Possibly not healing correctly after labiaplasty? (Photos)
Doctor Answers 9
Your wedge labiaplasty is falling apart
Wedge labiaplasty scars are weak and prone to separation. Yours is already separated. It won't come back together and will require revision in six months to achieve a normal appearance.
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 hole will probably not close. Even if it does, you will need a reconstruction. The reconstruction technique depends on the deformity. 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 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. 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
Wedge Labiaplasty Not Healing Correctly (Photos)
Dear Shawna, Thank you for posting your post operative labiaplasty photos with your question. It appears that the two edges of labia minora have separated, which is a know risk with the wedge labiaplasty technique, because of the tension of the tissue brought together. This labia minora tissue will heal with local wound care, but eventually will require a surgical revision, in a few months, to sew the 2 edges back together. Please contact the office of your Board Certified Plastic Surgeon, who can refer you to the covering doctor, for local wound care instructions, until they return. Best wishes, Dr. Richard Swift
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Possibly not healing correctly after labiaplasty?
When the wedge labiaplasty technique is performed, there is a risk of edge separation and hole formation. These should have been discussed with you prior to your surgery along with all of the other risks and complications of labiaplasty. At this stage of the healing process, there is nothing that can be done except comfort care. Once you are completely healed by three to six months, then a repair surgery can be done.
Usually doctors have someone covering their practices when they are unavailable, however, with a surgical complication, the office should be getting in touch with your surgeon and you should be able to have a phone conversation with him/her or the covering doctor. Also, be sure to call and make an appointment to be seen as soon as your surgeon gets back to discuss follow-up care.
I hope this information is helpful.
Troy R. Hailparn, MD, FACOG
Cosmetic Gynecology Center of San Antonio
Possibly not healing correctly after labiaplasty.
Thank you for sharing your question and photographs. It does appear that your wedge resection incision has partially separated. Though the hole may fill in partially over the next 6 weeks you need to discuss wound care instructions with your surgeon, as well as try and limit pulling on your tissues to prevent further separation. Hope this helps.
Do I have a separation of my V-Wedge labiaplasty??
Your pics do not show a clear view of the area in question, but it appears that you have had a separation of your V-wedge. This is not to damn the technique, but separations happen only when the incision is not repaired properly (in layers, with 1-2 layers of deeper sutures holding everything together well, so all tension is taken off the skin sutures), or when your activities in the first 2-3 post-op weeks are "excessive." Don't "...rub it with a Q-tip;" a gentle cleanse with a soft, small cosmetic sponge is enough, and that only after 10-14 days.
That said, even if your surgeon is on Holiday, (s)he should be available by e-mail or phone through the office, or have someone skilled covering for him/her. A surgical fee includes any follow-up necessary for ~ 6 weeks. For now, please avoid any activities that will lead to "shearing" forces between your legs, and see your surgeon upon his or her return. A better quality (close-up; in-focus...) photo will be required for us to help further. Use your smartphone at ~ 2-3 feet ("arms-length) distance and use the close-up adjustment, rather than placing the camera up close...
Michael P Goodman, MD
Davis, CA, USA
Healing after labiaplasty
it typically takes 6 to 8 weeks for patients to heal from their labiaplasty surgery. If you have some wound healing issues at this point they typically need to be managed with simple wound care. Only after everything heals can a decision about any possible revisions. The good news is that things off and heal and look much better than you expect. I cannot tell from your pictures exactly what is going on. If your surgeon is out of the office for the week, he or she should have coverage by another surgeon. I would call the office to express your concerns. Best wishes to you!
Thank you for sharing the photos and question. Unfortunately you will not know the final results until 6 weeks post operatively and in the meantime there is NOTHING you can do about the situation. Most likely if there is a hole now ( 3 weeks post operatively) there will still be a hole in 6 weeks. This is one of the unfortunate aspects of a wedge resection is sometimes they don't heal completely and the wedge resection completely breaks down and the patient is left with a cleft or it partially breaks down and the patient is left with a hole.
Also i see your labia minora are still protruding beyond the edge of the labia majora.......in my 2008 550 patient published study most women (99%) wanted their labia minora to be at the level of or lower than the majora. Again this is one of the difficult goals to meet if the surgeons is not extremely skilled in the a labia minora reduction or if the labia is are very long to begin with. I encourage you to be extremely careful on your 2nd or 3rd surgery when correcting the results of this surgery. Choose a surgeon with experience, expertise, a great reputation and one who has achieves great results. Best of luck in your care
John R Miklos MD
Atlanta ~ Beverly Hills ~ Dubai
Labiaplasty: Postoperative Results
Thank you for your question and photographs. One of the possible issues after wedge labiaplasty is edges separating. However, 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)
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.