Labiaplasty

"Despite media commentary, most women seek this operation for functional rather than cosmetic reasons. "
Dr Lisa

about the procedure

1 - Surgical aims

Originally a term to describe reduction and reshaping of the labia minora (inner lips), Labiaplasty now encompasses surgery to the vulval area in general, and includes any of the following surgical procedures:

  • Reduction and Reshaping of the Labia Minora
  • Reduction or Augmentation of the Mons Pubis
  • Reduction or Augmentation of the Labia Majora

2 - Why consider

There is a great range in the normal vulval anatomy amongst women. Just as we all have different faces, there is a variation in the sizes and relationship of the vulval components.

Women don’t usually compare their vulval anatomy, so it can be hard to get a sense of what’s normal. Whilst many believe that our perceptions have been swayed by social media, pornography and the Brazilian, I believe it is more associated with an increase in access to information with the rise of both female independence. Fashions have changed over the last 20 years, health and fitness have become daily pursuits such that most women will spend a significant part of their week in close fitting gym wear. 

Most commonly, women inherit the appearance of the vulva, but in some instances it can change with childbirth, chronic irritation and simple aging. 

Women consider labiaplasty for many reasons. Excessive length, size and/or asymmetry can result in both Functional and Cosmetic problems.   

Difficulty wearing clothes

Bulging and the appearance of a visible lump

Discomfort or pain wearing fitted clothes such as jeans or gym tights

Limitations in clothes that can be worn, ie bathers, where accidental show may occur

Difficulty with physical activity

Chafing

Compression and pinching, especially on bikes

Embarrassment and inhibition

  • wearing yoga pants/gym wear
  • in the bedroom with sexual partners

 

Pain during sexual intercourse. This may also result in difficulty achieving orgasm.

Most women seek this operation for functional reasons, even 2cm of labia minora protrusion can cause significant chafing and irritation. 

There is nothing wrong with wanting to achieve a cosmetically attractive vulva. The decision should be made after a consultation with a Specialist Plastic Surgeon. You should understand all of the risks and complications before proceding with surgery.

 

3- technique

edge trim

The outer edges of the labia minora are resected back to a length allowing them to sit comfortabley within the labia majora. 

This method produces a log scar line along the outer labial edge which can become sensitive in some. Care must be taken to avoid over-resection and the formation of dogears at the ends of resection.

wedge resection

This is my preferred method of performing labia minora reduction.  A wedge is marked on the inner and outer surface of each labia minora. The skin within these wedges is resected with preservation of the underlying tissue.

The skin edges are then sutured together. In some cases the tissue within the wedge is thickened and must also be removed.

4 - How it's done

The operation is performed under General or Local anaesthesia. Local anaesthetic is also used to decrease pain during and after the procedure.

Surgery usually takes 60 – 90 minutes, but as it is tailored to each individual patient, it will take a different amount of time depending upon what is done.

Most labia minora reductions will involve the removal of a wedge of tissue and suturing of the edges together.

Reduction of the mons and labia majora is most commonly done with liposuction, but occasionally needs direct excision if there is excess skin.

Augmentation of the mons and labia majora is accomplished by fat grafting. You can select where you want the fat to be taken from, but it is usually the lower abdomen, flanks or inner thighs .

All wounds are closed with dissolving sutures so they don’t need to be removed. An antibiotic ointment is applied to the closed wounds and a cooled absorbent pad is placed over this.

5 - hospital

Labiaplasty must be performed in an accredited facility in the state of NSW.  As it is deemed a cosmetic procedure, there are no Medicare or Health rebates that can be applied. 

It is usually performed as a day case. It is uncommon to need to stay overnight, but you are able to if needed.

You will need to come into the hospital a 90 minutes before your planned surgical start to complete your admission paperwork.

You are able to go 2-4 a couple of hours after the procedure providing you have recovered well from the anaesthetic and are not in too much pain.

You will need someone to pick you up when you are ready to leave.

Post operative followups are scheduled at 1 week, 1 month, 3 months and 6 months.

At least 1-2 weeks should be taken off of work.

6 - After Surgery

Pain and Swelling

  • You can expect to be a bit sore and swollen after the surgery. Sometimes you may have bruising. This will all settle with time and is completely normal.
  • Pain will usually decrease over the first few days and is generally resolved in 5-10 days.
  • Swelling may take a little longer to settle and depends on how much surgery you have had.
  • Cool packs (cooled pads) and baths may also help relieve discomfort in the early postoperative period.
  • Your anaethetist will discuss the best method of pain relief with you, and will give you a prescription for pain medicine.

At home

  • Once at home you should rest and not engage in any activities that are too strenuous.
  • If you have a major social event planned in the days after surgery- seriously consider rescheduling it or the surgery.
  • You should take 1- 2 weeks off work, depending on your occupation.

Showering and Bathing

  • You may shower the day after surgery, letting the water run over your wounds rather than washing with soap. 
  • A spray bottle with warm water may also be used for cleaning, or cool water to help with pain relief.
  • Salt water baths (in a sitz bath, or small washing tub) three times a day help to keep the wound clean and also provide pain relief.
  • After bathing pat your wounds thoroughly dry. An absorbant pad is useful as a dressing. It is not uncommon to have a small amount of bleeding in the first few days and a pad will help to manage this. 

Clothing

  • You will find loose clothing the most comfortable in the first few days after surgery.
  • You should avoid wearing tight pants such as jeans as they will rub and cause you pain.

Driving

  • To be safe to drive you should be off all strong painkillers and be able to sit comfortably.

Exercise and Sex

  • This is a critical time for your wounds to heal, so avoid all activity that will cause chafing of the wounds, this includes walking, running and sexual intercourse.
  • Light walking within comfort levels is safe, but all other activities should be stopped for at least 6 weeks. This gives your wounds the best chance of healing to their maximum capacity.

5 - estimated fees

If you have private health insurance, you should ring your fund and quote the item numbers above to obtain  confirmation of your cover and expected rebates.

Please contact us if you have further questions.