Might I benefit from a labiaplasty? If so, what will it involve?

 

 Labiaplasty (also spelled "labioplasty") is an aesthetic plastic surgical procedure of the female external genital folds, the labia minora (inner lips) and/or the labia majora (outer lips). Labiaplasty usually reduces the size and reshapes these inner lips or outer lips.

This aesthetic procedure has been utilized by plastic surgeons for well over a decade but, in recent years, it has experienced increased popularity. Reasons for this growing interest include such factors as more readily available information about this procedure (via the media and Internet) and the abundance of graphic adult material causing a realization that the appearance of female genitals can vary considerably (depending upon the size and shape of the labia).

Add to this, the desire of many women, after adopting a more cleanly shaven pubic appearance (e.g., Brazilian waxing), to be able to wear sheer panties or similar apparel without the fear of a noticeable "bulge" showing through, or even protruding labia minora "peeking out," creating a tremendous sense of insecurity.

There are, in addition, some women who, because of enlarged labia, are hampered by pain or irritation arising from trying to wear certain articles of clothing, participating in some athletic pursuits and even during intimate sexual activity. In these instances, the reason for surgery may be viewed more as a physical necessity than as strictly an aesthetic choice.

 To decide if you are a good candidate for cosmetic labia surgery, you must first decide if you fit into one of the above-mentioned situations pertaining to your labia minora (inner lips), your labia majora (outer lips), or even both. If you do, then the next step is to be examined by a labiaplasty surgeon, who is capable of safely and effectively performing the operation, and who can tell you the likelihood of a labiaplasty correcting your problem.

Once it can be confirmed that you'll benefit from labia surgery, you will want to learn the exact technique that will best fulfill your needs. As this implies, there's more than one way to perform a labiaplasty, and a detailed discussion of the various methods for labia rejuvenation is available to those who have an interest.

 The question occasionally arises regarding the advisability of labiaplasty for African American, Asian or Hispanic women who may also experience identical symptoms of discomfort or diminished self-esteem (and confidence) due to enlarged labia minora or an undesirable appearance of their labia majora. The obvious answer is that race or ethnicity is totally unrelated to the decision for or against labia surgery to correct those problems. These women are just as likely to benefit from labiaplasty surgery, and in my experience they are not exposed to any additional surgical risk. The only possible exception is the rare chance of forming thick or "keloid" type scars, occasionally associated with the dark skin pigmentation of African American patients. Although this is occasionally mentioned as a possible complication, I personally have never encountered it.

The true difference I encounter with respect to African American, Asian or Hispanic patients, who are interested in undergoing labiaplasty, relates to their greater likelihood of possessing dark labia minora margins, which may influence the type of labiaplasty to be selected (labiaplasty to correct dark labia minora margins is fully discussed elsewhere).

 

 Cosmetic labia surgery really has no age boundaries. As with most plastic surgery procedures, the decision hinges on whether a patient's health is satisfactory to tolerate the surgery and whether there are possible unwanted effects on subsequent development if this surgery is performed before full physical maturity has been reached.

With labiaplasty, though, there may be strong reasons to actually consider performing this surgery at an early age (during puberty). This should be considered, for example, when a young lady becomes inhibited from participation, with girls her age, in activities for which it is necessary to share locker room space, showers or bathrooms. The greater the availability of activities that require those facilities, the greater the challenge for the self-conscious teen to keep that part of her anatomy "private."

There are also those girls and young ladies, who, because of labial irritation and discomfort, choose to avoid certain physical activities or sports that they find associated this annoyance.

Since surgical correction is entirely possible and safe, it's very appropriate to offer labiaplasty as an option, provided the teen and her parents are in complete agreement. There is a place for "teen labiaplasty," although it should be approached with discretion.

 Although labiaplasty is a minor surgical procedure, the location for this surgery may vary from a full service hospital (along with an overnight hospital stay) to a well-equipped, accredited outpatient surgery center.

I prefer to perform labiaplasties as outpatient procedures, and the surgical time is approximately one hour. This is carried out in a fully accredited outpatient surgery facility. Frequently I combine labia surgery with other cosmetic surgery, when requested by my patients.

