Is this normal for post op Labiaplasty to look like this? (photos)

I had a labiaplasty done on Jan 23. I have sent pictures to my surgeon and he says to give it more time, but I am still concerned. On both sides of my labia the incision lines are not well approximated, to me they look sloughy. It is also still very painful. I am doing 2-3 sitz baths a day and applying fucidin ointment after each. Are there any other recommendations that you can make? Should I be letting it air out, still icing frequently? Any other tips? Thanks

Doctor Answers 14

Extended Wedge Separation

From the photo, it looks as though your suture line up to the clitoral hood region has separated. You basically have a soft scab in that area. The only thing to do is apply vaseline and/or bacitracin and allow the area to heal. Just like a scab in a swimming pool, moist scabs look yellow, though they are rarely infected. If you need a revision, you'll have to wait 4-6 weeks before you can pursue anything to allow the tissues to fully heal.

Post-op labiaplasty

Dear sarjones_76,

Early post labiaplasty there is often irregular edges to the mucosal surface with tremendous amount of swelling and distortion. Bruising and swelling will make the labia minora look quite unnatural.
Over 3-6 weeks this generally settles and by 6-12 weeks a more normal labia majora to labia majora relationship is established. As long as the skin excision and modification of the labia minora was done proficiently and precisely you should achieve an excellent result.

I would certainly visit your operative and certified plastic surgeon to ensure that all is healing well, watch out for fevers, chills and increasing pain as this may be a sign of infection. Complications like infection following labiaplasty are extremely uncommon so be vigilant and visit your operative surgeon.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 83 reviews

Wound separation/infection?

Hello,

Unfortunately I would agree with the comments below that sitting in water- sitz baths is not something I advise and in fact I ask my patients to avoid sitting in baths/pools etc. for at least 1 months post op. Typically, incisions heal well without the need for fucidin or other topical medications and these in fact can impair normal healing. I recommend that you have this evaluated IN PERSON as you may have an infection.

All the best

Ouch

Thank you for sharing your pictures and description. Although you are in the immediate healing process and it is common to experience swelling and bruising. I would strongly suggest an immediate evaluation by your surgeon based on the pictures you have submitted. There may be an underlining infection that needs to be treated.

Is this normal after labiaplasty to look like this?

Dear Sarjones_76,

This does not look like normal post-op healing.  With increased redness, swelling and pain, it is likely you have an infection and need to be seen by your surgeon right away and treated with antibiotics by mouth.  Wound care products like Skintegrity can also help with healing and scar reduction in addition to the antibiotics.  Antibacterial and numbing spray is available over-the-counter called Dermaplast, which I recommend to my patients to reduce the risk of infection and help with pain.  Anti-inflammatory meds like ibuprofen and ice can help, as well as Sitz baths at this point using mild anti-bacterial soap (1-2x/day) in lukewarm water for 10 minutes.

The swelling should start to go down once you are properly treated and will take at least 4-6 weeks to look more like normal.  By three months after surgery you should have a good idea of your final result, and at that point, you can address any revisions that you feel need to be done.

I wish you the best in your recovery.

Sincerely,

Dr. Troy Hailparn

Troy Hailparn, MD
San Antonio OB/GYN
5.0 out of 5 stars 27 reviews

Is this normal for post op Labiaplasty to look like this?

I have a few issues with your situation. First of all, why has your plastic surgeon not seen you in person? Second, from your photos it does not look like you area healing normally. I do not allow my patient to soak for several weeks after surgery. This mean no baths and therefore no sit baths. I also don't use any ointment on the wound and only allow the patient to gently rinse with soapy water in the shower - no wash cloths. Pat dry when get out. No tampons or sexual intercourse for 4 weeks. 

Improper postop care after labiaplasty

STOP. Think. and check with your surgeon in person.  No tub baths or sitz baths or swimming or hot tub use for at least two months after labiaplasty is what I instruct my patients.   Water will cause maceration of tissues, dissolve absorbable sutures and cause exactly your problem.   If your doctor recommended sitz bath treatment after labiaplasty, see another doctor.  You likely have wound separation and infection.  Get a culture swab, start using the right antibiotics and antibiotic ointment.  You are more likely than someone without this "pickle" to need touch up surgery to obtain the optimum cosmetic result.

It will take months before you will know for sure.... but follow closely with your surgeon or another trusted doctor who is expert in wound care until you obtain resolution.
Hope this helps.

Steven Yarinsky, MD
Albany Plastic Surgeon
4.8 out of 5 stars 17 reviews

Sitz baths and regular antibiotic ointment application to labiaplasties post-op = wound separation!

What NOT to do in the first 10 days after labiaplasty:
1. Sitz baths
2. Regular application of antibiotic ointment (it's too occlusive...)
3. Frequent "looking/touching/tugging..."

If your surgeon told you to do this, he/she messed up. If you did it on your own, you were "misguided."

The only saving grace is that vulvas are very forgiving, and all may heal well, but you will need to wait another 6-8 weeks to appreciate the final outcome. If you need a "re-do," it is not advisable to re-operate on the area until at least 4 and probably 6 months after your original surgery, so that the area has a chance to re-vascularize & heal properly. While icing is quite helpful for 3-5 days after surgery, I do not recommend it ongoing! (certainly not after the first 5 days or so...)

Don't immerse, pull/.tug or regularly apply antibiotic ointment to newly done labiaplasties, folks! The webkink below discusses the risks of genital plastic/cosmetic surgery.

Best wishes for a full recovery!

Michael P Goodman MD

How to destroy your labiaplasty results with Sitz baths:

The military term for your state is SNAFU. The absolute worst thing you can do after labiaplasty is to soak it in warm water and let the tissues soften up. Doing this 3 times a day is a recipe for wound separation as you've learned the hard way. The labia are delicate. Soaking them in water, not only softens the skin, but it increases blood flow to the area which causes it to swell and put tension on the stitches. Tension + soften skin equals...you guessed it: wound separation. Managing superficial wound separations is simple: keep them clean and keep them moist. Clean with gentle antibacterial soap (dilute hibiclens) twice daily) and moisten with vaseline or aquaphor. Avoid antibiotic ointments. The wounds will heal and contract, but they cannot be sutured back together. The risk for infection is minimal unless you are a smoker or diabetic.

Labiaplasty not healing well

Thank you for asking about your labiaplasty.
  • This is your 11th day after surgery.
  • Your wound edges have not healed but have separated 
  • The labia look pink and swollen, suggesting a possible infeciton.
  • Sitz baths are a good idea.
  • Generally ointment is not put over open wounds - it slows healing.
  • Open wounds usually heal well with moist dressings and regular washing with water, not soap.
  • Icing is unlikely to help and the cold may damage the tissues.
  • Your surgeon should be the one in charge of your care and should see you without delay. 
  • If you had surgery out of town, please see your OB-GYN, your regular physician or seek emergency care.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

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.