What are all the possible ways clitoral sensation could be lost after Labiaplasty?

Labiaplasty refers to reduction of the labla minora by removing skin. The two main categories of operations are linear reductions of the edges (aka trim procedures) and wedge reductions of the enlarged sections. Linear procedures don't affect clitoral sensation. Some wedge procedures, however, result in a downward pull that pulls the skin of the clitoral hood downward toward the vaginal opening. This can make it difficult to expose the head of the clitoris for direct stimulation. Don't confuse this with damage to the clitoral nerves. The clitoral nerves run along the top of the clitoral shaft. These can only be damaged by cutting them directly and that could only happen if a surgeon who isn't familiar with the anatomy damages these nerves during a clitoral hood reduction. A clitoral hood reduction is a component of linear and wedge labiaplasties.

We have never experienced clitoral damage nor loss of sensation. Each surgeon should be able to discuss and reassure you of any concerns while discussing any possible risks involved.

Hello, Some women may not feel normal clithoral sensitation in the first 6 months after surgery. This is a normal surgical process. We expect it to come back soon. This problem does not usually occur in a clitoral aesthetic performed with the right technique and by an experienced surgeon. In the rapid treatment process, the genital PRP method and estrogen-containing creams are very beneficial.
Thank you.
Dr. Mehmet Bekir ŞENGenital Aesthetic Expert

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. This can lead to scallops and irregularities. 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. A careful, experienced labiaplasty surgeon should not damage the clitoris as the clitoris is not involved in any labiaplasty technique. 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. About 40% of the female genital cases I perform are revisions of labiaplasties and clitoral hoods botched by other doctors.



Gary J. Alter, M.D.
Beverly Hills, CA - Manhattan, NY

If done properly, there should be no clitoral sensation loss after labiaplasty. IF a labiaplasty involves resection and retraction of the clitoral hood, a detailed awareness of the essential anatomy of the clitoris and its blood vessels and nerves must be understood to perform this procedure. Loss of clitoral sensation would only occur if nerve damage ocurred.

Agressive resection of the clitoral hood area can change sensation after labiaplasty. For my patients, I only remove the superficial mucosal area to ensure that no changes to sensation occur.

Drs. Pelosi and Alter are among the best in the business. Pelosi only does linears; Alter only wedges. Believe me (I do both), it is NOT the technique (both are safe provided that they are performed by a provider trained in Cosmetic Gynecology/Gyn Plastics, and one who is experienced.) The biggest risk is especially from gynecologists only trained in general Ob/Gyn, not in genital plastics, or a P.S. who has not received labial training. Clitoral sensation can only be lost with improper surgical technique, transecting the Dorsal Nerve to the Clitoris (a branch of the pudendal nerve) by an unskilled surgeon (Google Jessica Pin for MUCHO additional information.) The most dangerous surgeons (not trained in precise technique) are general Ob/Gyns who do LP "under insurance..." I review a lot of malpractice horrendos, and most all are performed by general ObGyns or PS' not savvy in vulvar work.

Best,

Michael P Goodman, MD, FACOG, IF, AAACS. Cosmetic Surgical Gyn and Revision Specialist. Sacramento CA USA