I had labia reduction surgery 9 days ago on the NHS. Cut downwards but it's been cut across and I don't understand why? (photos)

Also random pieces of skin that Im not sure what they are. I went to the hospital and my surgeon was unavailable but I saw another surgeon and he told me it's infected and iv been given antibiotics. I asked why it's been cut the way it has and he says he doesn't know as he wasn't involved in the surgery and told me it will heal fine. I'm really worried because it doesn't look like it is going to heal can you please tell me why it's cut this way and what the random pieces of skin are. Thank you!

Doctor Answers 7

Wedge resection breakdown

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I am sorry to hear of your post operative results but you are suffering from a wedge resection breakdown. These are not that uncommon -- and this can be noted by just following this website where there are wedge resection breakdowns as well as botched labiaplasties by using either the wedge or the linear resection.   The most likely reason this has occurred is that your surgeon lacks experience.  If the breakdown was limited to one side then I would say this was unfortunate complication of surgery but having both sides breakdown is indeed rare and most likely might have something to do with technique utilized in the repair.  You will most likely needs a revision in the future, please choose a surgeon who has experience in these types (labia revision surgeries aka revision of botched labiaplasties).  Your next surgery is crucial and you should choose your surgeon wisely, you want to minimize the chance of a 3rd or 4th surgery.

John R Miklos MD

Atlanta ~ Beverly Hills ~ Dubai

Wound separation of your labia

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has occurred and it will heal but you're going to have a notch.  You had more swelling on that side right after surgery and I would speculate you may have had a hematoma as well but its speculation and doesn't change your outcome.  Your wound separated for whatever reason it did and you will need a revision to correct the notch that will develop.  You must allow this to heal (6 months seems to be the textbook recommendation) and then talk to your surgeon about revisions.  It should have a good ending.

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

I had labia reduction surgery 9 days ago on the NHS. Cut downwards but its been cut across and I don't understand why?

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Thank you for sharing your question and I am sorry to hear of your wedge labiaplasty breakdown.  Whether due to the infection, or having too much tension on the repair, your incisions have separated and will likely require a revision procedure to achieve a result you want.  Be sure to see a labiaplasty surgeon for your next procedure in order to maximize your result. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Second botched wedge labiaplasty of the day is worse than the first

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Your wedge labiaplasty scars have torn apart. Wedge labiaplasty scars are the weakest of all labiaplasty scars and have a high risk of separation especially if the surgeon lacks expertise. Judging by the story that this was done for free under the NHS, you got what you paid for. There is no infection, just a clueless assessment from a non-expert in labiaplasty. Wait six months to get a revision. This will not improve. Antibiotics won't help.

You get what you pay for!! The "botches" usually happen on procedures covered by NHS or insurance w/inexperienced surgeons!

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You'll have to wait for total healing (will take 6 months) before a REAL plastic or cosmetic gyn surgeon can evaluate whether or not it can be "fixed". NHS and general ob/gyn surgeons usually = "botch." You are the victim of "Unintended Avoidable Female Genital Mutilation." Sorry, but it's true...  Go only to an EXPERT for revision as you will not have another chance. I am saddened by your predicament. See weblink and other areas on website for more info. LOTS on the blog!!

Best wishes,

Michael P Goodman, MD

Davies, CA, USA

I had labia reduction surgery 9 days ago on the NHS. Cut downwards but it's been cut across and I don't understand why?

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Thank you for your question and photos. You had a wedge resection labiaplasty and complete separation is extremely rare. This is a technical error from your surgeon's part. In the first photo, you have a hematoma which places more stress on the suture line and if your surgeon took out too much tissue, this places tension on the suture line as well. All this leads to wound separation which you experience on both sides. You do NOT have an infection. I never saw an infection in a labiaplasty in over 15 years that I'm doing it. The wedge resection technique that your surgeon did, gives the most anatomic result with a normal, non scarred labial edge if it is done appropriately. You will heal with a split labial edge which will need to be repaired at a later date, usually 3-6 months out. This can be done under local anesthesia with no discomfort or pain. See a board certified plastic surgeon or gynecologist with experience in repairing complications from labiaplasty. Remember, not all plastic surgeon or gynecologists are well trained in these surgeries. Good luck.

Bilateral wound separation following wedge resection labiaplasty

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Sorry about your experience with what should be an exciting time for you. There are several reasons why this has happened, but most likely your NHS surgeon isn't experienced in cosmetic Labiaplasty procedures. It is very unlikely that he performs 2-4 of these per week to have achieved the competence and experience to provide proven results. The technique itself, wedge resection, is associated with a high risk of wound separation because of the tension that is placed on the suture lines.

It's hard to tell what you refer to as random pieces of skin, but I do see redundant lateral prepuce (hood), bilaterally, that should have been reduced to achieve the best aesthetic outcome. I'm sorry to say, but you got what you paid for, which I believe is nothing within the NHS system.

You will need a revision by an experience cosmetic vaginal surgeon with experience in revision Labiaplasty and hood reduction. You will likely need to travel. See link below regarding information for traveling patients who travel from outside of the state and country to have their surgery.

Best of luck, 

Oscar A. Aguirre, MD
Aguirre Specialty Care - Pelvic Surgery & Intimate Aesthetics®

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 39 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.