Labiaplasty is the most delicate and nuanced procedure that I perform. My surgical mantra is “gentleness in all things,” and I bring that approach to the labiaplasty procedure for my patients. Most women seeking labiaplasty have two concerns: the appearance of their labia minora, and the discomfort that long labia may cause them. A labiaplasty solves the problems of both form and function, and there is no better surgeon to address these two issues than a plastic surgeon.
Training and Expertise
A gynecologist or obstetrician deals with all areas of female health and wellness. They may order your mammogram or deliver your baby. They are a medical doctor and a surgeon, depending on the day or the week.
A plastic surgeon is, more or less, a surgical technician. In my case, I spend 4 days per week only performing surgery, cutting and sewing, as it were, and focusing purely on surgical technique. My focus is on surgical beauty, fine suturing, camouflaging scars. Generally speaking, if it has an aesthetic improvement to be made, I am studying it deeply. The cosmetic appearance is my primary surgical outcome.
Ob/Gyn:
- Medical and surgical focus
- Surgical volume is variable
- Aesthetic understanding is low
Plastic Surgeon:
- Surgical focus
- Surgical volume is high
- Aesthetic understanding is paramount
Procedure Approach and Technique
Medical Functionality
Most problems that I encounter with regard to labiaplasties were performed by Ob/Gyns with limited aesthetic knowledge. In the cases that I have revised, the doctor used scissors to snip the extra labia minora tissue. There was no attention to the clitoral hood tissues, and many Ob/Gyns feel that a hood reduction can and should not be performed. I have never seen any nerve injury—zero—in my labiaplast experience which almost always includes a clitoral hood reduction. The subcuticular closure is rarely used in labiaplasty surgery by Ob/Gyn surgeons, instead using the “baseball” stitch, running continuous, approach which leads to notching and grooving of the labia minora and healing issues.
Common Techniques
In comparison to the amputation approach, my technique involves a delicate curved incision along the labia minora edge and a smooth removal of the excess labia and hood tissues, only. The gentle approach leads to less bruising and minimal spotting. The closure is a fine internal closure with absorbable suture and no visible or palpable knots or suture material.
With the edge labiaplasty with hood reduction, my preferred expert technique, all of the functional complaints from large labia—namely, pinching, pulling, pain with intercourse and exercise, chafing, yeast infections, difficulties with tight clothing—are all resolved. As mentioned, I have not had any patients have any changes in sensation, pain with intercourse, numbness, or problems with orgasm after labiaplasty.
Aesthetic Goals
The primary aesthetic goal of the labiaplasty procedure is to reduce the inner labia so that it is “tucked-in” within the borders of the labia majora, the outer labia. The edges are smooth and the texture is soft. In most cases, the darker edges of the labia minora are removed leaving a lighter pinker coloration which is more desirable.
Making the Right Choice
Professional Experience
The summary slide is simple: choose a doctor that has immense experience with performing the
labiaplasty procedure. It should be their central specialty. Because it involves delicate tissues, fine
suturing, and critical sensory structures, you should choose an expert plastic surgeon who specializes in
labiaplasty for your care. You should only see an Ob/Gyn for a labiaplasty if it is central to their practice
of cosmetic gynecology. Otherwise, their experience will be just too low to make sure that you have a
safe outcome that exceeds your expectations.
Personal Comfort and Trust – Consultation and Decision-making
Regardless of the surgeon’s experience, photos, reviews and videos, you have to make sure that you just
plain trust them, that you feel comfortable discussing your labiaplasty goals and concerns, and that they
are professional, kind and courteous at your consultation. Your gut feeling is there for a reason. Go with
it when choosing an expert labiaplasty surgeon.