4 months Post-Labiaplasty and Clitoral Hood Reduction (TRIM METHOD) - Is a revision reasonable? Suggested course of action? (pho

I posted a question along with photos at week 10 of my healing, with concerns about the outcome. I was assured by my surgeon that only someone with a trained-eye could find evidence of work being done. Now 4 months post-op, I'm still very unhappy with the "scalloped" edges of my labia and don't believe the skin surrounding my clitoris was addressed properly. Could I benefit from a revision? What is my best course of action based on the results seen in the photos? Really appreciate your time!

Doctor Answers 9

Revision Labiaplasty Needed?

There are definitely some specific points that I try to make sure that my patients know about revision of the #labiaplasty. Revison surgery for labiaplasty may be requested to remove more tissue: make the labia more even;  correct over reductions; treat adhesions between parts of the vulva; improve the appearance of color, texture, and scars after previous treatment. Revisions are generally possible but, as with other surgeries, revision becomes more difficult than the initial first operation. You should wait at least 6 months for the initial surgery to resolve, so I would say keeping in touch with your surgeon during further healing would be the best option. Tissues need to heal and soften before they are re-operated upon. Hopefully your physician will work with you to ensure that your final result is what you were initially hoping for. Best of luck to you!

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

A fine-tuning revision is always an option

Scalloped edges can be sculpted off with well conducted revision procedure. Whether it's reasonable or not is dependent upon your goals, but it can certainly be made smoother.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.7 out of 5 stars 26 reviews

Revisions can always be done

BUT is your improvement drastic or subtle following your procedure?  And just how bothersome is the skin around your clitoris?  If its isn't impacting your intimacy and your function is normal. you do have to ask yourself is it worth the risk, costs, and downtime in pursuit of perfection... and would you be happier if improvements were made or only if it was perfect?  Being as critical as I can, the edges don't appear to be a major problem.  But there is some excesses around your hood but your third photo looks great!

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

4 mos. post-op linear LP with "scalloped" irregularity. Revision??

At 4 months post-op, what you now see is more-or-less what you will "get." The question to ask yourself:"...Yes, it's not 'ideal,' but can I comfortably and sexually live well with these results? Do I wish to undergo the expense and recovery of a major revision?"  If the answer is a qualified "Yes," then you would need a consultation (in-person or by phone with a file of quality, in-focus photos) with a surgeon who is well-experienced in revisions. In California, thet would be Dr. Red Alinsod in Southern CA, or myself up North. Also good is Dr. Otto Placik in Chicago, and Drs. Rob Moore or John Miklos in Atlanta, and I am sure there are others well-qualified. Check for EXPERIENCE, and price... For you personally, it looks like a carefully performed "skinning" WITH PROPER SUTURE CLOSURE (last time most likely the sutures were "through-and-through and were too large caliber (??4-0 "regular" Vicryl/..?)

Revision techniques that mat be applicable for you include a careful "skinning" linear transaction with SUB-CUTICULAR closure with minimally reactive material (6-0 Monocryl; 5-0 Vicryl Rapide), or a RF (Radiofrequency) "air-brushing re-finishing which includes a rather brutal recovery, but is all that will work if there is not enough labia to work with for the "skinning..."
Best wishes,
Michael P Goodman. MDDavis, CA, USA

Based on your concerns a small revision makes sense

A revision is indicated almost always just based on the concerns of a patient. In your case, a trim was done that:1. Left you with scalloped edges2. Caused indentations and creases from a baseball suture3. Did not reduce the clitoral hood properly
These are reasonable things to pursue with a revision, but I would make sure that your doctor can actually do this for you. You may need to find a true expert. The problem is that this will cost you as opposed to a revision with your doctor. For example, in the rare case that my patients need a revision, I do it free of charge, including the cost of any procedure associated fees. Free. Because it is a super rare occurrence for me given that I use the extended wedge technique. 

Adam J. Oppenheimer, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 200 reviews

Labiaplasty revision

I reviewed your photo.  You had a trimming labiaplasty. 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. However, you can definitely have improvement of your scalloping and clitoral hood area. 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 may need various reconstructive techniques to give you a good appearance, but this won't be known until all the swelling is gone. I  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

Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 21 reviews


Labiaplasty results vary but Trim procedures take longer to mature in general. I would wait a few months at least. Most get better.
Best Regards,
John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

4 months Post-Labiaplasty and Clitoral Hood Reduction (TRIM METHOD) - Is a revision reasonable? Suggested course of action?

Thank you for sharing your question and photographs.  The decision to pursue any surgery is a personal one and based not on what someone else sees but rather your own motivations.  I see your areas of concern and as you stated in your narrative you are unhappy with the results of your trim labiaplasty.  Your current outcome is unlikely to change on its own but both the scalloped edges and asymmetrical excess clitoral hood tissue could be revised to leave you with a result closer to your expectations.  See a surgeon with extensive experience in labiaplasty surgery and revisions in order to maximize your results.  Best wishes.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 reviews

Revision surgery

Dear User9850:
Thank you for sharing your information and photos.  I want to make this very clear:  "the best course of action is to first identify a surgeon who is skilled in revision surgery".  This is not  a matter of choosing a surgeon just because he/she is board certified!! Instead you must choose a surgeon who is skilled, has experience, expertise, and can achieve excellent results.   Revision surgery is an art and I encourage you to choose your artist carefully.  Often like the original surgery the best result occurs on the first surgery or the first revision surgery.  
When choosing a botched surgery specialist or a person who performs revision surgery you need to see before and after photos so you can assess their skills and artistic talent.  No two patients who have poor outcomes are exactly the same but by reviewing others who have had revision surgery you should be able to get a good idea as to the talent of the surgeon.  Please do not choose a surgeon based upon location or board certification.  I am a board certified ob/gyn and a board certified urogynecologist as well as a sub specialist in cosmetic vaginal surgery. This does not necessarily mean I achieve great results instead you should base your decision on my results and experience.  I wish you the very best in your care.  Sincerely
John R Miklos MD

Urogynecologist & Cosmetic Vaginal Surgery
Atlanta ~ Beverly Hills ~ Dubai

John R. Miklos, MD, FPMRS, FACS
Atlanta Urogynecologist
5.0 out of 5 stars 20 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.