Labiaplasty in a patient with extreme anterior hypertrophy
This 26 year old patient came to see Dr. Medalie at his Beachwood office. Her chief complaint was labial hypertrophy with extreme irritation in tight clothes and during physical activity. On exam she had a great deal of excess and thick labial tissue as well as fullness of the clitoral hood. Dr. Medalie performed a labiaplasty under local anesthesia with mild oral sedation in his clinic. The wedge techniques was used and the post appearance is shown at three months. It can be seen that the labia minora are now no longer protruding beyond the labia majora and run in a straight line as opposed to being quite redundant. The clitoral hood was not operated on but has become more streamlined because of the pull of the labiaplasty. Her overall appearance is much improved and she has much less irritation during all activities. She was extremely pleased with her result.
Below is my Labiaplasty FAQ: Click on each question to see the answer!
Do I need general anesthesia?
No – Labiaplasty can be performed with mild oral sedation and local anesthesia.
How long does it take?
Typical surgery time is around 1-1.5 hours.
What is the chance of infection?
I typically give my patients antibiotics for three days around the surgery. I have NEVER had a post-operative infection. Sometimes patients who take antibiotics get yeast infections and this has happened to several of my patients. The treatment consists of stopping the antibiotics and applying a topical anti-yeast agent. Please be aware that smoking is the number one reason for post-operative infections and healing problems. I thus require my patients to STOP SMOKING at least 6 weeks prior to any labiaplasty procedure.
Are there bleeding risks?
The labia are very vascular and bleed easily. During the surgery local anesthetic is injected into the tissue-this blocks the sensation and also constricts blood vessels. As a result, there is very little bleeding during the surgery. I have NEVER had a patient have a bleeding complication post-op.
What is the recovery?
While it may seem that this is a very bad area to have surgery on, in fact, the labia are very resilient and heal speedily. Pain that may require narcotic pain medicine typically lasts only a few days. After that, ibuprofen (Motrin and Advil) is sufficient. I recommend that patients take a week off from work, but if you have a desk job, you can go back sooner. The post-op care is fairly easy and involves cleansing several times per day and the application of antibiotic ointment for a week. Most of the swelling and all of the external stitches have disappeared by two weeks.
When can I resume my normal activity?
I recommend that patients refrain from intercourse for at least 4 weeks after surgery. This does not mean that other types of sexual activity cannot take place. Even after 4 weeks, the labia incisions may be sensitive and patients need to use caution and plenty of lubrication.
When will I be completely healed?
Some of the deep sutures under the skin can take up to three months to completely dissolve. For this reason, some patients may report sensitivity issue such as itching for up to three months post-op. After that, sensation issues are very uncommon. Damage to the clitoris with resulting changes in the ability to have orgasm has never happened in my patient population.
Can other procedures be performed at the same time as labiaplasty?
Yes – I frequently perform multiple procedures on labaiplasty patients. Sometimes I perform clitoral unhooding. This procedure removes some of the skin overlying the clitoris to allow for greater stimulation during intercourse. The labia majora can also be reduced (this is more typically asked for by my older patients or patients who have lost significant amounts of weight). Vaginoplasty or vaginal rejuvenation is a procedure to tighten the vaginal introitus after child bearing. This is easily performed in conjunction with labiaplasty. Finally, all the other cosmetic procedures that I perform (e.g. breast augmentation, tummy tuck etc.) can be performed at the same time as labiaplasty. These would require a trip to the operating room and general anesthesia.
What does it cost?
Simple labiaplasty under local anesthesia and mild sedation costs around $3800 at Dr. Medalie’s outpatient procedure clinic. Clitoral hood reduction can be added for $500. Labia majora reduction is an additional $1500 (or $3000 as a stand alone procedure). All procedures are less expensive when combined with other procedures such as vaginoplasty or breast augmentation.
What if I am from out of town?
I frequently perform labia reduction and vagina rejuvenation surgery on patients who live out of town and are unable to easily to see me in consultation prior to the procedure. I have several requirements for these patients: I must see pictures of them prior to scheduling surgery. They need to contact my office and have my patient care manager fax or e-mail them a history and physical form to be filled out and sent back. Typically the patient will come in to town 1 day prior to the procedure, and I will see them the day of surgery. A phone consultation will be performed about 3 weeks prior to surgery. I will then perform the operation and see them back in my clinic in several days to check the surgical site and answer any questions. This means that the patient will spend around 4-7 days in the Cleveland area. Some patients have stayed only for 24 hours and had family doctors check on them. Patients who live far away, but can drive to Cleveland (2-6 hrs.), can go home the next day and drive back to see me for their first post-operative appointment. I will then follow the progress of the patient via e-mailed pictures on a weekly basis. My patient care mananger has information about hotels in the area as well as financing. You may contact her at [email protected].
Where can I get more information?
Please visit Dr. Medalie’s vaginal surgery specific web site at www.LabiaplastySurgery.net. There you can see multiple before and after labiaplasty and vaginoplasty photos as well as watch his live labia and vagina surgery video or call him at 216-393-9924. You can also e-mail his patient care manager at [email protected].