Any way to prevent bad scars after labiaplasty?

Is there anything I could do throughout the healing process to ensure that I won't have visible scars from labiaplasty? I had the wedge method 5 days ago and the sutures are hard and raised. I'm worried this will leave a hypotrophic scar. Any suggestions?

Doctor Answers 8

LABIAPLASTY: POSTOP SWELLING

Thank you for your question.  Swelling is common after labiaplasty with the amount dependent in part based on the time since surgery.  The final result will be seen after several months, which at that time one can evaluate if a secondary surgery would be recommended.  I would recommend contacting the surgeon who performed the original surgery to evaluate your current condition.  If you wish to be evaluated for a secondary procedure, I would recommend an experienced cosmetic genital surgeon even if that requires traveling.   

Best of luck.     

Jeffrey S. Palmer, MD, FACS, FAAP (Cosmetic Urologist -- Cleveland, Ohio)


Cleveland Urologist
5.0 out of 5 stars 4 reviews

Scars after labiaplasty

A labiaplasty with a clitoral hood reduction can reduce your size. The choice of labiaplasty techniques and the surgeon determine the scars after labiaplasty. However, it must be performed by a surgeon with experience. One of the two most common labiaplasty techniques is the central wedge technique, which I invented in 1995 and published in the plastic surgery textbooks. It is also known as the "V" or wedge technique. Gynecologists and most plastic surgeons perform a labioplasty very differently. They essentially trim the labia minora (inner vaginal lips) and leave a long suture line instead of the normal labial edge. Their technique is the same whether a scalpel or a laser is used. In contrast, the central wedge removes triangles of tissue and bring the normal edges together. Thus, the normal labial edges, normal color, and normal anatomy are preserved, but the darkest labial tissue is usually removed. The scars with the wedge labiaplasty can be virtually invisible.  If you have extra tissue on your clitoral hood, it can be reduced at the same time. Your clitoral hood is thick, wide, and protuberant.  It can be decreased somewhat by reducing the sides.  I pioneered a clitoropexy with clitoral hood reduction in which the clitoris is pushed closer to the pubic bone and the width, thickness, length, and protuberance of the clitoral hood can be decreased. I have done it over 250 times with excellent results.  No matter the technique, an inexperienced or unskilled surgeon can lead to a high rate of complications, chronic scar discomfort, labial deformities, and further surgery.

Gary J. Alter, M.D.
Beverly Hills, CA - Manhattan, NY

Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 20 reviews

How to prevent scarring and "grooving" after labiaplasty.

Prevention of scarring and grooving after labiaplasty depends entirely on your SURGEON'S TECHNIQUE AND CHOICE OF SUTURES In my opinion, if your surgeon uses a fine monofilament delayed absorbable suture such as 5-0 Monocryl "underneath" as a ":scaffolding" taking pressure off the skin sutures & eliminating "dead space" to prevent hematoma formation, and uses a fine short-time absorbable skin suture such as 5-0 Vicryl Rapide, which dissolves in 2 weeks, and uses proper suturing technique, you will not scar.


What is good technique? For a linear/trim, taking one's time and placing a careful "sub-cuticular" suture line is best, and will give a non-existent scar. For V-wedge modifications, it is best to use interrupted sutures (5-0 Rapide), using "mattress sutures" generously to prevent "rolling" of the edges. The use of a running suture, especially if it is "chromic" or plain 4-0 or 3-0 "Vicryl" leads to scarring, as these sutures stay in place 4+ weeks and can lead to permanent grooving, especially if they are put in too tight.


**IT IS NORMAL for your suture line to be tight, irregular, and firm/"rubbery" for the firts 2-5 weeks of your recovery. Nothing specifically you can do now except, of course, stay off your feet for the first 1-2 weeks!!


Best,


Michel P Goodman, MD


Davis, CA, USA

Any way to prevent bad scars after labiaplasty?

Thank you for sharing your excellent question.  Because of the thin nature of the labia minora tissues, as well as the mucosal surface along the inner aspect of the labia, incisions tend to heal very well and with little risk of a hypertrophic scar.  Whether due to the suture technique, or soft tissue swelling, the incision start raised and thick but will soften and flatten over the next 3-4 weeks. Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Labiaplasty scars

Hypertrophic scars are due to bacterial and or fungal overgrowth in the scars so pretreatment with antifungals and the correct antibiotics prevent hypertrophic scars.  I have not had any poor scars in 25 years of labiaplasty most likely due to the above.

Susan Kolb, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 23 reviews

Scars

I have never seen a hypertrophic scar in this area.  As long as you follow your surgeon's post operative instructions, you should heal well.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 55 reviews

Scar hypertrophy is extremely rare on the labia

Swelling is common in the first week and distorts everything. It should improve quickly. I've never seen a hypertrophic scar in over two decades doing this type of surgery.

Preventing bad scars after labiaplasty

Fortunately mucosa skin tends to heal well without thickening. Scars of the mucosa can widen and be more noticeable if the wound separates or tissue dies, which is why it is important to follow your surgeon's instructions. Scar gels and tapes are intended for regular skin, not mucosa. 

For more information about labiaplasty, click on the link below. 

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 29 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.