Patients may have concerns regarding size or symmetry of their labia. As a female plastic surgeon, Dr. Power appreciates the sensitive nature of these complaints and strives to make patients comfortable throughout their care, from initial consultation through surgery and post-operative management.
Labiaplasty (labial reduction) may be performed for either overall size reduction, or limited to one side in order to improve symmetry depending on each patient’s specific concerns and presentation. Incisions are placed along natural labial contours, and scars are fairly inconspicuous once fully healed.
Labiaplasty is performed as an out-patient procedure under local anesthetic in a minor procedure room. This ensures maximum patient privacy and comfort. Resorbable sutures are used and patients are generally able to return to work within one week. Dr. Power will discuss further activity restrictions following surgery.
Here are a few common questions regarding Labiaplasty:
1. What are common concerns of patients considering labiaplasty?
- There is typically a wide age range of patients who consider undergoing labiaplasty
- Younger patients (late adolescence and beyond) often express concerns about how their labia minora (inner labia) have developed following puberty
- They are often self-conscious about their development and may experience discomfort when wearing tight-fitting clothing or during sexual activity
- Prominent labia minora may also lead to irritation when performing certain exercises, e.g. bicycling or spinning classes
- Following pregnancy or during the normal aging process, the labia minora may appear elongated as tissue elasticity decreases and laxity develops
2. Who is a suitable candidate for labiaplasty?
- Patients with well-defined concerns about their anatomy with reasonable goals are often good candidates for labiaplasty
- A complete medical history and examination will be performed during consultation to ensure that there are no contraindications to surgery or any conditions that may need optimization before elective surgery is performed
- Smoking cessation at least 4 weeks pre- and post-operatively has been shown to lower risk of complications, particularly relating to infection and delayed wound healing
- It is also important for patients to understand and comply with post-operative wound care instructions and recommended activity modifications until well-healed to lower risk of complications.
3. How is a labiaplasty typically performed?
- The two most common types of labiaplasty are the trim vs. wedge techniques
- Both techniques are effective in reducing labia minora projection
- The technique of labiaplasty recommended for you will be based on your specific concerns and clinical presentation and will be discussed in detail during consultation
- During a trim labiaplasty, excess length of the labia minora which projects beyond the labia majora (outer labia) is resected
- This technique also removes any darkened tissue which is of concern to some patients and may be present at the leading edge
- Trim labiaplasty results in decreased projection of the labia minora and restoration of pink healthy tissue at the leading edge margin
- This technique places a scar along the length of the labia minora, which is often subtle in appearance once healed and scar maturation has been completed
- During this technique, a V-shaped wedge of labia minora is resected to reduce its size. The wedge labiaplasty technique does not resect the darkened margin of tissue, but the scar may be even less apparent once healed
4. What should I expect on the day of labiaplasty?
- Labiaplasty is performed in a minor procedure room
- On the day of surgery, a topical anesthetic cream will first be applied to the region to reduce discomfort associated with the local anesthetic (freezing) infiltration
- Pre-operative photographs will be taken with consent as part of your medical record and surgical markings performed
- The local anesthetic will then be injected through a series of small needles where the topical anesthetic cream had been applied
- After relaxing for approximately 10-15 minutes as the local anesthetic takes effect, the area will then be tested to ensure well anaesthetized
- During surgery you may experience a mild pressure or pulling sensation periodically, but there should be no associated pain
- The surgery itself generally takes between 30-60 minutes depending on whether one or both sides are being reduced
- Resorbable (dissolvable) sutures are used for wound closure
- Following surgery, a dressing will be placed and you will be discharged home
5. What should I expect following labiaplasty?
- The local anesthetic generally wears off within 3-4 hours following surgery
- Patients generally require pain medication for a few days post-operatively
- A prescription will be given to you following surgery in addition to a post-operative wound care instruction sheet
- I recommend cold compresses during the acute post-operative period to reduce swelling, bruising, and discomfort
- This should be applied 15 minutes on and off as tolerated for the first 24-48 hours while awake
- It is important to place a face cloth in between the surgical site and the cold pack to avoid direct contact with skin, which lowers risk of a frostbite injury
- Patients should begin showering daily starting the day after labiaplasty and to gently wash the incisions with soap and water
- Following the shower, it is important to gently dab the incisions dry to avoid disrupting the sutures
- Lightly apply Vaseline twice daily as well as a maxi pad or gauze within your undergarment for a few days after surgery until there is no bleeding from the site
- A small amount of bleeding is to be expected following any surgery, particularly in this region, given that the labia minora is quite vascular and also subject to irritation when sitting, walking, and performing genitourinary functions
6. When may I resume normal activity after labiaplasty?
- Most patients are able to return to school or work within a few days of surgery
- Follow up is scheduled approximately ten days post-operatively
- Any sutures which have not resorbed by this point will be gently removed
- I recommend refraining from exercise and sexual activity for one month post-operatively until medically cleared based on incision healing
- I also advise against taking baths or swimming until the incisions are well-healed, generally 2-3 weeks following labiaplasty
7. What are potential complications of labiaplasty?
- Understanding the potential complications of labiaplasty is an important part of the informed consent process
- Potential for hematoma formation (collection of blood or ongoing bleeding within the tissues)
- Delayed wound healing
- Wound dehiscence (wound separation)
There is also risk of sensitive scar formation or altered sensation. As with any cosmetic procedure performed bilaterally (on both sides of the body), there is risk of asymmetry post-operatively. In fact, the labia minora are often asymmetric pre-operatively, which will be assessed during your initial consultation. Additional aesthetic complications include overcorrection, undercorrection, dissatisfaction with cosmetic result, and potential need for revision surgery.
Labiaplasty is generally a well-tolerated procedure. The majority of patients report improved self-image post-operatively, which may lead to enhanced sexual experience and self-confidence.
Dr. Power has an all female team in her office. This may be important to some patients considering labiaplasty. We strive to make patients comfortable during every stage, from initial consultation through operative procedure and follow up visits.
Please contact us to schedule your consultation.