Tenderness/pain/sensitivity/fissures 6 months post-op - is revision possible for me?

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​. You had a trimming labiaplasty which resulted in pain and discomfort . At times, PRP (platelet rich plasma) and stem cells can reduce the pain, but not if it is severe. Frequently, removing the painful, damaged tissue and replacing it with normal tissue will eliminate the pain and improve the appearance. 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" over ten years ago. You may need various reconstructive techniques to eliminate your pain and give you a good appearance. You need a very skilled reconstructive labiaplasty surgery. Approximately 50% of the surgeries I perform are revisions of other surgeons' labiaplasties. I can get a better idea of what can be done if you send photos. 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

Hello,

Thank you for the question.

I'm sorry to hear that you have pain and discomfort issues following your labiaplasty and CHR procedure.

You are still in the early stages of wound healing, and there may be some improvement during intercourse over time.

I would also wait at least a full year from your original surgery prior to undergoing revision surgery because the wound healing takes up to 1 year to be completed.

I would definitely discuss your questions and concerns with your Plastic Surgeon or a board-certified plastic surgeon specializing in Labiaplasty procedures.

I hope this helps.
Best regards, Dr. Karanetz

Dr. Irena Karanetz
Fellowship-Trained
Board Certified Plastic Surgeon
Evolve Plastic Surgery
Queens, New York

Hello, first of all, get well soon. It is not normal for you to still feel these feelings and have tearing during sexual intercourse in the 6th month after the genital aesthetic procedure. If necessary, a revision operation can be performed after the examination. Six months is a suitable period for this. I wish you a healthy day.

Your result is not mature yet, swelling and fragility of tissues are mostly responsive for your discomfort. Injection of corticosteroid into the base of labia may decrease inflammatory reaction and take off some discomfort? Additional surgery will only make your condition worse. Discuss this issue with your surgeon.

This is a rare complication after labiaplasty (or any tissue trauma). I have had some success with injection of PRP or platelet rich plasma to help improve the tissue quality in the area. This doesn’t work for everyone, but it’s pretty low risk.

Dissolvable sutures would most likely be gone at this time, but some patients develop scar tissue around suture that can take longer to resolve. I don’t know that the laser is directly related to what is going on, but your surgeon is the best resource since he/she knows how aggressive the laser was and what type of suture was used.

ThanksDifficult to answer this question without seeing the before and after photos . It may help to wait a few more months. What type of laser did they use ?

Hello Habibi... While I would need a quality, in-focus photoset to give you a more in-detail opinion, YES, your situation can be helped. I see many women with issues of pain and fissuring. Treatment options depend on the individual situation. Often the issue is with neurogenic pain secondary to irritation of nerve endings, which can be well treated with topical neuroleptic medication, non-surgically. Sometimes a neuroma has formed, which might mandate a surgical approach. In your situation, with recurrent fissuring after work on the introitus and perineum, the issue frequently is recurrent tearing in the area of repair. The treatment is multi-focal, depending on the specific situation, and can involve several weeks of abstinence with perineal massage; administration of PRP to the area, and frequently a minor surgical procedure called a "reverse perineoplasty" along with administration of PRP (I prefer 2 administrations, one at the reverse PP; a second administration 4-6 weeks later...). Bottom line: YES, there is good treatment. The important thing is to consult with a cosmetic gynecologist with experience in treating your particular situation. While you may find someone "close to home," don't be afraid to "...travel" to find an experienced, competent practitioner who will carefully listen to you and who has the experience to offer you a choice of therapies. Many of us (myself included) are able to provide "virtual consultations" to evaluate your situation and offer you therapeutic choices. Do not despair: with proper treatment, you should recover 100%...

Very Best, Michael P Goodman, MD, FACOG, IF, AAACS. Sacramento, CA, USA