Labiaplasty wedge technique done. 1 week post op. Incision separation of labia from base? (Photo)

Doctors. Immediately post op - intense bruising and swelling on my left labia. I did everything I could to take it easy and i ignored the excessive bleeding from days 3-5 as I guessed a hematoma had formed and was draining. My wounds are a mere week old now and there is a hole from the incision site at the base of my body almost through the left lip. The right side seems okay as far as swelling but can't make out yet what that is supposed to look like. Please advise on how I should approach doc.

Doctor Answers 15

Labiaplasty wedge technique done. 1 week PostOp incision separation of labia from base?

Thank you for sharing your question and photograph and I am sorry to hear of your recovery issues.  I agree that due to a combination of swelling, bruising, and likely tension your labiaplasty wedge incision site has separated.  Unfortunately at a little over a week from surgery there is no opportunity at repair and you will need to allow the separated labia minora halves time to heal and fully recover before pursuing a revision procedure in 3-6 months.  See your surgeon for wound care instructions and find a labiaplasty surgeon for your revision.  Best wishes.


Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Wound separation from Wedge Labiaplasty - an all too common complication

Sorry about your experience with your recent labiaplasty. Wound separation of this nature is a risk of wedge Labiaplasty. There is nothing that can be done at his point other than supportive care and to allow healing to take place. My advice for you is to notify your surgeon of this problem and follow his recommendations, I'm sure you're not his first patient return with this issue.  As far as a future revision you should wait till you're fully healed and see a cosmetic vaginal surgeon with experience in revision labiaplasty.  See link below for additional information. 

Best of luck, 

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 23 reviews

You should be healing well by now

and if your suture line came apart as your photos suggests, you have a notched labia.  Your surgeon should be providing you all the reassurances you need to help you through this process and you will need a revision to correct the problem but most surgeons recommend at least 6 months healing before jumping back in.  Find out what your surgeon's revision policy is as well so you won't be surprised down the road.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Labiaplasty

It seems that your incision is separating. This is one of the downsides to getting the wedge technique. Be sure to choose a Board certified plastic surgeon who specializes in Labiaplasty. This is an important fact to remember when choosing a surgeon

Labiaplasty not healing properly

The best thing you can do now is have very close follow up with the surgeon or another surgeon who is experienced with the healing of labiaplasty.  You want the best results with healing now so it can be revised later if needed.  Keep light activity, keep the area clean and washed frequently.  Over the long run, you will see how it heals and what needs to be done in the future.  Good luck healing and choosing later an action plan.

Wedge labiaplasty falls apart yet again. No surprise, but what are you going to do now?

Do nothing. Keep it clean, let it heal, wait six months, then go for a revision with an expert. A perfectly executed wedge labiaplasty is always a weaker scar than a perfectly executed linear labiaplasty. We live in an imperfect world. I would advise you to seek out an expert in labiaplasty revision for your next try.

Advice on approaching doc

I am sorry to hear of your post operative results. This is one of the most common problems I see on the RealSelf website i.e. patients upset with the results of their labiaplasty. I agree that your results are less then desirable and I also agree with others to express your displeasure but unfortunately some times these results are not the surgeons fault.  It is hard to say if your surgeon did or did not do the right thing as I was not there watching the surgery.  Hematoma do occur and usually it is not beneficial to try to fix them as they are self limiting and generally resolve.  I am not trying to cover for your surgeon I am just being truthful--- I do not know your surgeon.  I disagree with most surgeon who state that you must wait 6 months as i have been performing labia revisions on botched surgery at 3-4 months post operative for years. Do not limit yourself to a surgeon in your locale as this next surgery is going to be the best chance of restoring you to as close normal as you can get.

Choosing a cosmetic vaginal surgeon or any surgeon should be one of the most important decisions of your life. Failure to choose a surgeon with experience, expertise and one who achieves excellent results is not an easy find especially a surgeon who has experience with botched labiaplasties. There are a lot of surgeons who think they are experts in the field but they don’t work on vaginas daily. Some surgeon have practices that allow them to operate and perform: breast augmentations, tummy tuck, butt lifts, hair transplant and then there are surgeons who dedicate their whole practice to vaginal reconstruction and cosmetic vaginal surgery. It is obvious which surgeon has more experience, expertise and better insight as to the a patients desires of their gynecologic area. Please don’t just choose a surgeon because they claims to be specialist in plastic surgery --- choose a surgeon who can prove to you they are specialists in your gynecologic area of concern. In your situation you need a surgeon who has experience in botched labia surgeries.  

Choose a surgeon who has great before and after pictures especially in the realm of botched labiaplasties.  Wait 3-4 months and then consider a revision but choose a surgeon with experience.  Please see the botched area of my website.

John R  Miklos MD

Atlanta ~ Beverly Hills ~ Dubai

Labiaplasty wedge separation

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 have performed several thousand of these procedures and have not had such severe separations. 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 almost certainly will be able to be reconstructed successfully once you heal.  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

Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 20 reviews

Healing wound

Once a wound is opened, you now just need to keep it clear and let it heal on its own (second intention). Once healed and around 3 to 6 months from now, you need to have your physician see it and see if you need a revision.

Robert L. True, MD
Grapevine OB/GYN
4.9 out of 5 stars 7 reviews

Wound Separation

Hello,

Although some doctors here have chosen to malign the Wedge labiaplasty technique, I have done these almost exclusively for nearly ten years. In skilled hands on the proper patient with the proper peri-operative management, they perform very well and I have never had a complete separation like you appear to have. Still wound failure is a risk even in the best of hands. I like to keep a close watch on freshly operated patients of mine. You should have seen your doctor by now and have his or her management ongoing. If not you should call him or her ASAP.


Best Regards,


John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 26 reviews

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.