Many women are unhappy with the size of their Labia Minora (inner vaginal lips), which may cause insecurity or embarrassment with a sexual partner, discomfort in tight fitting pants or swim wear, or other hygienic problems. Women have become more aware of differences in genital appearance, due in large part of nudity in magazines and nude presentation in movies.
When Labia Minora are enlarged or unequal in size, some women harbor feelings of deformity or being abnormal, with loss of self-esteem. Most women do not desire the smaller inner vaginal lips to project much beyond the larger outer lips, and many do not want the smaller inner lips to extend beyond the outer lips.
Labia Minora enlargement may be genetic and a normal variant from birth or it may be due to hormone manipulation in infancy, childbirth, chronic irritation or persistent manual stretching. Labioplasty or Labia Reduction is a relatively minor procedure in which the excessive labia minora tissue is removed. Women may desire Labia Minora Reduction for comfort or hygienic reasons, to relieve chronic irritation, to prevent interference with sexual intercourse, or simply for aesthetic reasons.
Most Labia Minora Reductions are performed by amputating or excising the excess tissue and oversewing the raw edge. This technique replaces the natural contour and normally darker pigmented labial border with an unnatural and irregular scar line of more lightly colored inner labial tissue. A newer technique preserves the normal contour and color of the labia minora edge.
The excess labia are removed in a way that allows re-approximation of the normal labia minora edges. After healing, the surgery is practically undetectable, as a normal appearing labia minora remains.
Other procedures to enhance the appearance of the vaginal area include Augmentation Labioplasty, which allows aesthetic enhancement and youthful Labia Majora (outer vaginal lips) by fat transplant/injections. In addition, Liposuction can be used to remove fat from an overly large or protruding mons pubis and upper parts of the labia majora. Lipo-sculpturing can alleviate the unsightly fatty bulges of these areas and produce an aesthetically pleasing contour.
These may be combined with other cosmetic surgery procedures including liposculpture, breast implants, breast reduction or lift, tummy tuck, nose or eyelid surgery, etc.
During the initial consultation, it is important to review the patient's medical history, goals and expectations, as well as build mutual trust and rapport. Before and after photos are reviewed, the procedure is carefully explained and alternatives are discussed. Additional procedures are reviewed if requested.
An evaluation and physical examination is performed for each patient, to ensure that expectations are met, as well as to determine the best procedure(s). The surgical plan is then reviewed. The labia minora are not naturally symmetrical. Every effort will be made to make the labia as symmetrical and as close as possible to the desired size. However, no surgeon can guarantee the exact size, shape, or symmetry. Patients are encouraged to speak with previous patients about their surgery and results.
Following the initial consultation, and after appropriate time for reflection, an appointment is scheduled for routine preparation and informed consent. Additional questions and concerns may also be addressed. Routine blood analysis and medical clearance is required before surgery.
This relatively minor surgical procedure is performed in our state-of-the-art outpatient facility under general anesthesia or intravenous sedation with local anesthesia. Epidural (spinal) anesthesia may also be used.
It is recommended to have this procedure performed just after one's period. After speaking with the anesthetist/anesthesiologist, the patient is brought to the operating room. After the patient is sedated, local nerve blocks, combined with medication that shrinks blood vessels and capillaries to reduce bleeding, are instilled.
The excess labia minora tissue is excised, allowing re-approximation of the normal labial edges, preserving natural color and contour. The incision is closed with self-dissolving. Any additional procedures are then completed. Liposculpture of the mons pubis will require one or two tiny hidden incisions.
The excess fatty tissue removed from the mons or a small amount of fat from the abdomen, thighs, or buttocks may be used to enhance and fill out a small area of the labia majora, if desired. Antibiotic ointment and a sanitary napkin are applied.
After surgery, patients will experience some mild swelling. The recovery is easily tolerated and patients generally report minimal to no discomfort. The evening, (or the following day,) of the procedure, the patient should shower and use phisoderm/phisohex or baby shampoo to gently clean the area and then apply Bacitracin or Neosporin antibiotic ointment to the incision lines.
Most patients return to work in two to four days. Sutures (stitches) are self-dissolving; hence, no sutures need be removed. Sexual relations may resume in about six weeks. Patients from out of town should plan to stay two or three days after surgery.
As with most cosmetic surgical procedures, complications are unlikely when performed by a skilled and competent surgeon. Complications include, but are limited to,:
* Anesthesia risks,
* Bleeding,
* Infection,
* Asymmetry,
* Poor or delayed wound healing,
* Incision separation,
* Under- or over-correction,
* Need for revisional surgery
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