Need labiasty revision. How bad was the job performed? What should I do? (photos)

Hello, I had Labiaplasty done without clitorial hood reduction about 3 years ago. I am not happy with my result, the area is always dry. I think the doctor seewed my lower labia incorrectly! I want to get a revision and get a clitorial hood reduction. What can be done? Which method should be used? Would I need reconstruction? Could I achieve nice results? Thank you!

Doctor Answers 8

Labiaplasty revision

It appears that most of your labia minora were removed, and you have significant clitoral hood remaining.  You had a trimming labiaplasty. 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" about two years ago. You need various reconstructive techniques to give you a good appearance. I probably would recommend clitoral hood flaps to reconstruct your labia since it appears that your surgeon left enough remaining clitoral hood for me to use.  The abrupt end of your clitoral hood and frenula will be sutured to the flaps to give a normal appearance with reduction of the size of your hood. I invented this technique about ten years ago and preformed it about 50 times with excellent success. 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, NY


Beverly Hills Plastic Surgeon
4.9 out of 5 stars 20 reviews

Revision?! Who to see? What to do?!

Hello RFL,

You have complex issues that any of the docs who have already responded, as well as yours truly, can understand, evaluate, and come up with the treatment that will MOST BENEFIT YOU! It's silly to expound further on the techniques ( Hood reduction?  ??Island flap ) that are already mentioned by my esteemed colleagues. The important thing, dear friend from Miami, is that you visit at least one, and better 2 or 3 well-qualified and well experienced plastic or cosmetic gyn surgeons from your area or elsewhere, and negotiate a path with a surgeon who is open to alternatives, is skilled,  experienced, and "...on your wavelength!

Best of wishes,


Michael P Goodman MD

Clitoral reduction

Thanks for sharing.  My assessment ( based on photos alone) is you would benefit from a clitoral hood reduction, clitoral lift, and frenulectomy.    If  you just have just a clitorral hood reduction I think you are going to overexpose the clitoris  ( which could lead to hypersensitivity).  If you lift the hood or reduce the hood the clitoris should be lifted also.   The frenulum are the small legs on each side of the base of the  clitoris which previously fused into the clitoral hood to form the the beginning of the labia minora.  Your previous surgeon has when resecting the lower portion of the labia minora has stopped short of the frenulum just as he stopped sort of the base of the clitoral hood.  To give you the best contouring  the frenulum should also  be reduced.

To get the best results your surgeon and you need to sit down and talk about your expectations. There is no way at this point that any surgeon can tell you whether you are going to get "nice results" unless the surgeon understands your expectations.  Please choose a surgeon with experience, expertise, reputation and results and who has experience with botch labia or revision labiaplasties.

John R Miklos MD

Atlanta ~ Beverly Hills ~ Dubai

Refinishing labia

In choosing your further management, there are a few layers of treatment.  One is the physical appearance and your dissatisfaction of the hood, this is a surgical repair.  Another is the dryness, and there are several ways to treat this.  The underlying cause of the dryness needs to be established from a thorough evaluation, it could be from the skin itself or from a process locally.  Then the treatment can be tailored to the cause, and an experienced gynecologist in general GYN and cosmetic GYN can manage this.  You have a few issues, and they need to be evaluated and managed all in conjunction.   Choose your consultant based on these needs.

Genital Surgery -- Cosmetic Urologist

Thank you for your question and photographs.  I am sorry to hear about your current situation.  It is challenging to access your currently condition and provide recommendations only based on your photographs without a physical examination.  I would recommend seeking the opinion of an experienced cosmetic genital surgeon.  There are several types of surgeons who promote themselves as performing cosmetic genital surgery, but a Cosmetic Urologist can offer unique qualifications compared to plastic surgeons, gynecologists and general urologists. 

Best of luck.    

Jeffrey S. Palmer, MD, FACS, FAAP (Cosmetic Urologist -- Cleveland, Ohio)

Jeffrey S. Palmer, MD, FACS, FAAP
Cleveland Urologist
5.0 out of 5 stars 4 reviews

Labiaplasty

I wouldn't say that this was done incorrectly but there is definitely room for improvement. I am a Board Certified Plastic Surgeon that ONLY performs Labiaplasty.  This is my wheelhouse and is a very niche procedure that I perform. I would say that you seem to need a clitoral hood reduction along with a secondary labiaplasty if that extra skin bothers you.

You need a clitoral hood reduction and a little bit more

Revisions are not done by predetermined methods, but are tailored to the amount and quality of the remaining tissues. You have redundant loose skin on both sides of the clitoral hood and a "dogear" on the left side that can be improved with clitoral hood reduction and excision of the dogear with repositioning of the corner of the hood. The gaping of the inner (medial) sides of the labia minora can be reversed with a modified perineoplasty. You can definitely achieve a more streamlined and natural look.

Need labiasty revision. How bad was the job performed? What should I do?

Thank you for your question and for sharing your photographs.  Though nothing replaces an in-person examination of your tissues it appears your surgeon was aggressive in removal of tissue along the middle aspect of your labia minora.  This skin resection did not taper smoothly into your clitoral hood region, causing it to look enlarged.  Revision surgery will depend on your goal appearance.  If you are interesting in reconstructing your labia, the excess tissue of the clitoral hood can be used, affording you correction of both areas.  If you are only interested in a clitoral hood reduction then this alone can be performed as well.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 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.