Labiaplasty

What is labiaplasty?

Labiaplasty is a plastic surgery done to reshape or reconstruct the inner lips of the vulva or labia minora. It is used to reduce the size of the labia minora.

Labiaplasty can also be done to reshape or reconstruct the outer labial lips of the labia majora, however, this is a less sought-after option for patients. Having said that, we must understand that we should not confuse labiaplasty with vaginal rejuvenation procedure.

Vaginal rejuvenation is a broad term used to describe various treatments and options that doctors for reconstructions or beautification of the vagina like vaginal tightening, vaginoplasty, decreasing vaginal dryness, etc.  Labiaplasty, on the other hand, is a part of vaginal rejuvenation and is used to reshape or reconstruct the labia.

Though labiaplasty is mostly done for aesthetic reasons, there are other reasons as well. Studies show that many women undergo this surgery for physical discomfort and not for sexual well-being or physical appearance.

What are labia?

The vulva consists of the portion of the external female genitals, the clitoris, and the labia. It has two folds of thin skin called the labia just above the vaginal opening. The labia consist of the inner fold (inner lip) called the labia minora and the outer fold (outer lip) called the labia majora.

The function of the labia is to protect the vaginal opening, the urethra, and the clitoris from external injury or trauma.

The average length of the labia may vary from 2 cm to 10 cm and width from 0.7 cm to 5 cm. Sometimes, the two labia may be of different sizes and it is completely normal. The size of the labia may also differ from person to person and it should not be considered abnormal in any way.

Women should remember that the size of the labia has nothing to do with ethnicity, age, hormones, etc. The size of the labia may also change after puberty or with strenuous activities like sports.

Who is the right candidate for labiaplasty?

Many women after childbirth may experience irregularity in the size and shape of their labia. Though plastic surgeons emphasize that there are no normal or perfect size and shape of the labia, many women may still want to undergo the surgery because they are dissatisfied with the shape and wants the labia to be more prominent.

A woman can undergo labiaplasty if:

• They are 18 years of age.

• Have sound physical and mental health.

• Have deformities or labial tears after childbirth.

• Physical discomfort.

• To be more confident about the overall look of the vagina.

Doctors, however, do not recommend labiaplasty on patients who have any preexisting medical condition. They also discourage patients who do not have a clear understanding of the surgery.

A patient who has unrealistic expectations is not a good candidate for the surgery.

A plastic surgeon may also discourage a patient to have labiaplasty surgery if he/she thinks that the labia is perfect and does not require any modification.

Doctors do not recommend surgery on patients suffering from body dysmorphic disorder.

In today’s society, there is an increased urge to look perfect and even the slightest flaw or distortion in the appearance can make a person feel vulnerable and severely anxious. This is common in many youngsters and especially older people.

A body dysmorphic disorder occurs in individuals who check themselves repeatedly in the mirror, are always grooming themselves and seeking assurance from others, have undergone numerous plastic surgeries on the face and body to look perfect. Their expectations are abnormal and no matter how many surgeries they undergo, they are never happy with the results.

Preparation

• Counseling – Before you undergo a labiaplasty surgery, your doctor will counsel you about the surgery and understand your expectations, health history, and how ready you are both mentally and physically to embrace the new change in your body. In younger patients, doctors may also ask the parents to accompany the patient during the consultation. It will help the patient to understand the concerns of the surgery and also take guidance from the parents. The healthcare provider will also explain to the patient the possible risks and complications after the surgery. A screening test can be done especially in young patients to understand the psychology of the patient and whether the patient has any underlying depression or body image issues. Counselors and surgeons may also encourage patients to have a second opinion before undergoing the surgery.

• Diagnostic tests – The doctor will perform a pelvic examination to examine the labia, its size, and shape. You will also be asked to do a routine urinalysis, blood tests, and a chest x-ray. The screening examination will also determine if you have any vaginal or urinary infections.

• Cost of the procedure – The doctor will also give you an estimated cost of the procedure and whether you have any insurance coverage.

• Decide on the location – You can choose the place of the surgery and decide whether you want to have the surgery in an outpatient surgical facility, clinic, or hospital.

