What is a Labiaplasty?
Labiaplasty is a surgical procedure that corrects excessively long, enlarged or redundant labia minora tissue and can make the external genitalia (the “vulva”) more cosmetically appealing. Women with enlarged or elongated labia may feel very conscious when wearing tight clothing or swimwear, as the outline of the labia may be visible through the clothing. Enlarged labia may also cause women to feel self-conscious during intimate contact. Some are concerned about asymmetry of their labias, or they may have pain or discomfort during sex or with exercise. Occasionally, redundant labia tissue predisposes to yeast infections or creates friction tears of the tissue.
During a labiaplasty, excess or stretched-out labia minora tissue is excised to create a more neat and tidy appearance to this region and to treat associated physical concerns. Occasionally excess tissue around the clitoral hood is also carefully trimmed as part of the procedure.
Who is a Good Candidate for Labiaplasty?
Labiaplasty is a personal procedure that should certainly not be associated with embarrassment or shame. Women of all backgrounds, shapes, sizes and cultures seek labiaplasty. Sometimes after childbearing, labial tissue can become stretched out or redundant, and following menopause the vulvar lips can droop with loss of collagen and elastin. Many women are congenitally born with asymmetric or excess labial tissue.
Women who experience awkwardness, pain with intercourse, or discomfort when walking or with exercise due to excess labia tissue are candidates for a labiaplasty. Other women are simply looking to improve the appearance of this part of their body to look as youthful as they feel. Rejuvenation of the labia area can be an empowering experience, potentially improving a woman’s body image, self-esteem and comfort during intimacy.
Can Labiaplasty Be Done Before Pregnancy?
A labiaplasty can certainly be performed at any time in a woman’s life. Labiaplasty is considered a “quality of life” procedure, and is a personal decision. Having surgery will in no way influence future pregnancies or childbirth delivery options.
What Are the Different Types of Labiaplasty?
Labia Minora Reduction
A labiaplasty usually involves trimming the inner lips of the labia, known as the “labia minora”. Only the inner or outer lips of the vulva are treated; the vagina is not normally addressed during a labiaplasty.
Labia Majora Reduction
Occasionally, the outer lips of the genitalia (“labia majora”) are trimmed to additionally reduce their prominence. This procedure involves incisions in the skin of the labia majora and is associated with-potentially additional scars and post-surgical swelling during healing.
Clitoral Hood Reduction
For women with redundant clitoral hood tissue, a reduction of the clitoral hood can also be performed as part of a labiaplasty. Clitoral hood reduction involves careful trimming of excess skin that hangs over the clitoris. The overlying skin is then rearranged without risking nerve injury or affecting sexual sensation or stimulation.
In order to ensure complete comfort and relaxation, we perform labiaplasty as an Day care procedure in the operating room, under a short and safe general anesthesia or under local anesthesia. Local anesthetic is used to prevent bleeding and bruising during surgery, and to keep the area numb for many hours after surgery. Excess labial tissue is trimmed, the clitoral hood is reduced if appropriate, and a neat and tidy closure is performed in multiple layers using dissolving (absorbable) sutures. Antibiotic ointment is applied, and an absorbable pad is placed over the incisions. Surgery takes around 1-2 hours to complete, and women are allowed to return home a few hours after awakening.
Types of Labiaplasty
Many surgeons these days are performing wedge labiaplasty, for two main reasons:
A wedge of tissue is removed from the middle area of the labia, preserving the natural labial edge for a less obviously surgical look.
The wedge method leaves a shorter scar that’s harder to see because it runs across the labia rather than along the edge.
However, there are some potential drawbacks to this approach. The wedge technique generally only addresses the middle one third of the labia and does not treat the irregular dark hyperpigmented edge of the posterior parts of the labia. It also does not treat excessive clitoral hood tissues which commonly accompany prominent labia minora.
In addition, the wedge technique creates a condition where the amount of tissue resected must be balanced against creating wound tension with closure. Excising too much tissue may result in a potential for wound separation, whereas conservative resection may produce insufficient reduction. It takes an experienced surgeon to advise you on the anticipated results.
Until recently, trim labiaplasty was the go-to choice for women who wanted to improve the appearance of their labia. This method, as the name implies, involves trimming the excess labia tissue to a more proportionate size and shape relative to the rest of the vaginal area. Many women appreciate that the trim method removes the existing edges of the inner labia, which can darken with age or following pregnancy.
The tissue is typically excised from the clitoral hood and along the edge of the labia minora to the vaginal forchette. In this manner, excess tissue from the upper, middle and lower one/thirds of the inner lips can be removed.
The trim technique leaves a longer scar but it is tension free and commonly is barely visible. Unlike the wedge, wound separation is less likely.
An irregular, thickened and darkened edge is what leads so many of our patients to choose trim labiaplasty as their preferred approach. For those with excess tissue limited to the mid portions of the labia only, the wedge method is an excellent option.
Wedge vs. Trim: Which Is Best?
Both procedures accomplish the primary goal of labia reduction just fine. The question of which labiaplasty technique will give you better results depends on your unique anatomy and your personal goals for surgery.
What is the Recovery After Labiaplasty?
Mild discomfort is treated with oral pain medication for a few days. Swelling and bruising of the genital region can develop over the first few days. You may shower the next day, and will apply antibiotic ointment daily. If you start your menstrual cycle, it is recommended you avoid using tampons for your next 1-2 cycles to avoid irritation of the incisions while they are healing.
At least couple of days should be taken off work or arrange to work from home during this time. Aggressive physical activity should be avoided for at least a week or two after surgery. Sexual intercourse should be avoided for approximately 6 weeks after a labiaplasty. By week 6 to 8, the healing is complete, and no restrictions are needed.
Like any surgery, it takes at least 6 weeks for the initial swelling to recede, and 6 months up to a year for the results to be absolutely complete. Incisions are hidden in the natural crease of the labia region. There is usually very little scarring, as incisions are made in the labial “mucosa” (similar to the inside of the mouth or the gums) rather than the skin.
Possible Complications of Surgery
Some complications associated with labiaplasty are specific to this procedure, while others are complications that could be encountered as a result of any cosmetic surgery, or any surgical procedure in general. Complications common to nearly all surgical procedures include bleeding, bruising, swelling, infection, and scarring. Since labiaplasty is often performed under local anesthetic and sedation rather than general anesthetic, the risks are somewhat less than with more invasive surgical procedures.
Procedure specific complications include Loss of sensation, Spotting, Difficulty urinating ,Change in pigmentation, Asymmetrical results after full healing has occurred ,Separation of the incision site; this occurs in roughly five percent of wedge labiaplasty patients, but is easily to correct. The majority of these symptoms will also be temporary, and resolve within a few days to a few weeks depending on the individual symptom and how quickly your healing progresses.
Will the procedure affect my fertility?
No, the procedure will have no affect on your ability to have children. However, you should use contraception to avoid pregnancy before and after the procedure. Your surgeon will cancel your procedure if you are pregnant on the appointed day. After surgery, you should avoid giving birth for one year following the procedure. As a normal delivery would stretch the tissue and damage the results achieved.
Will there be scarring?
There is usually evidence of scarring following surgical incisions. Your surgeon will try to make the incisions in the least conspicuous areas so that the scarring may be virtually invisible. Even visible scarring will tend to fade over time.
Will labiaplasty affect my sensitivity?
Sensitivity typically stays the same after labiaplasty when done right. After recovery, sexual intercourse is often more enjoyable, because patients feel more confident without the excess skin.