Labiaplasty Basics

Labiaplasty surgery is controversial, though the kerfuffle is slowly subsiding. Physicians, including gynecologists, feared that women were influenced by pornography. They emphasized to their patients that they were normal the way they were. Which they were. But normal isn’t always pleasant or comfortable.

Why Get a Labiaplasty?

When we first started to do labiaplasties several years ago, there was little information available to patients. But gradually, thanks to the Internet, women began to find out about the procedure. Many were relieved to find out they weren’t alone. Common complaints included:

  • Pain, itching, and discomfort
  • Pinching in tight jeans and lace underwear
  • Visibility in bathing suits and yoga pants.
  • Fear of exposure in a bathing suit.
  • Pain with intercourse
  • Feeling unfeminine.

Who gets a Labiaplasty?

The age range in our practice is from teens to middle age. Usually our teenagers experience so much pain during sports that it impacts their participation, while older women learn that the symptoms they’ve had for so many years can be alleviated. The age of onset of long labia varies from “as long as I can remember” to puberty and childbirth. In some women only one side is affected.

How to Find a Labiaplasty Surgeon?

Choose your surgeon carefully, since a badly done labiaplasty can be debilitating or demoralizing. Some patients need reconstruction after too much was removed or incisions were misplaced. Look for a board-certified plastic surgeon or a board-certified gynecologist who has good before-and-after photos. If you’re interested in another plastic surgical procedure, the plastic surgeon can perform the labiaplasty at the same time. During the consultation, your surgeon will examine you, and then discuss your goals. How much do you want removed? If you have pigmentation, does it bother you? If there is extra clitoral hood skin, do you want that removed as well?

How is a Labiaplasty Performed?

Labiaplasty is an outpatient procedure done under local anesthesia, unless the patient is being put to sleep for another procedure (or if she requests general anesthesia). Most labiaplasty surgeons perform either the trim (linear) or the wedge technique. With the trim, the extra tissue is removed, and the edges sewn together with absorbable suture. In the wedge technique, after removal of a pie-shaped piece, the surgeon brings the wound edges together like an alligator’s jaws.

Recovery

Our patients typically take 4-7 days, sometimes longer, depending on their type of work. During that time, elevation (yes, bottom up in the air!) and cold packs help the swelling and pain. Most people are off their prescription pain pills after a few days. Depending on the procedure, we ask patients to delay activities that cause trauma to the area, like intercourse, cycling, and horseback riding, for four to six weeks, depending on the procedure done. Swelling can last for three to six months.

Results

The satisfaction rate after labiaplasty is extremely high. Just a couple of days ago a patient who was only two weeks out from surgery sat in the exam chair and said, “Before my surgery, I would have been sitting here miserable from itching. This has changed my life.”

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