Labiaplasty

Labiaplasty in Western PA

Labia sizes greatly vary among women. Labiaplasty improves enlarged labia minora (inner vagina lips) and labia majora (outer vagina lips) . These are not uncommon, and although they do not harm the woman, she may feel dissatisfied with the appearance and experience discomfort with undergarments and intercourse. Several factors including genet

Labiaplasty

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ics, age and childbirth can contribute to women developing a laxity of vaginal tissues.

During the Labiaplasty surgery, Dr. Giraldo will trim the labial tissue to make it smaller and complementary, yet still natural-looking. Although all surgeries administer scars, the scars after the Labiaplasty are virtually invisible.

Ask the Advanced Liposuction Center about vaginal rejuvenation with labiaplasty.

It certainly hasn’t replaced breast enhancement as the most popular cosmetic procedure, but vaginal rejuvenation appears to be catching up. According to the New York Times, a growing percentage of the cosmetic procedures performed on women in their 20s are labiaplasty surgeries. In layman’s terms, these are minimally invasive procedures which improve the appearance of the labia (lips) of the vagina.

According to a report issued by the Adolescent Health Care Committee, young women today are under increasing pressure to achieve an “ideal” body. Furthermore, this increasingly involves the appearance of the vagina. In particular, the size, shape, and proportions of the labia.

Complications

Labiaplasty is a delicate procedure, and is considered by surgeons to be technically demanding. Very rare yet serious complications are possible, which can include scarring, infection, and ongoing pain. When performed in teens, the long-term effects on sexual function haven’t been adequately studied. This procedure is generally well tolerated among healthy women in their 20s and beyond.

The Ideal Candidate

A healthy woman who desires a more cosmetically pleasing and comfortable labia region. Patients should have realistic expectations and be in good overall health and not pregnant or nursing. Candidates include women who feel their labia are:

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    • Thinned out
    • Poorly shaped
    • Too large
    • Protruding
    • Uncomfortable
    • Uneven
  • Boost self confidence
  • Improve v
    aginal appearance
  • Eliminate pain during intercourse
  • Reduce discomfort of rubbing undergarments
Dr. Giraldo’s patients are often surprised with how little discomfort there is with this procedure. After the procedure, patients may experience soreness for 3-4 days. During the first month post-surgery, patients must be very gentle with the tissue because of the small, dissolvable sutures used. Patients will be prescribed antibiotic ointment to apply to the labia. Patients should refrain from sexual activity for 4 weeks.

Labiaplasty Popularity

As women are considering more cosmetic procedures or all types, the popularity of labiaplasty has soared in recent years. Read on to discover more about this fascinating, if little talked about, procedure.

  • In many cases the patient doesn’t need the procedure to begin with.

“I routinely see women as young as 16 in my office, and they think they need a labiaplasty. They don’t. In all, I’d say that I talk women out of this procedure more times than I perform it.” According to one New York based cosmetic surgeon Dr. W. what these women are actually concerned with is what is known as “camel toe.” Says Dr. W “it’s completely normal. What I end up doing is sitting down with the young woman and using pictures to educate. There’s countless ways that the vulva can appear. At the end of a 20 minute consultation I want them to leave thinking that theirs is perfectly normal.”

Body Dysmorphia

Women with a psychological condition known as body dysmorphia should also be excluded as candidates. The hallmark of this condition is the strong, often consuming belief that one’s body appears different than it does in reality. This condition goes beyond simple low self-esteem and poor body image. In such cases, it’s likely that no cosmetic procedure will challenge this false belief. “What these women really need is counselling. We work with several very good counsellors in the area, and I refer patients every week.”

  • There’s multiple different reasons why someone might choose labiaplasty. 

“I see a lot of patients whose inner lips (labia minora) are very large. It’s a genuine problem, because many of these individuals have problems simply inserting a tampon. Sex is often painful, and these patients frequently complain of chaffing from tighter clothing. These are all excellent reasons, and these folks are great candidates. They’re doing it for the right reasons,” says Dr.  G“I also see women with one inner labia that’s larger than the other. I consider this a good reason. I’m still always concerned with possible psychological issues, but I’m very comfortable operating on these candidates.

