Botched labiaplasty - can these issues be fixed in revision? Please help! All answers appreciated !!

Dear Genuine833772
Thanks for sharing your photographs and asking your question. I am really sorry that you had an unsatisfactory outcome after labioplasty. Your observations are very true. Looking at your photographs, it seems you had excessive amount of labia minora tissue removed. This is a very easy mistake to make if you are not careful as a surgeon. Labia minora has multiple functions in women and therefore amputating it is not a good idea. a good labioplasty results mean that even with legs spread open, the inside of vagina should not be visible. My opinion is that you may benefit from reconstructive surgery to improve your vulva closure. The type of surgery depends on availability of local tissues which could be determined after a clinical examination. I hope you find this explanation useful.

Thank you for your questionThere are actually two pairs of inner labia: a lower pair that inserts into the clitoris and an upper pair called prepuce which forms the hood that frequently inserts into and may distort the lower pair. Typically the excess prepuce needs to be removed to effectively treat the lower pair. Your photos show the prepuce was not attended to and the intralabiall crease is not well demonstrated. I would be interested in seeing how removing the excess prepucial folds , which looks like what you are calling rippling, would significantly improve results. As to the fusing of minors and majora, it is difficult to evaluate the intralabial crease with the photographs presented. It would appear there are corrective options but this will require an on site evaluation.

Hello, flaps from the clitoral area will reform the inner lips, this is a very precise surgery and needs good after care also. as you had the labia major reduction the entrance of the vagina is separated from each other.after the correction of the inner lips with the flap, I would do a thread placement to reshape the entrance of the vagina. Hope this advise finds you well. Best

HI genuine,

The only way that I see to correct the tightness between the labia minora and labia Major would be to do full thickness skin grafts in the crevice between the 2 structures. These are not difficult to do but it is difficult for the grafts to take or heal due to the friction in this area.
Please see an experienced surgeon who specializes in skin grafts in your area.

Good Luck and Best Wishes,

Dr. Christine Rodgers

Hello,
Thank you for your enquiry. The photographic information is very helpful.
Within the first 6-9 months following surgery, there can be some distortion due to swelling. This often gets better with time. If your surgery was fairly recently, I would wait for 6-9 months first. Regular massage can help with swelling and rippling from scars. If you are beyond that time and if scar massage has not helped, it might be possible to deepen the fold or to use flaps or skin grafts to give you more tissue.
I would suggest to confirm this with your surgeon.

As I understand from your photos, you have had labiaplasty with edge resection. The part we call the foreskin around the clitoris has not been intervened.
The skin around the clitoris, which we call the foreskin, and your inner lips can be reshaped.

The ligament separating the labia minora and majora is still intact. I would first try a hyaluronic acid filler to provide more volume to the majora which will push the minora closer together and help reduce the amount of labial separation when you open your legs. If successful a fat transfer can be done later as a permanent fix.

Hello Friend from the U.K.; Your question is complex. I suspect that you did not view your vulva this closely or critically prior to your surgery; you now are closely looking critically at every nook & cranny, which is common after vulvar aesthetic work, and are critically focusing on every detail. Can there be a revision to get appearance closer to your standards. Of course there can be, but 2 things are important: # 1: only work with a surgeon well experienced in both primary and revisional LP, and #2: Understand that you will never accomplish every detail of what you comment upon. Labia have normal "folds," irregularities, and traction forces that are different from woman to woman. You will never look "exactly" like your ideal photo. Design overall, especially for revision, is an honest "negotiation" between patient and surgeon, endeavoring to result in an outcome that you can "live in," while probably not exactly like the ideal picture you present. You will need a "virtual" (phone; facetime; Zoom?) consultation with an expert to more critically answer the legitimate questions that you pose. Warm Regards, Michael P Goodman, MD, FACOG, IF, AAACS. Davis, Northern CA, USA