• Medications – You will be asked not to take any NSAIDs (non-steroidal anti-inflammatory drugs), herbal supplements, multivitamins, or blood thinners for two weeks before the surgery.

• Diet – Patients are not allowed to eat any food or take any drinks at least 8 hours or after midnight prior to the surgery. However, you can ask your doctor whether you can take sips of water if you are feeling excessive dryness in the throat.

• Take ample rest – The night before the surgery, it is normal to feel anxious and nervous. Try to have a good sleep at night. This will help your recovery after the surgery.

• Take assistance – Ask a friend or a family member to assist you on the day of the surgery who can take you home as you may have local or general anesthesia. Also remember to bring all your documents, personal identification, etc.

Labiaplasty procedures

Labiaplasty is usually done on an outpatient basis under general or local anesthesia. Labiaplasty can be done as:

• Trimming procedure – This is the oldest procedure. Here, the excess labial skin from the labia minora is trimmed and sutured to align with the labia majora.

• Wedge procedure – The surgeon only partially removes the wedge thickness from the labia minora without disturbing the submucosa to give the labia a more natural look. In this way, the labia retain their natural look even the wrinkles along the edges.

Before the surgery:

The nurse or the attendant will perform certain blood tests and urinalysis tests. He/she will take your blood pressure, and check your vitals, and oxygen saturation rate. A urinary catheter will be inserted. All this will be done in the pre-operative area before you are prepped and taken to the operation room.

During the surgery:

The procedure takes approximately 1 to 2 hours. Patients can go back home the same day unless they develop any complications that need medical supervision.

Procedure steps:

• You will be put in an IV and administered local or general anesthesia.

• The excess tissues from the side of the labia minora will be cut or trimmed with surgical scissors, scalpel, or radiofrequency.

• Surgical sutures will be used to close the incisions.

• If the patient wants to enlarge the labia majora, the surgeon will remove some fat from the thigh or abdomen area and inject it into the labia majora.

• After the surgery, the incision site will be prepped with a surgical dressing.

After the surgery:

You will be taken to the recovery room where a medical team will watch your vitals and give you pain medication. After some time, they will remove the urinary catheter and you will be encouraged to walk and use the toilet or a bedpan for comfort.

Before discharge, the medical supervisor will explain the wound-care routine, and restrictions, and make an appointment for a follow-up visit.

When should you go for labiaplasty surgery?

Most often we associate a labiaplasty surgery with simply a cosmetic procedure that can improve the appearance of the labia. However, a woman can undergo labiaplasty surgery for several other reasons as well.

• Makeover of sagging labia – This is by far one of the prime reasons for women especially after childbirth to undergo the surgery. After childbirth especially multiple vaginal childbirths, the vagina of a woman changes and it is very hard to return to its older form. The vaginal muscles become loose and so do the labia. This can also happen in older post-menopausal women who may experience sagging labia. Customized labiaplasty surgery can help give a tucked-in appearance and restore your pre-baby look.

• Labial hypertrophy – This is a medical condition that causes enlargement of the labia. Usually, the labia minora may outgrow the labia majora and cause physical discomfort and pain. The extended fold of labia minora and may cause irritation and pain during sex. This can also hinder your normal physical activity like riding a bicycle, sports activities, jogging and even walking. The labia minora can get folded and disturb normal physical activities.

• Clothing comfort – An oversized labia may be challenging while wearing close-fitting clothes like leggings, swimsuits, etc. The discomfort may cause physical pain as well. A labiaplasty can help trim the labia and can women can wear clothing as per their choice.

• Enhance sexual pleasure – Expanded labial folds can cause discomfort during sex and also can be embarrassing. The expanded labial lips can get folded and twisted during sexual intercourse and cause discomfort and pain. Trimming the excess skin in the labial lips can reduce discomfort during sex, enhance sexual pleasure, and make it more enjoyable.

• Improve self-confidence – Many women with an enlarged labia may feel awkward or self-conscious about their appearance especially while wearing tight clothes, yoga pants, or swimsuits. Labiaplasty surgery can help them be more confident in their bodies.

