Will I have to continue the use of Cortisone injections to ease pain after labiaplasty? Is PRP a better option?

What I think you are describing is chronic neuropathic pain also called “neurogenic pain”. To control and eliminate this pain can be very elusive. Neuropathic pain is directly related to hyperexcitable nociceptive neurons (nerves) due to trauma like that seen with labiaplasty. Neuropathic pain is caused by either 1) overly aggressive reduction of labia resulting in amputation 2) Inappropriate usage of type and caliber of suture for labiaplasty which can lead to "grooving" . Grooving can cause pain if the grooving is close to nerves leading to the nerve(s) being kinked, creating tender areas in around the labia. Lastly, changes in sensitivity can occur with injury to a branch of clitoral nerve. Neuropathic pain "ENDS" when the wound site is completely healed. We are not just talking about superficial healing (how things look) rather, a healing process than cannot be seen with the naked eye and occurs on a cellular lever. Healing is considered COMPLETE when axon regeneration occurs along with re-innervation (re-growth of nerves) of the target tissue and complete elimination of the inflammatory process. Often times, patients are prescribed neuroleptics such as Gabapentin and Pregabalin but are unable to tolerate the excessive sedation associated with these medications. However, you may have some success by compounding Gabapentin+Lidocaine+ Estradiol, and massaging this compound to tender areas resulting in significant improvement in sensitivity and pain syndromes. A second option is surgical resection/ revision of affected areas. A new non-surgical adjunct for the treatment of neuropathic pain is the use of platelet rich plasma (PRP). PRP is harvested from one’s own blood that can be activated and injected to tender areas of your labia. This activated PRP causes a cascade of healing events, stimulating your body to form new blood vessels, decrease inflammation and releases growth factors resulting in axon regeneration and re-innervation of the target tissue (re-growth of nerves) ultimately eliminating ongoing pain. This Neuropathic pain can begin to improve 3 weeks after the application of PRP. Reference article: Platelet-Rich Plasma and the Elimination of Neuropathaic pain by Damien P Kuffler Best of Luck! Dr Michael Reed aka @thecosmeticgyn

Painful scarring after labiaplasty is usually due to over-resection and/or poor suturing techniques. Cortisone or PRP injections may improve the discomfort, but it is doubtful that they will eliminate it if the problem is painful scars. Excising the scars and replacing the painful area with normal healthy tissue usually eliminates the pain and gives a more normal appearance. 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" over ten years ago. Approximately 40% of the surgeries I perform are revisions of other surgeons’ labiaplasties. You may need various reconstructive techniques to give you a good appearance which I can usually determine by seeing photos. Sometimes I take skin from the sides of the clitoral hood (clitoral hood flaps) to reconstruct your labia if your surgeon left enough remaining clitoral hood. I invented this procedure and published in that medical journal. Other times, I move local tissue around. You only get one good chance to reconstruct you, so ask a lot of questions and see examples of such reconstruction.

Gary J. Alter, M.D.
Beverly Hills, CA, Manhattan, NY

Dear patient.
Sorry that you have developed a complication after your surgery.
yes the PRP injections can help your healing and as is result decrease in the pain,
Good luck and Best of health