 

 Labiaplasties can be performed using just a topical anesthetic cream (Emla Cream), in addition to administration of a local anesthetic, without the requirement for any sedation. In this circumstance the patient may keep this procedure extremely private.

On other occasions, it may be performed using local anesthesia but under light oral sedation or, even, heavy intravenous sedation (twilight sleep). In these cases, the use of sedation raises the necessity for someone other than the patient to be the driver.

Finally, if the patient prefers and is willing to pay the additional cost, labiaplasty may be done under general anesthesia (totally asleep). Discharge from the outpatient surgery facility is then about one hour after the operation ends, and, with the patient still slightly sedated, someone else (family or friend) must drive her home.

 Naturally, there's the onset of some discomfort as local anesthetic wears off, several hours following the procedure. I prescribe adequate oral medication to help patients tolerate this without difficulty. After a couple days, pain medication is no longer necessary, and patients can plan to resume work or school. Though all patients are different, this typically occurs between the 3rd and 5th day following surgery. I advise all of my patients to avoid any activity that might be particularly traumatic to the genital area for a period of six weeks. This obviously includes horseback riding, bicycling and sexual intercourse, to name a few examples.

 Although labiaplasty is considered by most surgeons to be a form of "minor surgery," there are still surgical risks that prospective patients should consider before finalizing a decision in favor of this surgery. Providing this risk information for labia surgery is not an attempt to frighten patients, but it should encourage them to carefully select a qualified and skilled labiaplasty surgeon. Few will argue against the fact that skilled and caring surgeons experience fewer surgical complications, and when faced with an unexpected outcome, a highly skilled surgeon is in a far better position to satisfactorily correct the problem.

Aside from a small risk normally associated with the use of anesthetic agents, the following is a brief list of complications occasionally seen following labiaplasty:

 Revision labiaplasty (known also as "secondary labiaplasty") becomes required when the original labia surgery has either failed to completely improve a labia problem or has resulted in a deformed appearance of the labia. Such a deformity can even occur when an unexpected postoperative complication causes distortion of a well performed labiaplasty that was originally . Most often, it's not a difficult matter for an experienced labiaplasty surgeon to correct these deformities.

Unfortunately, deformity may also result when an unsuspecting patient has her labiaplasty performed by a surgeon who is inept with regard to good plastic surgical technique or is lacking in the understanding of sound labiaplasty concepts.

Women seeking revision labiaplasty often find themselves to be humiliated and of very low self-esteem because of their deformed appearing genitalia. It isn't uncommon for these women to realize the error they made in the selection of their original surgeon and, understandably, to be hesitant to return to that same doctor for a revision. These women are strongly encouraged to seek the services of a well-regarded plastic surgeon for their secondary surgery (preferably one who also has an active labiaplasty practice).

Since the variety of possible labial deformities is immense, it's impossible to describe a single approach for the surgical repair. As a general rule, the less labial tissue that was removed by the initial surgery, the greater flexibility the next surgeon has with which to accomplish a successful surgical revision.

 By their very nature, labia are extremely pliable and stretchable. A labiaplasty reduces the length of the labia, but it does not eliminate the ability of the labia to stretch. As a consequence, having a previous labiaplasty does not, in any way, hinder natural childbirth and, in fact, may make it easier.

 Labia minora labiaplasty, with or without clitoral hood reduction, can be performed under heavy sedation (twilight sleep). If no sedation is used and the procedure performed under local anesthesia, the fee is less. If general anesthesia is chosen, the fee rises accordingly. Please call the office to request a quote tailored to your personal needs.

 Coming in from another city in south Louisiana should not present a problem.

Labia surgery, being a minor surgical procedure, does not require an overnight stay in Baton Rouge, as is sometimes required with other cosmetic surgery. It's fairly simple to arrange this operation "long distance" and then to make a single trip to Baton Rouge to have the labiaplasty and then travel directly back to your home in New Orleans, Lafayette, Lake Charles or anywhere else, within a few hours drive of Baton Rouge.