What is a Labiaplasty Revision?
Over the years, labiaplasty has been gaining popularity, with patients requiring it for both functionality and aesthetics.1 According to the 2017 Cosmetic Surgery National Data Bank Statistics by the American Society for Aesthetic Plastic Surgery, labiaplasty is the most common genital cosmetic procedure being performed. From 2012-2017, there was an increase of 217.3% and the procedure ranked 16th among female surgical cosmetic procedures.2 It was postulated in 2017 that about 29 million US dollars were spent in the United States on labiaplasty.2
Labiaplasty revision is a cosmetic surgical procedure aiming to correct undesirable results from a previously performed labiaplasty. The revision procedure entails a total redo of the primary labiaplasty procedure that yielded an unsatisfactory result. A botched labiaplasty may result in the form of asymmetry, irregular labial edges, prominent scars, or the removal of too much or too little labial tissue.3
When cosmetic vaginal surgery for any reason is performed, the main objective of the patient and surgeon is to improve the appearance and, as such, to meet the patient’s expectation(s). Unfortunately, for some patients, this is not the case. Hence labiaplasty revision is a rising field in female genital cosmetic surgery for a botched labiaplasty.
What Are the Reasons for a Labiaplasty Revision?
Here are some of the common reasons why patients seek labiaplasty revision surgery.
- In the case of poor post-operative healing after a labiaplasty resulting in fluid accumulation and/or infection.
- Painful scar tissue formation after a labiaplasty may arise when an inexperienced surgeon performs a labiaplasty or when a labiaplasty surgeon uses outdated methods.
- Labial enlargement following a labiaplasty may be caused by hormonal changes, especially during pregnancy.
- Unsatisfactory results from inexperience, outdated or inadequate technique on the surgeon’s part.
- Functional defects such as flow of urine to the right, left or back while urinating, pain, a feeling of dryness and loss of pleasure during sexual intercourse.
Who is an Ideal Candidate for a Labiaplasty Revision?
Any patient who has undergone a labiaplasty with unsatisfactory results can consider a labiaplasty revision. Labiaplasty should be performed on women aged 18 years and above. This is because gynecology experts believe that the genitalia of minors are still developing and thus do not recommend performing the procedure too early. This follows that labiaplasty revision, along with its complementary procedures is performed in women aged 18 years and above.
The American College of Obstetricians and Gynecologists advises that labiaplasty should only be performed in minors with congenital genital malformations from birth or persistent symptoms directly related to the labia structure.5
How Can Labiaplasty Surgeons Prevent Labiaplasty Revisions Before & While Carrying Out a Labiaplasty?
Before a Labiaplasty:
- It is important for labiaplasty surgeons to have the relevant training and experience required to carry out the surgery.
- Proper patient selection before a labiaplasty is also of utmost importance, as the first surgery is the best time to get it right. A botched labiaplasty may not always present a second chance for a revision.
During a Labiaplasty:
- Surgeons should be careful not to remove excess labial tissue. Inexperienced surgeons may apply undue traction on the labia minora while making their incisions. This can result in too much tissue being excised as the labia are elastic in nature and will retract in size after releasing the tissue. This can be difficult to correct surgically. However, in some cases, some extra tissue may be located close to the perineum or towards the clitoral hood and in these instances, a V-Y reconstruction can be performed.
- Surgeons should eliminate outdated or poor surgical techniques as they may result in the development of a hematoma, which is the accumulation of localized blood within the labia, usually causing pain and swelling. Also, a hematoma can prevent the suture edges from apposing and healing adequately, leading to an operation site breakdown. In some instances, these edges can be trimmed by your surgeon, but often it may require a repeat wedge technique to be performed.
- Surgeons should be mindful of removing inadequate labial tissue. This may arise when there is ineffective communication between the client and the surgeon on the requisite amount of labial tissue to be surgically removed. From a surgical standpoint, though, removing less tissue compared to removing excessive tissue during the procedure is preferable. However, the patient has to be unnecessarily subjected to a revision procedure if unsatisfied with the operation.
Importance of Communication Between the Surgeon & the Patient
To ensure patient satisfaction after a labiaplasty revision procedure, the surgeon must determine the patient’s expectations before the procedure. During the consultation, the surgeon should provide an honest, non-biased, accurate clinical assessment of what can be done, or if anything can be done at all, to improve the previous labiaplasty results. The surgeon should provide realistic expectations to the patient, and this is usually done during the preoperative assessment.
Types of Labiaplasty Revision Procedures
An original labiaplasty and a labiaplasty revision procedure are alike, though their objectives and methods may differ a bit. Several methods exist for carrying out these procedures; the best technique is the one the surgeon is most conversant with and which helps achieve desirable results.
