Labiaplasty - What technique if only One Side needs "work"?

Question

See attached. Asymmetrical. Only one side is too long. Don't think the other side needs anything done to it. Also, how "hooded" is my clitoris? I am strongly considering a clitoral dehooding as well. That said, what technique would you use for the labiaplasty, in combination with the dehooding? I am very concerned about sensation loss, as I get a lot of please from the general area around my clit, and am apprehensive about trimming because of that.

Adam J. Oppenheimer, MD, FACS · Answer

I didn't use to feel that way, but either technique in the right hands will work.you can do an edge removal and a separate lateral hood removal and stay very very far away from the clitoris.If you want to keep the normal labial edge and contour, I would use the wedge approach and one continuous incision. you can watch that exact surgery above in a lady I helped with the exact same problem on the same side.

Ryan A. Stanton, MD · Answer

Please keep in mind that an in person consultation with physical exam is first necessary before any final surgery recommendations are made. Nonetheless your story and concerns are in good company with almost ever other patient that undergoes labiaplasty and/or clitoral hood reduction (aka hoodectomy). Based upon your photos, your anatomy is very typical of someone who seriously considers having these procedures and experiences a major boost in (sexual) self-confidence and pleasure thereafter. Labiaplasty, which most commonly involves surgical reduction of the labia minora (inner/thinner lips) but not infrequently trimming or tucking of the labia majora (outer/thicker lips), has become a relatively common procedure over the last ten and even more so last five years. Most commonly it is done under light sedation (aka twighlight sleep) with local anesthesia, in which case the patient should feel no pain during the operation. Whether the surgery is done using a laser, scalpel, or scissors does not really matter but what does matter is "symmetry". Symmetry is the most important aspect to the final aesthetic result. Most women, just like yourself, prefer to have as much of the darker pigmented edges removed as possible. Also, it's not how much tissue is removed but how much is left remaining because a certain amount is necessary to maintain proper form and function - typically ~10 mm or so of the dry part of the labia. Finally, I have found the scar along the edge of the labia after "Trim Method" to be much more imperceptible compared to the scar running perpendicular through the entire labia minora after "Wedge Method". Thus to achieve these four most important elements, I have found that the Trim Method satisfies best.  One unique potential complication after Wedge Method is that the clitoris gets pulled downward which sometimes is annoying and sensory changing to women.  Thus it is extremely important to consult with a board certified plastic surgeon that specializes in this operation (does at least 1 - 2 per week). It may cost you a bit more but it is this type of result you will want to live with for the rest of your life. Typical (all inclusive) fee at my office/surgery center is $4500. Although there is no guarantee, women frequently do seek clitoral hood reduction (Hoodectomy) to improve exposure of the clitoris and hence better stimulation during sexual activity. By removing some of the excess &/or redundant skin concealing the clitoris, it becomes more readily exposed to sexual stimulation and hence a heightened sexual experience/orgasm is possible. Sometimes I recommend adding hoodectomy to labiaplasty to better harmonize the aesthetic outcome. Again, the key is seek consultation with a board certified plastic surgeon or gynecologist who performs this procedure regularly (>2-3 x/month) so that just the right amount of tissue is removed and just the right amount remains such that the clitoris is not constantly exposed and rubbing on clothing, etc... Typical fee for a hoodectomy is ~$3000 but reduced to about half that price if done along with a labiaplasty. Now for recovery, because the labia tissue is so robust with blood supply it has an amazing ability to heal relatively quickly. Most patients are sore for 4-5 days before things start to get a lot better from there. Some patients can resume work before this time depending upon their occupation. No exercise for two weeks, no baths/jacuzzi or swimming for 3 weeks, and no sexual activity for typically 4 weeks. My patients are given an oral pain medication such as Vicodin or Percocet but icing the area for the first 48 hours and applying some custom made take-home topical local anesthetic cream seems to work the best. Glad to help.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

If you dislike the hood, then you need to do both sides because they look equally baggy. However, the excess is mild and hood contouring is optional. A linear sculpted labiaplasty of the left side would give superior results and greater symmetry than all other approaches if you limit the work to one side only. A wedge would pull the left side of the hood downward and leave you with a crooked hood. Don't concern yourself with the loss of sensation with an expertly performed procedure; it doesn't happen with trimming - it happens with any technique done by a non-expert. Also, don't use the term unhooding - that's a procedure to expose the head of the clitoris and is only done to treat disease usually cancer and is certainly not what you want. You want hood contouring, not unhooding.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Based on your photographs, you do have some moderate asymmetry which I think could be corrected or improved with surgery. In my hands, I think a small wedge on the larger side with a possible extension vertically to address hood excess would produce excellent results. Hope this helps!

David Ghozland, MD · Answer

Thank you for sharing.   Based on the pics I would recommend either a trim or wedge.  The technique is only as good as the surgeon, so please make your selection carefully.  I would also recommend a small resection lateral to the clitoral hood to optimize and achieve the best overall look.

Labiaplasty - What technique if only One Side needs "work"?

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Answer: Labiaplasty - What technique if only One Side needs "work"?

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Labiaplasty - What technique if only One Side needs "work"?

Answers (10)

Answer: Labiaplasty - What technique if only One Side needs "work"?

Answer: Labiaplasty - What technique if only One Side needs "work"?

Answer: Technique for unilateral wedge labiaplasty resection

Answer: Technique for unilateral wedge labiaplasty resection

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Everything you need to know about Labiaplasty

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