Dr. Pane evaluates the relative benefit of a labiaplasty revision for a viewer.
The Question
One of the fastest-growing trends in women’s cosmetic surgery is that of labiaplasty, which addresses the appearance of the outer and inner “lips” that cover and protect the vagina. Because of its increasing popularity, Atlantic Coast Aesthetics gets a lot of questions from people who are interested in this procedure. However, sometimes patients who go elsewhere aren’t altogether happy with the final result, as with this patient who contacted us through Facebook. She asks, “Got a labiaplasty about three months ago and it looks choppy. There is a small amount of labia left and I don’t want it to be completely amputated if I go back for a revision. Also, I am afraid of losing sensation if too much is taken near the clitoris. Will this fill in eventually and would you personally recommend getting a revision if it does not? Thank you.”
The Case
As the patient did not provide any photos or other ways to evaluate the case, Dr. Pane adopted a more general approach in discussing past cases he has undertaken and what the possible issues may be that the patient describes.
Dr. Pane’s Opinion
In the vast majority of labiaplasty, revision is not necessary. It is a very simple and safe procedure with a revision rate well under 1%. Dr. Pane says he had a stretch of four years straight in which he performed labiaplasty procedures and only had a single revision for a relatively minor issue. The patient in that case was concerned about “fullness” and a sense of hardness near the top of the mons and what is commonly known as “scalloping” along the suture line, which is an artifact caused by certain methods of suturing the area after the labiaplasty is complete. Neither of these impact sexual function or response, but from a cosmetic standpoint it needed to be addressed and was successfully revised.
With this particular patient, because it is so soon after the initial procedure, Dr. Pane says he would be reluctant to undertake a revision at this time. The reason for this is because although primary healing has already mostly occurred, internal healing is still going on. Additionally, many patients place the area under a microscope, so to speak, which may make things look like they aren’t healing or progressing as well or as quickly as the patient might prefer. This is especially true when it comes to procedures which affect the genitalia, because they are such an intimate area and one where most people prefer to look their best.
With regard to the actual patient herself, Dr. Pane says that from what he can tell, there is no immediate cause for concern. He would recommend that the patient wait until at least 5-6 months postop and then reevaluate the area. In many cases, where there is hardness or fullness at the top of the mons/vaginal crevice, this will self-regulate as the healing process continues and the irritated tissue resolves to a more normal state. However, there should be no reason in any case that the clitoral area should be involved at all, and if the issues the patient sees now remain, then it would be appropriate to consider revision at that time.
Other Considerations
Because surgical intervention can take 3-6 months, or more, to fully heal and demonstrate final effect, revisions of procedures less than 6 months old is not normally recommended unless there is an obvious defect or flaw in the procedure, and/or a medical necessity to perform the revision. This is by no means to say that a defect may not be there which is visible to the patient, and it is important for the patient to be willing to advocate for their own care, regardless of the type, location or relative necessity of the care in question. Following proper aftercare practices is always a good starting point, but it takes on a special importance when dealing with sensitive areas such as the genitalia, to obtain the best results and minimize the risk of complications.
If you have a burning question about cosmetic surgery and aren’t sure who to ask, Dr. Pane and the staff of ACA are pleased to discuss your interests and needs! Simply email us at https://acplasticsurg.com, follow us on Facebook and Twitter, or call us at (561) 422-4116. Your question may even be the topic of an upcoming Ask Dr. Pane segment, where the doctor will address your question live in a Google Hangout. It’s a great way to help us share information with others who have your interests while getting real, honest answers. Remember, at ACA we believe the only bad question is the one you don’t ask!