• Bacterial growth – Oversized labia or excess skin tissues near the labia can lead to bacterial growth and other urinary tract infections (UTI). Labiaplasty can trim these excess tissues and reduce the risk of UTIs and other vaginal infections.

Surgery options

The patient may decide to have the surgery in a small facility or a reputed hospital.

Small clinics

Pros

• Personalized care.

• Cheaper rates of surgery.

• Faster consultation.

Cons

• Less access to modern techniques and facilities.

• A small setup may be unable to handle risks post-surgery.

Hospitals

Pros

• Highly trained staff and reputed surgeons and doctors.

• Innovative technology and the latest surgical equipment.

• High success rates and more efficient in handling emergency situations post-surgery.

Cons

• High cost.

• Patients may have to wait for days or weeks to get an appointment.

Cost of surgery

The cost of labiaplasty surgery depends on various factors:

• The type of surgery. Whether the patient wants to correct only the labia minora or also wants to undergo other corrective procedures will determine the overall cost of the surgery.

• The clinic or hospital. The cost of surgery is much more in big or reputed hospitals compared to small clinics.

• Charges for diagnostic tests and anesthesia fees.

• Surgeon’s consultation fees.

• Hospitalization and post-op care charges.

• Patient’s age. Older patients may require additional precautions and treatments.

• The cost of operation largely depends on the locality and the city.

• Transportation costs and cost of the hotel stay especially if you are travelling to a different city to have the surgery.

Post-op care and things to keep in mind

Total recovery may take six weeks. Patients must follow the doctor’s instructions regarding recovery and post-op care.

• Do not go to work for at least two weeks.

• Avoid strenuous activities for 6 to 12 weeks.

• Abstain from sex for 6 weeks or more as instructed by the doctor.

• Use sanitary pads instead of tampons.

• Wear loose-fitting cotton clothes and underwear to avoid friction.

• For inflammation, you can use ice packs.

• Sitz baths can be taken to reduce soreness and inflammation.

• Take pain medications, anti-inflammatory, and topical ointments as prescribed by the doctor.

• Avoid using soap or rubbing the wound site for at least a week post-surgery.

• Gently wash and wipe the incision site after urination.

• Consult a dietician to increase roughage in your food to avoid constipation and straining the wound site.

• Keep the wound site clean and dry to prevent infections.

• Limit your activities. You can take a brisk walk in your home or in the park. Ask a friend to accompany you.

Labiaplasty complications

It is common to have nausea or drowsiness after the surgery due to the anesthesia. The patient will gradually come out of it after 24 hours as the anesthesia wears off. It is also normal to have some soreness and bruising on the site of the incision for two weeks. The swelling will gradually resolve with medications.

Other complications include:

• Deep venous thrombosis – Due to restricted movements after surgery, some patients may develop blood clots in the veins of the leg. This condition is known as DVT or deep venous thrombosis. Doctors may recommend wearing compression stockings for relief of the symptoms.

• Bleeding – There is a risk of bleeding after the surgery. Patients must not exert themselves and take a few weeks off from work and exercise.

• Infection – The incision site can get infected. Doctors may recommend oral antibiotics or oral antifungal medications.

• Inflammation and bruising – Some patients may develop temporary swelling or bruising in the incision site.

• Numbness – Temporary numbness or loss of sensation may occur on the incision site. This may occur due to the anesthesia. Return of full sensation and sexual stimulation may take some time.

• Dissatisfaction – Some women may complain of asymmetry or absence of balance in the labial lobes. However, 100% symmetry may not be achieved and some areas may differ in size.

Best option

Labiaplasty is a safe procedure and is mostly done as an outpatient surgery. Risks are minimal and recovery is also fast. Though it is a minimally-invasive procedure, choosing the right surgeon and the facility for the surgery may be daunting.

At goficure, our highly-trained medical counselors will connect you with some of the best surgeons and hospitals. They will assist you in booking appointments, hospitalization, transport, post-op care, insurance, and many other facilities.

References