But others have some experience with plastic surgery techniques. The best thing is to see reviews for labiaplasty and before and after photos to understand the experience and the attention to detail. Best wishes for your surgery

Mark N. Scheinberg, MD · Answer

Thank you for your question Gynecologists are more familiar with working on the vaginal and vulvar tissues and plastic surgeons are generally better trained at aesthetic techniques. You really have to evaluate the specific training for labiaplasty procedures, checking out their before and after photos and looking at reviewsThe video below will be useful in getting knowledge about the procedures which can help you evaluate your surgeons. Take your time and do your homework Better to get it right the first time

Falguni Patel, MD, FACOG · Answer

thanks for your question. the benefit of using a gynecologist is that they are experts in the anatomy and function of the area you are concerned with although not all gynecologist are cosmetic surgeons, but that does not discount that there are plastic surgeons that are just as qualified.  i believe everyone has a different experience with each doctor they consult with.  the best thing to do would be find board certified doctors review their pictures and reviews and go to a few consults to see who you feel the most comfortable with

Courtenay Poucher, MD · Answer

Hi Angeleyes.
This is such an excellent and important questions. The most important thing to consider when choosing your surgeon is their volume and frequency of performing the surgery you want to have done. On one had gynecologist have superior knowledge of the female anatomy (in general) and on the other hand, usually plastic surgeons have superior suturing and corrective techniques. For labiaplasty procedures and even more so for hood reductions, a surgeon who has both a keen sense of female anatomy (the nerves and blood vessels, the natural flow) AND superior surgical skills with thousands of these procedures under their belt, is the way to go for sure. Please do your homework. They should not be offended at the request for this information. There are many well meaning doctors that just don't have the skill set needed so be careful. Best wishes to you!~Dr. Poucher

Nelson Castillo, MD · Answer

Thank you for sharing your question.  It is more important to research the doctor rather than their speciality to ensure your results.  Hope this helps.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

There are excellent labiaplasty surgeons that are gynecologists and there are excellent labiaplasty surgeons that are plastic surgeons. Specialty doesn't matter. Experience and skill matter. This can only be assessed by viewing the results of their work. Anything else is irrelevant. Anyone who tells you otherwise is telling you a story. You don't want stories. You want predictable results. Your next step should be a virtual consultation with an expert.

Erik Miles, MD, FACS · Answer

My recommendation would be to research the doctor, regardless of the specialty, to see who you feel will give you the best results. Ensure that the physician is very experienced. Surgical techniques can vary..  You might want to go to several consultations before you decide.  Best wishes.

Heavily considering Labiaplasty - plastic surgeon or gynecologist?

Answers (17)

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