Of course, there are many patients who come in with purely cosmetic concerns. They’re often doing it for the right reason as well—to make themselves happier and more confident. I’d say that these women are the majority, in fact,” continues Dr.  “I’m equally comfortable with this. But sometimes the procedure just isn’t needed, and I’m not afraid to tell patients that.”

Labiaplasty is an outpatient procedure, using only local anesthetics such as lidocaine . However, we do regard it as a relatively complex procedure. When choosing a surgeon their level of experience should be a key factor. While all of these procedures fall under the labiaplasty category, some are trickier than others. The outer labia (majora) are more commonly enlarged, yet the inner labia (minora) can become so as well. For the inner lips the procedure is somewhat more complicated. Less demanding cases labiaplasty can take as little as 15 minutes. In complex cases operating time can be much longer, up to 2 hours or more. If both sets of labia are involved this will obviously add to this time.

  •  The recovery process is longer than other minimally invasive procedures. There’s also likely to be more downtime.

According to Dr. , most patients are likely to underestimate how long full recovery will take. Self-dissolving sutures are typically used, and these are usually gone in about 3 weeks. It can be much longer, however, before the vagina is fully functional, e.g. ready for sex. “I always advise my patients to soak in epsom salts 3 times daily for the first week. After that it’s a good idea to continue with once a day until full healing takes place. A hair-dryer should be used to dry the area immediately afterwards. I also prescribe compression garments, which minimize the chances of chafing injuries.

It’s all about optimizing the healing environment—this is a sensitive area, after all,” continues Dr. G . We prescribe antibiotics as a safety precaution against infection, typically during the initial phases of healing.

  • Insurance is unlikely to cover Labiaplasty .

Labiaplasty is rarely covered unless there’s a genuine medical issue which interferes with day-to-day functioning.  Even if sex is painful or the patient is prone to chafing most major insurances will be hesitant to pay. For the vast majority of patients this remains an elective procedure, and costs must be covered out of pocket. Says Dr. G “Our office rarely sees this procedure covered. Almost never, in fact.”

Post-Operative Care for Labiaplasty

Labiaplasty is a cosmetic procedure done to enhance the appearance of the vagina, specifically the inner and outer labia. As with any surgery, proper aftercare must be taken to both reduce risks and maximize benefits. There is no single labiaplasty aftercare protocol agreed upon by the cosmetic surgical community. This being said, almost all aftercare plans will address the following:

Reducing the risk of infection

Any time something breaks the skin there is a risk of infection. Surgical procedures are no exception. Even though they’re performed in a sterile environment there’s always some level of risk.

Medications

Most surgical offices prescribe a short course of antibiotics to greatly reduce the risk of infection. This is done prophylactically, meaning that the purpose isn’t to treat infection but to rather to prevent one. Both prescription broad spectrum oral antibiotics and prescription topical antibiotics are used together in nearly all cases. Oral cephalosporin and topical erythromycin are a typical combination. In the early phases of healing the vulva should be gently washed using warm water without soap. After each wash the vulva should be carefully dried and the topical ointment should be applied.

Most surgeons prescribe a 5 day course of oral antibiotics and advise the use of the topical ointment until the wound is closed. A 10 day course is also fairly common. Aside from health concerns, an infection during early healing increases the odds of adverse effects such as scarring.

Avoid

Following their procedure patients should avoid swimming, hot tubs, and other forms of prolonged soaking. Patients should limit themselves to short showers. The vulva should be cleaned without soap and promptly patted dry with a soft towel. After using the toilet rinsing with warm water is advised. Dressings are usually worn for the first 5 days until the wound becomes “dry.” Change them as recommended by your surgeon’s office.

Sitz Bath

Many cosmetic and plastic surgeons also recommend sitz baths. This reduces swelling and inflammation, eases pain, and helps remove dead skin.

Not surprisingly, patients should wait a minimum of 6 weeks before engaging in any sex acts involving the vagina and perineum. After this period sex can be resumed as normal, with no restrictions.

