Labiaplasty Procedure in Norwalk, Connecticut

Labiaplasty, also known as  labia reduction, is a procedure for altering the labia minora (inner labia) and the labia majora (outer labia). A 2008 study in the Journal of Sexual Medicine reported that 37 per cent of patients have the surgery for aesthetic reasons alone (1).

The size, color, shape and symmetry of the labia minora and labia majora vary. They can change as a result of childbirth, weight gain, weight loss and aging.  The labia may be asymmetrical, or they may hang down in the standing position. The labia may be uncomfortable when wearing tight underwear or pants and may be visible when wearing a bikini or yoga pants, causing embarrassment. The labia majora can lose volume. The mons itself may also have an excessive amount of fat. 

According to a 2011 review, also in the Journal of Sexual Medicine, overall patient satisfaction is in the 90–95 percent range (2).

Ideal youthful appearance of mons and labia majora and minora. The labia minora should not hang down below the labia majora. See drawing top left..

Aesthetic surgery of the female genitalia includes reduction and reshaping of the labia minora and labia majora as well as reduction of the clitoral hood. Liposuction or fat injection of the mons pubis and the labia majora can be combined with these procedures to give the best aesthetic result.

Surgery of the labia minora is performed with local topical and infiltration anesthesia and oral sedation. Patients may also elect to have iv conscious sedation.

Labiaplasty Procedure

Labia minora reduction

There are two techniques for reduction of the labia minora: Edge Resection and Wedge Excision (3,4)

Edge resection or trim technique

This is a simple resection of tissues at the edge of the labia minora.  It can also be combined with a reduction of the clitoral hood. The advantage of this procedure is that it removes pigmented excess tissue and that there is less risk of disruption of the incision. It can also be combined with a reduction of the clitoral hood.

Wedge excision

This is a wedge resection of the labia minora which preserves the natural edge and pigmentation of the labia. This is particularly useful when trying to match the opposite side which may require no surgery. Like the edge technique, it can also be combined with a reduction of a prominent overhanging clitoral hood.

Labia majora modification

The labia majora may be reduced with an elliptical excision with the scar at the junction of the inner lining and the external skin. This surgery can be performed at the same time as a labia minora reduction.

Loss of volume of the labia with age or weight loss can also be corrected with fat grafting.

Post-operative management

After surgery wear cotton underwear, keep the area dry and clean with warm water irrigation once a day. Mupirocin ointment is applied to the incisions, twice daily. Vaginal discharge for several days is not uncommon. Depending on your progress, you can resume physically un-strenuous work three to four days after surgery. Avoid sitting for prolonged periods. To allow the wounds to heal, do not use tampons, or wear tight clothes such as thong underwear and yoga pants, and abstain from sexual intercourse for six weeks after surgery. Avoid high impact exercises including jogging for six weeks after surgery. Use a laxative, drink plenty of fluids and eat lots of fruit and fiber to keep your stools soft.

Potential complications of surgery

These include dehiscence or separation of the wound. This is more common in patients who are obese, smokers and where there is excessive tension on the suture lines or injury to the repair as a result of sexual intercourse. Other possible complications include infection, a ‘dog-ear’, notching or webbing, a hematoma, pigment changes and a posterior constriction as well as increased or decreased sensitivity.
After the procedure it will take 6 weeks before being completely healed and a full 3-4 months before being able to truly assess the results of surgery. Sometimes further surgery may be indicated to fully reduce the size to your liking. The exact results cannot be guaranteed. Although good results are expected it is possible that the result might not live up to your expectations or goals.

References:

• Miklos J.R. and Moore R.D. “Labiaplasty of the labia minora: patients’ indications for pursuing surgery”, Journal of Sexual Medicine, 5(6), 2008, pp. 1492–1495.
• Goodman, M.P. “Female genital cosmetic and plastic surgery: a review”, Journal of Sexual Medicine, 8(6), June 2011, pp. 1813–1825.
• Alter G.J. Aesthetic labia minora and clitoral hood reduction using extended central wedge resection. Plastic & Reconstructive Surgery.2008; 122(6): 1780-1789.
• Alter G.J. Labia Minora reconstruction using clitoral hood flaps, wedge excisions and YV advancement flaps Plastic & Reconstructive Surgery. 2011; 127:2356-2363.