Would labiaplasty fix all that is going on or do I need multiple procedures?
Doctor Answers 7
A perineoplasty plus labiaplasty should help
Will I need multiple procedures for genital reconstruction?
A labiaplasty with a clitoral hood reduction will reduce your size. 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. If you have extra tissue on your clitoral hood, it can be reduced it 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.
Your labia majora have stretched which resulted in excess skin. In addition, they probably have lost some fullness. I suggest reducing the excess skin and maybe increasing the fullness with fat injections if there is a fat deficiency. The technique I use leaves a scar on the inside of the majora in the fold between the majora and the minor and clitoral hood.
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.
Labiaplasty fix all this?
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Labiaplasty, perineoplasty questions
Below is a patient who had labiaplasty and perineoplasty simultaneously.
Labiaplasty | Vaginoplasty | Perineoplasty
You will need an in-person consultation to sort out what might be best for you, likely some combination of labiaplasty, vaginoplasty or perineoplasty
To be sure, see two or more experienced, licensed and certified providers for a complete evaluation to make sure you are a good candidate and that it is safe for you to have the procedures.
I hope this helps.
Complex repair of perineum and labia
Thank for for providing good-quality photos that give me a decent idea of the "lay of your land" and what you wish to accomplish.
Both before and after babies, women present iin a wonderful array of shapes, sizes and appearances, and it is all "...normal." However, I can see where your individual anatomy might be bothersome to you.
Exactly what to do depends both on what specifically YOU wish to accomplish, the anatomy, and the skill, experience, and instrumentation of your surgeon. Although i am located in Davis, near Sacramento, I operate on many women from the SF Bay area, L.A. area, and Central valley, so I see many women "virtually" for a first appointment, either via telephone or Skype. As we consult, I look at several selected photos that show all the areas that are problematical, to decide beforehand approximately what will be done both for discussing, scheduling, and pricing purposes.
So, what about YOU, specifically? First off, and most importantly, since your anatomy and desires are highly individual and not just "...a simple labiaplasty, you would be best served by going to an experienced genital plastic/cosmetic surgeon who has done many cases and can show you many "before and after" photos of combined complex perineoplasty/labiaplasty combinations. Again, pending an in-person exam, my recommendations would revolve around exactly what is bothering you, If the redundancy of your outer lips, the labia majora, bothers you, a well-done vertical reduction would remove the redundancy. I would reduce the redundant skin below the vaginal opening with a cosmetic perineoplasty going down all the way to the anal verge, removing the anterior hemorrhoidal tag at the bottom (although that is the area that will bother you most during healing...). The bases of the labia minora (called the "posterior commisure") would be reduced most likely in a linear fashion, but I would withhold judgement on technique pending evaluation.
Most importantly: yours is a complex situation-- best handled by a surgeon who is well experienced in complex, combined procedures and who has done many and has either a laser or radiofrequency needle at his or her disposal so as to be able to "scroll" as indicated around the perineal redundancies.
Very best wishes!
Michael P Goodman MD