Labiaplasty for functional and aesthetic concerns

Actual patient of Dr. Devgan, before and after labiaplasty

Labiaplasty (or cosmetic rejuvenation of the female genitalia) is one of the most popular procedures in my New York City plastic surgery private practice. As a female plastic surgeon, many of my patients feel comfortable discussing their most intimate concerns with me. Equally important, I am committed to giving superb surgical results to each patient in my practice. Examples of results from my actual patients are displayed at the bottom of this page.

U.S. plastic surgeons have reported a 44% increase in labiaplasty procedures over the past several years, according to the American Society for Aesthetic Plastic Surgery. This makes labiaplasty the fastest growing plastic surgical procedure in America.

WHAT IS LABIAPLASTY?

Labiaplasty is an outpatient surgical procedure designed to make the female genital area more aesthetic and comfortable. Women seek labiaplasty because they are unhappy with the way their private parts look, or because they are uncomfortable with friction caused by exercising, sexual intercourse, or wearing fitted clothes. Labiaplasty can address the inner labia (labia minora), the outer labia (labia majora), the clitoral hood, or any combination of those areas. Atrophy or sagging of the labia majora can also be addressed with filler or fat grafting. 

WHAT IS THE ANATOMIC CONCERN?

The most frequent complaint related to labiaplasty is protruding or enlarged labia minora (inner labial lips). This is also the most common reason for women to seek labiaplasty in my practice. As women get older, some experience atrophy or sagging of the labia majora (external labial lips). Occasionally, women also complain of enlargement of the clitoral hood, looseness of the perineal tissues, sagging of the labial majora, or bulkiness of the mons pubis.

Labiaplasty is tailored to your individual anatomic considerations and concerns, as each woman is different. Labiaplasty does not affect sexual sensation, enjoyment, or ability to have an orgasm. The female erogenous zones, such as the clitoris and "g-spot" are not operated on and experience no changes during the operation.

WHAT IS THE SURGERY LIKE?

Labiaplasty is done under local anesthesia with or without light sedation ("twilight"), which is always supervised by my board-certified female anesthesiologist. About 70% of my patients elect to have the surgery done under local anesthesia alone. The surgery itself typically takes under 1 hour. When surgery is complete, you will have ointment and a maxi pad placed as a dressing. If you have had local anesthesia only, you will feel fine immediately after surgery. If you have had sedation, you will feel a bit tired and you will recover in one of our private recovery room suites, where you will be able to relax, sleep, watch TV, or read a magazine. Once you are feeling fully awake and alert, usually after about half an hour, you will be able to go home the same day. 

WHAT ARE THE SCARS LIKE?

Scars for labiaplasty are hidden in locations that are not visible under most circumstances. Even when scars are closely examined, as in during intimacy or mirror examination, the female genitalia generally heals extremely well. Any scars that are present will heal in a camouflaged manner, and care is taken to design your scar placement in a buried or hidden location.

EDGE OR WEDGE?

There are two well-described techniques for performing labiaplasty that addresses the labia minora: the external trimming technique (excising the "edge" of the protruding tissue-- the edge technique) and the v-shaped surgical excision (excising a "wedge" of the protruding tissue-- the wedge technique). I am well-versed and facile in both techniques and will tailor the procedure to your individual desires. Both procedures have their role in labiaplasty, however, generally speaking, I prefer the wedge technique in most women, as I consider it to provide a superior cosmetic result.

In general, the wedge technique is considered the gold standard of labiaplasty technique, and it has supplanted the edge technique in the hands of many modern and experienced surgeons. The wedge technique is more technically challenging from a surgical perspective, and for this reason, it is less common to find a plastic surgeon to perform this procedure. However, the wedge technique is considered a superior operation in most women for several reasons:

• The Edge technique creates a linear scar along the edge of the external genitalia, which can appear scallopped or irregular when the stitches heal. The Wedge technique has a buried scar that is less noticeable and leaves the external genitalia with a smooth contour.
• The Edge technique is associated with occasional complaints about dysparunia, or pain with sexual intercourse. These complaints are almost unheard of with the Wedge technique.
• The Edge technique is more traumatic to the tissues and has an increased amount of swelling, as well as an increased risk of wound breakdown. While swelling is also present with the Wedge technique, it resolves more quickly. Wound breakdown is not common with the Wedge technique.

WHAT IS THE RECOVERY LIKE?

After surgery, you will wear a maxi pad with a small amount of ointment on it, and use ice packs for comfort. All of your stitches will be dissolvable. You will use a "peri bottle" or water bottle to cleanse yourself after going to the bathroom. When you are resting at home, I advise pelvic elevation by keeping your pelvis propped up on 1-2 pillows to help the swelling come down.

Swelling after labiaplasty peaks in the first 2 weeks. During this time frame, swelling is gravity-dependent, so you will notice that spending more time doing pelvic elevation helps the swelling decrease. Even if you are up and about right after surgery, this will not effect your long term result, although it may take a bit longer for your swelling to go away. After the first 2 weeks, swelling continues to decrease on its own. You will have about 80% of the final surgical result at 1 month after surgery and 90% after 6 weeks, although it takes a full 6 months for all swelling to completely dissipate. 

WHEN CAN YOU RETURN TO WORK AND PLAY?

You will be able to do normal activities, such as walking around the block and running an errand, the day after surgery. Depending on the nature of your job, many women are able to return to work within 2-3 days. For more strenuous types of work, this may vary. Strenuous activity is not advised for the first four weeks after surgery, although pending Dr. Devgan's recommendations for your individual case, you may be able to resume some light exercises at 2-3 weeks. You will be able to return to sexual intercourse, strenuous exercise, swimming, and normal activities after approximately 6 weeks.

WHAT IS THE NEXT STEP?

Patient satsifaction with labiaplasty is extremely high. For questions about the procedure or to set up an in-person consultation, please call our office at (212) 452-2400 or email info@LaraDevganMD.com.