Q: What does Labiaplasty involve?
A: Dr. Giraldo performs the Labiaplasty in our Cranberry Township office suite under local anesthesia with mild sedation. The procedure typically lasts 1 hour. Patients must have a driver to take them home after surgery. We recommend taking 1-2 days off of work to rest.
Q: Is Labiaplasty painful?
A: The procedure is not painful but patients may experience mild-moderate discomfort post-surgery.

Controlling pain

As with antibiotics, a short course of narcotic pain medication is usually prescribed after a labiaplasty. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are also almost always used to bring down swelling and reduce inflammation. While it may seem acutely uncomfortable, many women apply ice packs over their sterile dressing for temporary relief. This has many of the same benefits of NSAID therapy as well. Until full healing has taken place only loose, breathable under and outer garments should be worn.

Miscellaneous advice

Surgeons commonly recommend 24 hours of bed rest following a labiaplasty. If this is the case, compression garments, usually thigh-high stockings, are prescribed to limit clot risk. Since the patient isn’t sitting up during this time no weight is put on the surgical site, which greatly reduces the risk of reopening the surgical incisions. It’s also advisable to take a week long leave of absence from nearly all forms of work, including sedentary jobs. In general, it’s best to take it as easy as possible during this initial phase of healing.

Strenuous exercise such as strength training, swimming, and running should be avoided for at least a month. These activities can put pressure on the perineum which can potentially reopen incisions or cause wound breakdown. Specific activities such as riding a horse or bike should also (obviously) be avoided.

Although prolonged walking or sitting should be avoided, it’s a good idea to periodically take very brief walks. Along with compression stockings, this is one of the best ways to reduce the risk of potentially harmful blood clot formation.

Smoking or other tobacco use can impede healing and should be avoided during the first two months following the procedure. If you’ve considered quitting for good this is an excellent opportunity. Also limit alcohol intake during this time.

In many cases It’s normal for labiaplasty patients to experience periods of mild fever. These can be easily managed using Tylenol or other antipyretic medications. If constipation is an issue a high fiber diet rich in fruits and vegetables is recommended. Proper hydration should also be maintained throughout the healing process.

Most labiaplasties go smoothly and complications are extremely rare. They are possible, however, and can include:

  • Failure of the flaps to unite normally (wound dihescence).
  • Clot (hematoma) formation. This can lead to potentially life threatening conditions such as Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).
  • Failure of the incisions to develop an adequate blood supply, a process called neovascularization. This can result in tissue death, known as ischemic necrosis. This can lead to very serious infections and may require surgical removal of the dead tissue. This can have highly negative cosmetic consequences.
  • Chronic pain caused by nerve damage.
  • Painful sexual intercourse (dyspareunia)
  • Contraction of the surgical incisions, resulting in visible scalloping of the labial edges.
  • Visible scarring.
  • Infection.
  • An overly conservative approach can leave the patient with labia which are larger than they’d like.
  • An overly aggressive approach can leave the patient with labia smaller than they’d like. In extreme cases the remaining labial tissue is minimal and clitoral hood structure is altered.
  • The formation of fistulas.
  • The need for follow-up surgical intervention to correct any of the above.
  • The patient may feel that revision surgery is necessary if they didn’t achieve the results they’d hoped for.

If the patient experiences prolonged pain, swelling, bleeding, or other discharge this could be a sign of something more serious. Contact your doctor immediately. Also seek attention if a persistent fever is present. It’s also possible for post-operative medications to cause an allergic reaction. Consult with your doctor or pharmacist if this is the case.

Q: How many appointments are needed?
A: Patient’s need an initial consultation and 2 postoperative appointments after the Labiaplasty.
Q: Will the surgery result in decreased sensation during intercourse?
A: The surgery does not result in scarring, so no, there should be no changes in sensation. Actually, many patients report enhancement since they no longer feel self-conscious.
Q: When can I return to work after the Labiaplasty?
A: Most patients return to work 2-4 days after surgery. Patients should not lift heavy equipment and should not exercise for 2 weeks.

Q: Can I deliver vaginally post-surgery?A: Yes.

Q: When can I resume sexual activity after Labiaplasty?
A: Sexual activity can resume after 4 weeks.

Q: What is the cost of the Labiaplasty?
A: Call for a consultation. Depends on extent of condition.

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