Why do I still have discomfort horseback riding three years after labiaplasty? (Photo)

Question

I had a labiaplasty trim procedure over 3 years ago in New York with a board-certified plastic surgeon. The results were aesthetically satisfactory. However, before the procedure I was an avid equestrian, and it has completely changed the way I ride — I am far less confident, feel like I’ve lost “feel,” and am much less balanced to the point where I don’t feel safe jumping. I’ve tried microneedling to help with scar tissue and also use amitriptyline cream to help with nerve sensitivity. Are there any other suggestions or things I can do? Overall I’m experiencing a loss of sensation/dullness as well as areas of increased sensitivity. Riding has been a lifelong passion, and losing that connection to it has been absolutely devastating — both physically and emotionally.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

The most important part of your story is that the appearance was satisfactory, but your function was not. Persistent changes in sensation, pressure tolerance, or "feel" more than three years after labiaplasty cannot be diagnosed from a photo alone.

Before recommending any treatment, I would want to know:

• Was horseback riding comfortable before surgery?

• Did your symptoms begin immediately after surgery or develop later?

• Is the problem pain, numbness, hypersensitivity, loss of sensation, or a combination of these?

• Have your symptoms changed at all over the past three years?

Because your symptoms are most noticeable while riding, I would also evaluate saddle fit, riding position, and pressure-distributing equestrian seat cushions before considering more invasive options.

The encouraging news is that persistent symptoms do not automatically mean the situation is irreversible. However, determining whether this is related to scar tissue, sensory changes, nerve irritation, pressure distribution, or another cause requires a detailed examination by a surgeon experienced in labiaplasty evaluation and revision.

Michelle Jones Singer, MD · Answer

I’m so sorry you’re dealing with this. For someone who has spent a lifetime riding, I can understand why this would feel devastating.
What you’re describing can sometimes be related to scar tissue, changes in sensation from small nerves in the area, or even pelvic floor muscle tension that develops after surgery. The fact that you have both numbness and increased sensitivity makes me think it’s worth having a thorough evaluation by someone who specializes in cosmetic gynecology and labiaplasty revision.
I would also consider seeing a pelvic floor physical therapist who works with vulvar pain and sensory issues. They can sometimes identify problems that are not obvious on a routine exam.
One question I have is whether you had a trim labiaplasty alone or if a clitoral hood reduction was done at the same time. That information could be important.
And one thing I want to emphasize: just because the surgery looks good does not mean everything is fine. Function matters too. If riding has changed this much for you, your concerns are absolutely valid and worth investigating further.

Why do I still have discomfort horseback riding three years after labiaplasty? (Photo)

Answers (2)

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