Labioplasty: all your questions answered by our gynaecologist and obstetrician, Dr. Jiří Chod

Article

17. 03. 2022 Gynecology

Having seemingly too large, or asymmetrical labia is often a sensitive topic that most women are too ashamed to talk about openly. In reality, it is a very common issue, one that has a relatively simple fix that can bring back a woman’s confidence and make her day-to-day life more comfortable. This solution is a procedure called labioplasty. Canadian Medical’s gynaecologist and obstetrician, Dr. Jiří Chod answered all of our questions.

Is labioplasty simply an aesthetic procedure? Or can the procedure help women in other ways?

Enlarged labia don’t just have to be an aesthetic issue. For many women, having larger than normal labia can cause discomfort when wearing tight clothing (underwear, swimwear or trousers), when cycling or horse riding, or even during sex when the labia can be pulled into the vagina. As a result, these activities can cause swelling and pain or even minor injuries to the sensitive tissue.

Who tends to seek out this type of surgery the most?

With a growing movement towards pursuing a healthy lifestyle and good mental health, the awareness and demand for aesthetic surgeries in the field of gynaecology is also growing. Our clients often come for a consultation for cosmetic reasons or because they are experiencing discomfort during exercise or in their intimate lives.  Some women also come with functional defects of the uterus, most often after a birth injury. Women who are not happy with the external appearance of their genitalia, or whose vaginal mucosa loses its natural moisture and elasticity due to declining hormones. This can very easily be solved with a simple and effective plastic surgery to tighten the loose vaginal walls (vaginal tightening), perineoplasty, or a local application of hyaluronic acid to strengthen and replenish the volume of the labia. Vaginal application restores vaginal hydration and elasticity.

Is there a risk that women may experience less sensitivity around the genitals following the procedure, and that the conditions could be irreversible?

Labioplasty is a procedure that reduces the size, solves congenital asymmetry or modifies the shape of the labia, especially in excessively small or large  labia. This procedure does not impact the normal functioning of the genital area. The most receptive part of the female genitalia the clitoris, which remains fully untouched during labioplasty and therefore the sensitivity of the intimate areas should not be affected. Temporarily, for a few weeks following the procedure, the patient may experience a reduced sensitivity, especially during procedures involving the removal of the small labia longitudinally. However, in the vast majority of cases, these concerns are temporary and usually reside within 6 weeks of the procedure.

What can the patient do in preparation for the procedure?

The optimal period for performing this procedure is in the time following menstruation. One day before, it is advisable to shave the hair on the external genitalia and it is also necessary to ensure that there are no small lesions on the vagina in order to prevent infectious complications. In agreement with the general practitioner, it is recommended to discontinue all blood-thinning medication. There is no need to discontinue or interrupt any usual contraception.

Is plastic surgery performed under general or local anaesthetic?

Anaesthesia options for labioplasty can be chosen according to the extent of the operation, the patient’s personal preferences and the usual procedure of the workplace. With a small extent of resection, local anaesthesia is a very gentle, and generally more comfortable option. During the operation, it is accompanied by a slight feeling of pressure and no pain. If major resection or reconstructive surgery is planned, for example, to correct postpartum injury, it is better to choose general anaesthesia due to the sensitivity of the intimate areas.

What are the most common postoperative complications?

The labia usually heal very well after labioplasty and the operation does not leave any visible scars. During the so-called "wedge resection", there may sometimes be a noticeable transition in the pigmentation of the labia, but this discolouration often disappears over time, leaving practically no signs of surgical intervention. Stitching is done with an absorbable fibre, so there is no need to remove any stitches after the operation. Bleeding into the surgical wound is a potential early postoperative complication of labioplasty. To minimize the risk, it is advisable to remain in the medical facility for 12 hours post-surgery, where the healing can be monitored. The risk of infectious complications can be managed by careful preoperative healing of the vaginal environment and disinfection before the procedure or, if necessary, subsequent antibiotic treatment.

Is there anything that the patient should do in the post-operative period?

In the early postoperative period, i.e. in the first 5-7 days at least 5 to 7 days, it is recommended to follow a rest regime. To prevent swelling, it is advisable to avoid prolonged sitting and to apply cold compresses to the external genitalia. In the first days, the patient should cover the wounds with sterile dressings and replace them every two hours. Increased hygiene is necessary, i.e. after using the lavatory (urination and stool), showering the external genitalia at least 5 times a day, or applying a sitz bath in the morning and evening (preferably with pine water or hypermanganese).

How long is it should you wait to have sexual intercourse after the procedure?

It is better to abstain from sexual intercourse until after the tissue has healed completely, i.e. usually 4 to 6 weeks after the procedure. The use of vaginal tampons is also not recommended during this period.

Who is this procedure not suitable for?

Contraindications to labioplasty include: incomplete development of the external genitalia, i.e. age under 18; acute inflammation of the uterus or other inflammatory stress in the body; blood clotting disorders; pregnancy and/or lactation. The procedure is also not suitable for people with mental disabilities.

 

The full article can be found on Žena-in.cz.

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