What are the possible treatments for painful labiaplasty scars?

Painful labiaplasty scars are incredibly rare and if you have this it’s usually because of poor suture technique combined with swelling that results in notched or grooved labia. I sometimes refer to this as baseball stitching from labiaplasty but the medical term is a running stitch. This suture technique strangulated the labia tissue and leaves multiple groups and notches that are painful. A labiaplasty revision may be necessary. Sometimes there can actually be a painful area right at the junction of the clitoris and the labia if the doctor cuts these tissues at a right angle. I have seen this on several occasions and have revised those patients with great success and relief.

Hi there , I am very sorry to hear that you suffer from this very unusual complication. Have you tried daily massage with Bio oil, patients report that the extra lubrication helps healing of this intimate area. My best wishes for a speedy recovery

HI Adalheida,

Several treatments can be available for painful labiaplasty scars, but it is difficult to advise you without a picture. If the scar is hypertrophic, a possible steroid injection or a simple re-excision can be done, but all treatments need to be individualized based on the patient's unique anatomy. Perhaps, it might be a good idea for you to send a picture or describe in better detail exactly how you have been scarred?

Best,
Dr. Christine Rodgers

Hello Adalheida,
A photo would have been helpful.
The answer to your question depends on the timeframe following your surgery. I'll assume you are several months or years post labiaplasty and thus pain or discomfort from the actual surgery is gone.
Painful scars following any procedure is usually due to tissue being placed under too much tension. Time usually helps to self-resolve this, but if it doesn't and the anatomy needs to be aligned correctly this may require a surgical revision. Prior to moving in that direction I have found great success in injecting PRP into the painful tissues. It is certainly worth trying since it won't make things worse.

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. I need to see photos to give you the options for eliminating your pain. It is possible that PRP or stem cell treatments may improve the pain. However, the reconstruction technique depends on the deformity and the location of the painful scars. 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 ten years ago, and about 40% of my female genital surgeries are reconstructions of botched labiaplasties. You may need various reconstructive techniques to give you a good appearance and to eliminate your pain. The painful areas probably need to be excised and replaced with normal healthy tissue. You only get one good chance to reconstruct you, so ask a lot of questions.

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NYC

Hello,
I have performed more than 1000 labiaplasty surgeries. I have not encountered such a problem.
What was the incision made with in your labiaplasty surgery? scalpel ? cautery ? laser?

Q 1: What are the treatments options for painful labia minora following trimming labioreduction and Q2: Is PRP effective and safe for pain associated with labioreduction?
A 1: Trimming the labia minora (a straightforward amputation) should not be used as a surgical intervention for labioreduction of the labia minora because
a) often results in over-resection leading to labial neuropathy (pain at the incision site) or pudendal neuralgia (pain in the multiple areas that is innervated by the pudendal nerve) is the result of the referral pain from the original surgical site); b) permanently changes the natural shape and look of the labia minora. In the case presented here, most likely, pain is related to labial over-resection. When a surgeon resects the labia minora above Hart’s line, that demarcates a transformation from smooth transitional vulvar skin to vulvar skin and is located on the inner surface of the labium minus is well visible during a medical examination. Such resection can result in pain that may trouble a patient for the rest of her life. In the case presented here, most likely, the surgeon over-resected labia minora.
Usually, over-resection of the labia minora requires a corrective surgery that I performed in two separate stages under local anesthesia in the office. Stage I - is the tissue-expanding-elongating labia minora materials (no classic skin-expanding materials are used). Stage II - removes tissue-expanding materials, and I perform cosmetic surgery on the labia minora in harmony with a patient’s request. Offering labial wadge resection or additional trimming can worsen the pain.
A 2. There is no single scientific-clinical published research in the medical literature that references the safety and effectiveness of Platelet-Reach-Plasma (PRP). Additionally, FDA has not specified the labia minora therapy with PRP for postoperative labial treatment of pain. Therefore, I do not recommend using PRP for these medical indications.
With regards,
Prof. Dr. Adam OstrzenskiUS Cosmetic Gynecologic Surgeon