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External Cosmetic Vaginal Surgery (Labiaplasty) Facts and Questions

Labiaplasty Procedure Overview

Operative Time:

Labia Minora Reduction 1 hour
Labia Majora Reduction 1 hour
Labia Reduction and Redundant Prepuce1.5 hours
Labia Majora Augmentation 1 hour

** Please make sure you (as the patient) do your research. Many surgeons will tell you they can do your labiaplasty in 10 minutes, however, look at their results. Our surgical times are based off of years of experience and successful results. We have a 97% Labiaplasty patient satisfaction rate with one surgery

Anesthesia General:
Patients have the choice of general and epidural anesthesia. With general anesthesia most patients are not intubated with a tube in their trachea or windpipe. Instead a simple mask is used to allow the patient to sleep during surgery. The reason why we do not use local anesthesia for vaginal surgery is that the injection of the fluid into the tissue makes the tissue swell dramatically. If the tissue is swollen it is very difficult to artistically shape the labia because now you are no longer operating on the original labia. What you are operating on is a swollen version of the labia thus making it quite difficult to shape the labia with great confidence.

Performed in Operating Room:
Though many doctors will tell you this can be performed in the office, it is almost impossible to get the BEST cosmetic results in the office. Why… because in most states you cannot give general anesthesia in the office. Thus it would require local anesthetic injections (please see the above about local anesthetics) Many patients have come to our office with disastrous results after having these procedure performed in the office by other surgeons.

Post Operative Pain:
Though there are no generalized statements about the pain you will feel after having a labiaplasty, most patients don't have much discomfort after the first day. Many patients say they have more of a soreness, but not pain. Many of our patients do not even use narcotics and will only use anti-inflammatories such as Toradal/Motrin/Ibuprofen. Patients will usually have swelling up to 6-8 weeks postoperatively, but by using cold compresses during the first 48 hours most of the swelling is gone by 3 days.

Labiaplasty Recovery

24-48 hours
The first 24-48 hours the patient should use ice packs on her external vagina i.e. at the surgical site to reduce swelling. Often patients will purchase two or three bags of frozen peas and keep them in a freezer. The patient will use them as an ice pack on their labiaplasty site and should rotate them every 30-60 minutes. Rotating the ice packs assures the best chance to minimize swelling of the vulva postoperatively. You may do routine tasks the day after surgery as long as there is minimal irritation to the surgical site. Loose clothing is a must.

After 48 hours
Resume most normal everyday activities that do not require physical exertion or much friction in the area of healing. We do not recommend riding motorcycles, horses, bicycles for the first 4 weeks after surgery. A patient should attempt to minimize friction in the surgical area.

How long will the sutures last?
The sutures are made of a delayed absorbable material called Vicryl or Monocryl. These sutures usually dissolve in 6 weeks, however we have seen them last anywhere from 3-12 weeks. At which point they dissolve and the ends of the sutures fall off. There is no reason to surgically remove the sutures.

Resume Driving
You may resume driving when you are no longer using narcotics.

Resume Work
Most patients can go back to work 24-48 hours after the surgery, as long as it doesn't require aggressive physical activity, friction in the healing area.

Resuming Intercourse
You may resume intercourse in 6 weeks
- 10% patients still tender at 6 weeks
- 1% patients still tender at 12 weeks

What should I expect when resuming intercourse?
For labiaplasty patients, most patients do not have pain when engaging in intercourse, however every patient is different. The general consensus is patients will tend to be a little tender or on occasion may feel a pinching effect isolated to a specific area. When pinching occurs it is usually due to a suture knot or the ends of the sutures are irritating the patients skin. Take it slow, but most importantly…RELAX.

Can I take a shower / bath / go swimming?
You may shower the day after surgery, however you should not scrub the incision areas. They can be bathed gently using a soft washcloth, soap and water. No tub baths for 4 weeks including pools, oceans, hot tubs, etc.

*A detailed aftercare plan will be outlined by your surgeon and given to you during your surgical scheduling

Frequently Asked Questions About Labiaplasty

What is the normal size of the labia minora?
There is no so called "normal size" for labia minora. Like a nose, every labia of every size is considered normal. No person can dictate what a normal sized labia should be. However, there have been some unscientific surveys that state most women would prefer their labia minora not protrude past the length of the labia majora. Most labia minora surgery patients prefer the labia minora to be at the level of the labia majora or lower.

What type of symptoms do prospective labiaplasty patients have with enlarged labia?
Many prospective labiaplasty patients complain of pain, discomfort or irritation during physical activity, sexual intercourse, or wearing certain types of clothing as a result of enlarged labia.

Why remove normal natural looking darkened edges during labia surgery?
The idea that darkened edges are normal is a misnomer. Having a saggy butt is normal for an 80 y/o, but it's not youthful. Most patients develop a darkening appearance due to hormonal changes. This occurs most frequently with pregnancy and getting older. Pink labia are associated with a more youthful appearance and thus most patients actually prefer lighter colored labia. If a labiaplasty patient is adamant about keeping the darkened edges we have no problem upholding their request by doing a "wedge reduction," a type of surgical procedure for labia reduction. This procedure will maintain the darkened edges of the labia yet will reduce the size of the labia. The drawback of using a wedge resection is that it will reduce the size but it is difficult to get an even contouring of the labia throughout its length.

Do you use a laser to do your contouring?
We use a variety of instruments including a laser, an electric micro tip cutting devise which employs radiofrequency (RF) , plastic surgery scissors, and scalpels. We believe that each patient is different and we use whatever instruments we believe will give us the best results for an individuals labia contouring. We personally have not seen any difference in healing or pain associated with one or the other.

What if I am unhappy with the results?
Though no surgeon can make a guarantee of 100% satisfaction, we will do everything possible to give you your desired results. Our revision rate for labiaplasties is approximately 3%. This is considered low revision rate. Most patients just need a little nip on one side or the other. If a patient needs to go back to surgery, we do not charge a new surgeon's fee for the surgery. Sometimes it can be done using local anesthesia ie using a cream called EMLA and maybe some local anesthetic agent. However,if the patient needs to go to the operating room the patient will be required to pay for the use of the operating room and anesthesiologist. Once again there will not be a surgeons fee charged to the patient.

Click here to view Before and After Photos

Labia Minora Enlargement Before and After Photos
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