Labiaplasty revision - will a trim without stitches remove bumpy edges? Is this a normal approach? (photos)

Dear Snapdragon1991
Thanks for sharing your photos and posting your question. Irregular bumpy edges can be an adverse outcome after edge trim technique labioplasty. All tissues after surgery will swell up and the surgeon doing this procedure should be experienced enough to leave allowance for the swelling when stitches are put in place. If you don’t do this, the edges will swell up and the stitches cause this lumpy edge.
The treatment would be either further trimming of the edge and stitching it carefully or maybe just trim the dome of these lumpy edges and leave it to heal with no stiches.
Looking at your photos, my opinion is to have the second option as you don’t have much labia tissue left behind. Removing further tissue from edge would cause size discrepancy between labia minora and clitoral hood.

Thank you for your questionSmall bumpy edges can usually be trimmed or smoothed without stitches. The little bumps on your left photo are often treated that way

It’s all about the suture technique! A trim or edge labiaplasty heals much quicker than a wedge labiaplasty and there’s much less likely chance of separation when an edge or trim labia plasty is performed. The rough, bumpy edge, however, is often related to the suture technique. In labiaplasty surgery there are baseball stitches and there are subcuticular or buried stitches. Labiaplasty should always have subcuticular stitches that are hidden under the surface. If baseball stitches are used, also known as a simple, running suture then you will have grooves, notches and even piercings where the suture material goes through the labia. Because the labia are so delicate, the subcuticular suture is really the only suture that should ever be used in this area. When the labia swell and a running suture is used, that’s really what causes all those notches and grooves. Find a surgeon who can do a subcuticular suture and you’ll have a perfectly smooth result and an invisible scar. Look at photos, reviews, and videos to make sure that your surgeon is experienced in labiaplasty, and has the results that you want to see for yourself.

The bumpy edges can be removed with a technique that is called feathering with radiofrequency. It is important that you contact an experienced cosmetic surgeon or urogynecologist that is familiar with type of procedure.

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. The reconstruction technique depends on the deformity. 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 eleven years ago. You need various reconstructive techniques to give you a good appearance. The bumpy edges on your labia can be improved by several techniques. Some doctors would trim the scallops and bumps, but I do not feel that is the best method. You can also have a combination of wedge excisions to remove most of the bumps with a little bit of a trim of the bumps. Another way is to take the excess skin from the sides of your clitoral hood and transfer it to lay on top of your labia minora, which would eliminate all the bumps. Fortunately, you have adequate clitoral hood to reconstruct your labia minora with these clitoral hood flaps, which I invented and published in that journal article. In this surgery, I take the remaining tissue of your clitoral hood and transfer it downward to create labia minora. I have done this surgery about 60 times with excellent results. The surgery takes about 3+ hours so it is not a simple office procedure. If any surgeon reduces more of your clitoral hood, you will be ineligible for this repair. 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

Trim labiaplasty doesn't cause bumpy edges WHEN IT'S PROPERLY DONE. I and most experts who have perfected the trim method don't have this problem with our patients. So, all that can be said is that your trim labiaplasty wasn't properly done. Fixing the bumps certainly can be done without stitches if you simply sculpt away the high points with any reliable ablative technology such as RF or laser. I'm not sure what your surgeon proposed, but that would leave you with a smooth edge.

Thank you for your post with photos demonstrating labial asymmetry and bumpy edges resulting from the way the sutures were used and left to dissolve over time. The problem isn't in the sutures, but in the surgeon's technique and length of time they were left in place.
You will need a curvilinear labiaplasty, but this will make your labia even smaller and then not be proportional with your hood. Your hood could use a lift for that optimal result.
I recommend you seek a second in-person consultation.

hello, my idea is to cut out the rough edges in revision surgery. Even if the clitoral hoodoplasty procedure is added to you in the same session, a much more satisfactory image will be obtained.

Thank you for sharing your question. A "before" photograph would be useful comparison to your current result but I do think you can improve your outcome with a revision trim but one which entails sutures being placed beneath the skin and not oversewing the edges in a pattern such as what would be found on a baseball.

hello. your problem cannot be fixed without using stitches. rough areas should be cut with a straight incision and sutured with 6/0 monofilament sutures. this way the problem goes away.