If enough labial tissue was not removed during the original labiaplasty, the most common procedures that can be done are the wedge method and trim method (also known as the linear, edge excision or amputation labiaplasty). The wedge technique is ideal for patients with thin, well-defined labial edges, while the trim technique is a good choice for patients who dislike their thick, darkly pigmented, or rough labial edges.6
1. The Wedge Technique
With the wedge method, a V-shaped wedge of the labia minora is cut off, and the remaining edges are apposed together. This method, however, leaves behind the darkest part of the labia minora, which a patient may want removed.
2. The Trim Technique
In the trim method, an incision is made that excises the outer edge of the labia minora. This leads to a smooth transition to the larger labia majora (outer lip). If poorly performed, this technique can result in a noticeable suture line or an uneven transition to the labia majora. On the other hand, if too much labia minora was cut off, a V-Y reconstruction can be performed.
Also, if there is too much separation of the labial edges, a simple trim of the tissue can help repair the separation. However, if the separation is severe and significant, a new procedure may be required.
These procedures can be performed under general or local anesthesia, depending on the extent of surgery required, the patient’s preferences and the discretion of the labiaplasty surgeon.
How to Achieve Optimal Labiaplasty Results & Prevent a Labiaplasty Revision
Following a labiaplasty surgery, patients are instructed to engage in minimal activities for at least a week and to commence activities like cycling, exercising and sexual intercourse up to four weeks. They are to ice and elevate the operation site and should urinate in the shower or with a squirt bottle in the toilet. Tampons are to be avoided for at least four weeks.8
What are the Benefits of a Labiaplasty Revision?
A botched labiaplasty can leave a patient feeling physically, emotionally, and psychologically traumatized, which is why a successful revision procedure has many benefits. Some of these include:
- Increased confidence and sense of well-being
- Comfort in clothing such as bathing suits and tight-fitting clothes
- Increased sexual pleasure
- Reduction in pain and discomfort during exercise & other regular activities
- Improved vaginal hygiene and health.
Potential Side Effects/Complications Associated With a Labiaplasty Revision Procedure
As with any surgical procedure, certain risks or complications may arise following a labiaplasty revision procedure. Although rare, some of these risks or complications include
- Anesthetic complications like allergic reactions, hypotension and others
- Pain
- Swelling
- Redness
- Bruising
- Infection
- Bleeding
- Scarring
- Temporary or permanent nerve damage with loss of sensation in the operation site
- Hematoma formation
- Itching and irritation
- Discomfort while urinating
- Fever and fatigue
- Failure of the procedure and need for another revision or labiaplasty reconstruction.
Safe & Effective Vaginal Rejuvenation
When it comes to your genital and overall health, safety should be of utmost importance. This is why whether it is vaginoplasty, labiaplasty or any other vaginal rejuvenation treatment, it should only be performed by a highly experienced & qualified professional. The best way to know which option is right for you is to schedule your no-obligation consultation at Alinea Labiaplasty NYC.
Dr. Ammar Mahmoud is a world-renowned minimally invasive cosmetic gynecological surgeon who specializes in cosmetic vaginal surgical and non-surgical procedures involving sexual wellness and function.
References
- Sorice, Sarah C., et al. “Why women request labiaplasty.” Plastic and reconstructive surgery 139.4 (2017): 856-863.
- Cosmetic Surgery National Data Bank Statistics. “Cosmetic surgery national data bank statistics.” Aesthetic Surgery Journal 38.Suppl. 3 (2018): 1-24.
- Learner, Hazel Isabella, et al. “‘Botched labiaplasty’: a content analysis of online advertising for revision labiaplasty.” Journal of Obstetrics and Gynaecology 40.7 (2020): 1000-1005.
- Goodman, Micheal Dr. “Revisions, Redos and Botched Genital Plastic Surgery.” Www.Drmichealgoodman.Com, 23 Sept. 2019, www.drmichaelgoodman.com/revisions-redos-and-botched-genital-plastic-surgery/. Accessed 28 Jan. 2023.
- American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice. Elective female genital cosmetic surgery: ACOG committee opinion, number 795. Obstet Gynecol. 2020;135(1): e36-e42
- Oranges, Carlo Maria, Andrea Sisti, and Giovanni Sisti. “Labia minora reduction techniques: a comprehensive literature review.” Aesthetic surgery journal 35.4 (2015): 419-431.
- Tahery, Micheal MD. “Trim Labiaplasty Vs Wedge Labiaplasty.” Www.Drtahery.Com/Trim-labiaplasty-vs-wedge-labiaplasty, 31 Mar. 2021, www.drtahery.com/trim-labiaplasty-vs-wedge-labiaplasty. Accessed 25 Jan. 2023
- Furnas, Heather J. “Trim labiaplasty.” Plastic and Reconstructive Surgery–Global Open 5.5 (2017): e1349
