What kind of concerns should I have regarding labiaplasty?
Doctor Answers 6
A labiaplasty must be performed by a surgeon with experience. One of the two most common 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. 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.
Gary J. Alter, M.D.
Beverly Hills, CA - Manhattan, NY
Your story and concerns are in good company with almost ever other patient that undergoes labiaplasty and/or clitoral hood reduction (aka hoodectomy) and experiences a major boost in (sexual) self-confidence and pleasure thereafter. In a multi-center peer reviewed study I was involved in back in 2009, 98% of labiaplasty patients were satisfied with their results and had an improved sexual experience post-operatively.
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. To achieve these three most important elements, I have found that the "Trim Method" satisfies best. 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.
It can seem like a daunting task to be sure that you select the right surgeon for your procedure. Look for someone that has pictures that you like but don't judge it on one or two pictures. The surgeons with the most experience have lots of B&A pictures and most likely many testimonials to speak for their work. Don't go for the cheapest either. Since this is a procedure that you have to pay for and it's permanent, best to pick someone you feel totally good about. It's the surgeon's job to give you the best looking job, and then it will be up to you to take care of yourself during the healing process for the best possible outcome. Good luck in your decision.
Dr. Jennifer Hayes, DO, FACOOG
Cosmetic Vaginal Surgeon
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How to spot a labiaplasty expert
Ask to see lots of before and after photos. If you don't like the after photos, you probably won't like your after photos either. Don't be impressed by diplomas and degrees if the photos don't look good. Make sure the clinic is clean and that the surgeon is reachable to see you and address your concerns after surgery.
Experience, Images and Reviews
Good questions. :)
You want to look for actual experience doing this operation in the form on images of your prospective surgeon's patients "Before and After" as well as reviews online if possible.
John Di Saia MD
What kind of concerns should I have regarding labiaplasty?
Thank you for sharing your excellent question. There is a wide variation in the size and appearance of a women's anatomy, but some women may have, or develop, enlarged or asymmetrical labia that can make exercise, sexual intercourse, or wearing certain types of clothing difficult. In these instances, a labiaplasty allows for a reduction in the size of the labia, while also making a more symmetrical pairing. When evaluating your treatment options find a series of labiaplasty surgeons in your area for an in-person evaluation and discussion of your goal results. Then evaluate their work product through before and after images of prior clients and potentially ask to speak with former clients if possible. Hope this helps.