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
Why consider labiaplasty ?
- 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 male genitalia
- 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
- 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.
- Difficulty wearing clothes
- 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 proceeding.
What does the operation involve?
- The operation is performed as a day case in hospital under general 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.
What do I need to do to before the the operation?
- Avoid or cease smoking and nicotine in the weeks before your surgery (ideally quit 6 weeks prior) as it can significantly interfere with wound healing and may increase your risk of respiratory complications after anaesthesia.
- Avoid aspirin and anti-inflammatory medications 2 weeks before your surgery as they can increase your risk of bleeding. Some herbal medicines can also affect bleeding, so it is best to stop these 2 weeks before surgery as well.
- Shave or wax no sooner than 3 days before surgery (any closer to surgery may cause skin irritation and increase your risk of an infection).
- Remove all of your nail polish so that an oxygen monitor can be placed on your finger. If you have shellac nail we can use an earlobe probe instead.
- Do not eat any food or drink after midnight the night before surgery, unless you are on an afternoon list. If so, you must fast for a minimum of 6 hours. This prevents reflux of acid from the stomach to the lungs.
- Shower on the morning of surgery and wash yourself with an antibacterial soap.
- Wear loose and comfortable clothing. Jeans and other tight fitting pants will be uncomfortable after surgery.
- Wear light or preferrably no makeup. Avoid wearing jewellery in case it gets lost.
- Buy some sanitary napkins for after surgery.
How long will I need to stay in hospital?
- As mentioned above, this is usually performed as a day case.
- 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.
- It is uncommon to need to stay overnight, but you are able to if needed.
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.
- 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.
- 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.
- 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.
- Dr Lisa will usually see you before you go home from the hospital to check you are ok and answer any questions you may have about your surgery.
- Your first scheduled followup appointment is 7 days after your surgery. If you have any concerns between your hospital discharge and your appointment, please email or call us for advice.