7.5 wks post labia/vaginoplasty. Several questions re: pebbling, perineum healing, and this UGLY skin tag on my anus. (photo)

1 month post-op I engaged in sexual activity resulting in a torn perineum. It is now almost 8 weeks. I am worried about the pebbling on my labia & worried the perineum is not 100% healed. I saw my MD 2 weeks ago & he said I could have gentle sex next week. I now have this horrible ball of skin on my anus! It's not an old hemorrhoid & it doesn't hurt. I understand a dermatologist can remove it, but will it further delay my ability to heal & have sex? I am ashamed to let my boyfriend see.

Doctor Answers 8

Post-Op Healing and Sexual Activity

Swelling after #Labiaplasty is usually present for several weeks.  It’s possible that swelling can persist for two or three months. Firmness of tissue can remain for 4-6 months. Ice can help reduce swelling. Arnica and Bromelain may help.  Direct massage may be useful for swelling as well. Postoperative care will usually consist of sitz baths or soaking the area in warm soapy water starting approximately 2 days after a surgery.  The sutures will dissolve over the course of several weeks.  This will in part depend upon the #Labiaplasty technique used, the amount of bruising and they way in which your body heals. Patients return to most normal activities immediately after surgery with the exception of activities that will create direct pressure on the #vaginalregion such as certain exercise equipment and #sexualactivity.  It will be necessary to refrain from these forms of physical activity, including sex, for approximately 4-6 weeks. There is a possibility that sexual activity was engaged just shy of the complete healing process, causing your irritation. If you are still having problems with the surgical area it would be a good idea to visit your surgeon in person to have the area evaluated for proper healing and to make sure whether anything needs to be done to repair the issue. Best of luck!

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Trimming labiaplasty

I reviewed your photo. It appears that most of your labia minora were removed. 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. 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. 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

Pebbling and excess skin

I am sorry about your situation. The truth is that the irregularities of your labia (from trim labiaplasty) are a concern. They may get better over time, but they may not. The excess skin may also be trimmed, but the reality is that your result is not optimal. These and other results are the reason why I developed my personal technique to doing labiaplasties I call the True Labiaplasty. You can get more information on the link below. Good luck.

Robert L. True, MD
Grapevine OB/GYN
4.9 out of 5 stars 9 reviews

Trim methods of labiaplasty

leave results like yours with the pebbling and the fullness towards the upper incisions.  It may get better but its unlikely to resolve completely.  As for the torn skin, it should heal if you avoid any tension or trauma to the area.  Finally, the tag on your anus requires further evaluation as skin tags don't just pop up overnight and as mentioned by the other surgeon, is most likely a hemorrhoid until proven otherwise.

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

Post Vaginal repair concerns

Good Morning,Thank you for the photo and sharing your concerns. Any time there is trauma or other factors that disrupt surgical healing it does tend to take a bit longer to completely heal as compared to an uninterrupted surgical healing. Rest assured your perineum will heal completely but in order to help this I would recommend refraining from intercourse until it is completely healed. The labial pebbling may not go away however could "soften" over time.As best as I can tell from your photo it appears the "ball of skin on your anus" is more akin to a hemorrhoidal skin tag. I would have your surgeon evaluate this and if related to the surgery remove it. Wishing you the best moving forward.

Paul Pietro, MD
Greenville Physician
5.0 out of 5 stars 3 reviews

Post labia and vaginal rejuvenation

Ms Portland :
Thanks for sharing.  The perineal skin will heal as long as you refrain from intercourese. The pebbling on the the labia will not go away it may go down some but this is the result of your surgeons suturing technique.  I can see the bump and I would suggest it is a hemorrhoidal skin tag.........if it is not then it is the result of your surgery.  Ask your surgeon to remove it --if it result of your surgery. Yes it will delay healing and having sex.    
John R Miklos MD
Urogynecologist & Cosmetic Vaginal Surgeon
Atlanta ~ Beverly Hills ~ Dubai

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

Post labia/vaginoplasty

Hello, you have to give it time to recover from your surgery I think you started very fast intercourse after surgery two months is recommended to initiate sexual activity but the perineum is closing alone but you have to give it time that ball you say is an inflamed hemorrhoids treatment is yielding about eating lots of fruits fiber to avoid constipation.

Miram LucianoDominican Republic / MD

Miriam Luciano, MD
Dominican Republic OB/GYN
4.7 out of 5 stars 3 reviews

Your dermatologist doesn't remove hemorrhoids and your boyfriend doesn't care what your vagina looks like

Looks like a hemorrhoid to me and I've removed many of them. Even if it's not, it can be removed. I wouldn't let a dermatologist remove it just in case it turns out to be hemorrhoid and requires a little bit more work. As far as "gentle" sex, I can't quite grasp how reducing the speed of the action makes it any better from a healing standpoint. There's either sex or no sex, healed or not healed.

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