Definition and Overview

A labiaplasty, or labia reconstruction, is a surgical procedure that aims to improve the general appearance of the female genitals. It is performed on the inner (labia minora) and outer labia, the folds of skin around the vulva.

Who Should Undergo And Expected Results

Women who undergo labiaplasty are those who suffer from conditions that affect their genital area and those who, even without a medical reason, wish to simply improve the appearance of their genitals.

The medical conditions that cause some abnormalities in the labia include:

  • Vaginal atresia, or when a woman has no vaginal passage
  • Mullerian agenesis, a condition that causes the malformation of the fallopian tubes and uterus
  • Intersexuality, or a woman with male characteristics
    Other medical reasons for undergoing a labiaplasty include:

  • Trauma or injury to the labia

  • Tearing of the labia minora due to childbirth
  • Stretching of the labia due to aging
  • Sex reassignment surgery
    About 30 percent of labiaplasty cases are performed due to functional medical reasons, whereas almost 40 percent are performed for purely aesthetic purposes.

Labia reconstruction surgery, which has up to 95 percent satisfaction rating, has proven to be highly effective in improving the appearance of the labia and resolving any problems associated with it. However, it is not for everyone and the following are advised against it:

  • Women with existing and active gynaecological diseases, such as malignant tumours or cancer
  • Are smokers and are not willing to quit, as smoking can compromise the patient’s ability to heal after the procedure
  • Have unrealistic aesthetic goals, in which case, patients may require counselling

How Does the Procedure Work

A labiaplasty is available in hospitals as well as specialty and plastic surgery clinics.

However, not all gynaecologists and gynaecologic surgeons support and perform cosmetic labiaplasty. The largest criticism of the procedure is that the desire to undergo a labiaplasty stems from poor self-esteem fueled by unrealistic expectations and standards. This is why cosmetic labiaplasty may only be available in private cosmetic clinics, especially in countries where guidelines have been set as to which cases can be cleared for a labia reconstruction procedure. In some countries, women are first advised to undergo counseling and are only allowed to undergo the procedure if they still desire to do so following their meeting with a counsellor.

During a labia reconstruction surgery, the patient is placed under either local or general anesthesia depending on the extent of the procedure and whether it is being performed on its own or in combination with other procedures.

Techniques that can be used in performing a labiaplasty include:

  • Edge resection technique – This is known as the original labia reconstruction technique wherein a simple resection of the excess tissues of the labia minora is performed. The surgery ends with the surgeon suturing the cut part together using dissolvable stitches. However, it is known for producing unnatural results, such as making the labia looks too smooth.

  • Central wedge resection technique – This method cuts and removes a wedge of tissue from the labia’s thickest part to effectively reduce its size while keeping its natural wrinkles and giving it a more natural contour.

  • De-epithelialization technique – This method cuts the epithelium using a scalpel to reduce the excess tissue while preserving the labia’s sensitive and erogenous nature. It also effectively maintains the natural corrugation of the labial skin, making the resulting labia look more natural.

  • Laser labiaplasty – This method uses laser technology to cut the labia minora. The use of laser rather than manual incisions helps lower the risk of epidermoid cysts.
    Following the procedure, patients may experience some pain and swelling, but are typically allowed to go home on the same day. They are instructed on how to properly clean the affected area with the use of a topical antibiotic. They are also asked to return to the surgeon’s office for a follow-up visit about a week after the procedure.

The recovery period following a labiaplasty is usually fast and uncomplicated, with most patients able to return to their daily routine three to four days after, as long as strenuous activities are avoided. The use of tampons and tight-fitting underwear, as well as sexual intercourse, are usually not allowed for the first four weeks after the procedure.

Possible Risks and Complications

The risks associated with labiaplasty include:

  • Permanent scarring
  • Bleeding
  • Infection
  • Labial asymmetry
  • Delayed wound healing
  • Undercorrection
  • Overcorrection
  • Making the inner lining of the labia minora turn outwards
  • Skin irritation or irritation of the genital area
  • Hematoma, or when blood accumulates outside the venous and arterial system
  • Nerve damage, which may cause genital sensitivity to increase or decrease
  • Neuromas

    References:

  • Motakef S, Rodriguez-Feliz J, Chung MT, Ingargiola MJ, Wong VW, Patel A. Vaginal labiaplasty: current practices and a simplified classification system for labial protrusion. Plast Reconstr Surg.2015;135(3):774–88.

  • Wu JA, Braschi EJ, Gulminelli PL, Comiter CV. Labioplasty for hypertrophic labia minora contributing to recurrent urinary tract infections. Female Pelvic Med Reconstr Surg. 2013;19(2):121–3

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