I am afraid I will keloid after my labiaplasty surgery. How can I avoid it?

Question

Hello, I am very interested in getting labiaplasty. However, with that said I have had a breast augmentation and a bunionectomy which has resulted in keloids from the sutures. I’m under the impression that the labia tissue is different from the actual skin, therefore do you think I would still keloid on my vagina? Also, which method (trim vs wedge) is preferred for people who scar?

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

Keloids on the labia minora are extremely rare. However, since you are prone to keloids, you should take specific measures after surgery to reduce the risk. There are various common options including steroid therapy that your surgeon will recommend. The type of labiaplasty has no bearing on the risk level - any scar can keloid.

Jerome Edelstein, MD · Answer

Hello,The good news is that the labia tissue tends to scar very well in most people- even those who's skin elsewhere on the body tends to keloid. You are right- the labia skin is different and this is why scars become virtually invisible there. Talk to your Plastic Surgeon about your concerns and be sure to have regular follow up care to keep an eye on it as you heal.All the best

George Volpe, MD · Answer

Keloid scarring would be very uncommon following Labiaplasty for excessive labia minora, even with a history elsewhere utilizing a wedge technique. Discuss your concerns with your surgeon and he or she will discuss with you possible post operative maneuvers to minimize any risks. Closer follow-up is warranted in this situation.

David Ghozland, MD · Answer

I am happy to report that I have never had a keloid post labiaplasty and we have done hundreds.  The tissue in that area rarely if ever keloids.Best of luck to you and make sure to do your homework before choosing a surgeon.

Robert L. Steely, MD, FACS · Answer

Good morning!The good news it that labia are one of those sites we call "privileged"- the tissue there does not tend to keloid even in keloid prone skin- just be sure to see a surgeon who does this type of procedure regularly.I hope this helps

Oscar A. Aguirre, MD, FPMRS · Answer

Hello Michelle,Thanks for a great question, one that I've been asked during consultations many times by patients who are prone to keloiding. Surgical sites which are under a lot of tension are more likely to keloid, such as following breast augmentation or abdominoplasty. You should be reassured with the fact that the labia is a tension-free "zone" and so the risk of developing a keloid is minimal.Technique and method used for your Labiaplasty is variable, however.  The wedge technique is more prone to complications such as wound dehiscence due to tension placed on the suture line as well as infection.  I would recommend you avoid this method.In patients who keloid who also need a clitoral hood reduction with clitoropexy at the time of their laser reduction Labiaplasty, the area of the hood reduction is under great tension. I have successfully injected PRP into the clitoropexy suture lines with excellent success. I have seen no keloid formation.  The results have been so remarkable, I now use it routinely at the time of clitoral hood work to minimize any scar formation.  As a bonus, these patients also receive an O-shot at the time of their Labiaplasty to enhance orgasmic response.

Raffy Karamanoukian, MD, FACS · Answer

Although labial skin is different than other areas, there is still a finite risk of keloids. Our office specializes in keloid reconstruction and labiaplasty and I would recommend an aggressive post-treatment protocol to avoid keloids. This would include early application of Plato's Scar Serum.

David J. Wages, MD · Answer

Thank you for your question. The labial skin is much different from other areas and much less likely to form keloid scar formation.  I would recommend starting with a
face to face consult with a Board Certified Plastic Surgeon who has experience
in labiaplasty. During your visit your surgeon should be evaluating your
health to determine if you are a good surgical candidate and examining your
tissues to get a sense of what type of procedure your tissues will allow. Only
with a hands on exam can this be determined. Once an exam and opinion is
rendered then you can decide if surgery is right for you. Be sure to ask for before and after photos.  I discuss the risks and benefits of trim vs. wedge techniques with my patients.  After understanding the differences you will be able to make an informed decision.  Good luck.

Courtenay Poucher, MD · Answer

You have been correctly informed that the skin of the vagina is quite different and it is much less prone to keloid. It is similar to the skin on your lips.  However, I would recommend routine follow up after your procedure so that if any evidence of keloid formation should rear it's head, it can be swiftly treated.  I recommend the linear trim technique for all of my patients as it has a much lower risk of wound infection and breakdown. Best wishes on your journey.~Dr. Poucher

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

Thanks for sharing your question. I can
appreciate your concern.
You are totally right on target with your comments. The skin
and the mucosa heal completely different. The fact that you have bad scars on
your skin does not represent that they are keloids anyway. However, it is not
appropriate to say that things will never happen.

The technique is up to the surgeon’s
experience. Some techniques work on some people and not others. The important fact
is making sure that your surgeon shows you pictures of patients with good
outcomes. Then the technique is irrelevant.

Finally, make sure that you have a
consultation with a board certified plastic surgeon that specializes in after
weight loss surgery.

Wishing you the best in your journey

I am afraid I will keloid after my labiaplasty surgery. How can I avoid it?

Answers (11)