Labiaplasty post-op hole along suture line. Will it heal? (Photo)

Question

Exactly 3 weeks post op today. The same thing happened on the right side and the surgeon put 2 stitches in a week after surgery. The hole on the left side appeared just 10 days after surgery and if anything, seems to be getting bigger (0.5-1cm in diameter now). Sutures have come out since. It now appears quite deep, and the edge is not straight or smooth. He seems to think it will heal over time and gave me 2 options - leave it alone, or put in 2 dissolvable stitches. What should I do?

Gary J. Alter, MD · Answer

As the inventor and innovator of the wedge technique in 1994, I reconstruct many women who have had labia reductions by other surgeons, both wedge and trimming techniques. The hole in your labium will not close.  However, no attempt to revise your it should be done until you are at least five months after your past procedure so that the swelling is less and the tissues have a better chance to heal. You need to control your anxiety and wait. The reconstruction is 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, NYC

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

Suturing at 1 week or 3 weeks is pointless. It won't heal closed because there are layers of healing skin in "the hole" that won't adhere to each other unless all of the healing layers are removed (debrided). Let it heal open and wait six months for the healing of all the layers to complete, then get a revision if you think it doesn't look right.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs. At three weeks I would counsel patients to leave the area alone, follow local wound care instructions and allow your body to heal this area fully.  Sutures are unlikely to provide improvement because of the healing and swelling that is already present in the tissues, they simply will not hold.  Once your results mature over 5-6 months you can evaluate your result to assess the possible benefit of a revision.  Hang in there!

John R. Miklos, MD, FPMRS, FACS · Answer

Dear Mistyc:I have performed labiaplasty routinely for 17 years and between my partner and I have performed approximately 2000 labiaplasties.  It is my experience adding a suture more than 24 hours after the initial surgery is not helpful.  Now I would not argue with a surgeon who said "Well lets add a couple of sutures " after 24-72 hours after the original surgery  but in my opinion rarely is ever is going to help. You are 3 weeks post op - though nothing in this world is 100%  it is highly highly highly unlikely adding sutures now is going to help. If you were my patient I would counsel you to: 1) keep your hands off of the area ie don't pull on the area ( I am sorry I don't mean to be rude as it is a natural tendency to inspect multiple times a day) but looking at the area is not going to make it heal faster.   Being a patient in your situation is very hard and anxiety provoking so I understand the desire to inspect 2) allow the are to heal on its own  and 3) don't waste time, energy or anxiety of putting in sutures.  The reason why it will not heal back together at this time is because the suture line split and the newly cut/split edges are no longer touching one another to heal together ( ie the breakdown of the initial repair).  At this point since the raw cut edges can't heal together the body starts the healing process on each cut edge individually and this process starts by laying a new layer of inflammatory / healing cells on the  now independent cut edges which are no longer healing together.  What you have now are 2 separate cuts on each side of the labia healing independently.  Your body is trying to heal each cut and once a layer of healing tissue covers that raw edge the it is not longer raw and will no longer fuse to the other recently cut edge.  The edges need to be raw to heal and fuse together. At 3 weeks post operative there is not way your edges are fresh/raw. Just look at your own photos.  Not raw edges will not heal together.  Example there are no raw edges or wounds in the palms of both of your hands.......... I can't just suture your hands together and hope they will fuse-----impossible unless you had a rawness on both sides.  Even if one hand had a ulcer or wound and we tied your hands or sutured  your hands together it will never stick together or heal together.  So again my opinion is don't waste the time, energy or anxiety of getting more sutures. Allow it to heal and then wait 5 months ( with a wedge resection ) and find a surgeon who is skilled in revision labiaplasty surgery and travel if you must for their care.  Choose a surgeon with experience, expertise, a great reputation as well as one who can achieve great results.  Best of luck !!John R Miklos MDAtlanta ~ Beverly Hills ~ Dubai

Ozgur Kartal, MD · Answer

You underwent labiaplasty surgery with wedge resection. Most of the stitches are opened in labiaplasty surgeries performed with this technique.
These holes do not close by themselves. Holes can be closed with revision labiaplasty surgery 3-4 months after your surgery.

Robert Drielsma, MBBS, BSc, FRACS · Answer

Your appear to have had a wedge labiaplasty procedure.  This can lead to troublesome complications when would breakdown occurs and this is why I favour the trim technique.  You need to discuss further the likely course with your surgeon but I would agree operative repair is the best option.

John P. Di Saia, MD · Answer

Hello,I would lean on following your surgeon's advice as he is your doctor. We can't examine you except through images which is quite crude particularly in early post-operative cases. Discuss the risks and the benefits of your options with your surgeon and make a decision. Best Regards,
John Di Saia MD

Carmen C. Munteanu, MD, FRACS · Answer

Thank you for your question and for the photos, it takes a lot of courage to not only go through surgery, but also to share the experience. The labia tends to heal very fast and once you have such big distance between the wound edges the chances to coming together are very limited. So healing will occur, and it's progressing now, but the left side contour looks different than the right, and the straight or smooth contour does not look likely, as you correctly said. One week after surgery, restitching ,with appropriate approximation of the wound edges can be successful, not at three weeks. Sometimes it's better to wait, let the area settle and then revise for the shape correction, after about 3 months. The surgeon who not only performed the surgery but also reviewed you after would be able to assess whether these is a role into refreshing the wound edges and reapplying stitches earlier, however it might be that a layered repair would be more effective than a two stitches operation.

Heather J. Furnas, MD · Answer

From your photos the repair appears to have separated, leaving the hole you describe. In general it is best to wait to reconstruct the labia, typically six months or more. Reconstruction can be difficult, and if one attempt fails, a second attempt becomes even more difficult. You may want to seek a second opinion from an experienced labiaplasty surgeon before embarking on reconstruction.All the best.

Jeffrey S. Palmer, MD · Answer

Thank you for your question and sharing your photographs. Swelling is common after labiaplasty with the amount dependent in part based on the time since surgery.  The final result will be seen after several months, which at that time a revision labiaplasty can be performed. Genital reconstruction can be more challenging than the original labiaplasty.  I would recommend finding an experienced reconstructive genital surgeon, which include Cosmetic Urologists, even if it involves traveling.  There are several types of surgeons who promote themselves as performing labiaplasty, but a Cosmetic Urologist can offer unique qualifications compared to plastic surgeons, gynecologists and general urologists. Cosmetic Urologists typically have both extensive training and experience in both cosmetic and reconstructive genital surgery.  Some surgeons offer virtual evaluation through encrypted services, which is an option prior to traveling to meet the surgeon for consultation.  
Best of luck.   
  
Jeffrey S. Palmer, MD, FACS, FAAP (COSMETIC and RECONSTRUCTIVE UROLOGIST -- Cleveland, Ohio)

Labiaplasty post-op hole along suture line. Will it heal? (Photo)

Answers (12)

More Labiaplasty Questions

Help! Labiaplasty infection? 4 days post.

5 weeks post labiaplasty healing. I have lumps. Will these fade?

Labiaplasty 4 months after - unhappy with the result! Bumpy and too big clitoral hood/clitoris (Photos)

1 month post op, still in pain. Right labia is all gone and my clitoris is sliced where stitches were! Can I fix this?

My right labia is missing, and I am in pain and my clitoris hurts me. I can't walk normally. Is this normal?

Physical exercise after labiaplasty?

WE SEND PRETTY
EMAILS