Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Labiaplasty is most commonly performed under local anesthesia with oral sedation. The patient takes a relaxant (like Valium) an hour before. In the operating room, the surgeon injects a potent numbing solution (lidocaine) directly into the labia.
The injection is the only part that pinches; after that, the area is completely numb. This approach avoids the risks and grogginess of general anesthesia. Patients can chat or listen to music. For those with high anxiety, IV sedation (twilight sleep) or general anesthesia are options.
For the wedge technique, the surgeon marks a V-shaped wedge in the center of the labium. This segment is excised. The key to this surgery is the closure. It must be done in multiple layers to prevent a “V-shaped” notch or separation.
The surgeon sutures the inner lining (mucosa), the middle tissue, and the outer skin separately. This multi-layer closure distributes tension and ensures the edges heal together strongly. The natural rim of the labia is preserved and reconnected seamlessly.
For the trim technique, the surgeon clamps or marks the excess tissue along the edge. A precise incision is made to remove the dark, irregular border. The surgeon then sculpts the remaining edge to ensure a smooth, tapered contour.
Hemostasis (stopping bleeding) is critical. The edge is then sutured using a running stitch with fine, dissolvable suture material. This rolls the edge slightly to cover the raw tissue and ensures a smooth, healed line that blends with the surrounding skin.
If a hood reduction is planned, it is usually done after the labia are addressed. The surgeon makes incisions lateral to the clitoris (on the sides), avoiding the midline where the nerves are densest.
Excess skin is removed in a crescent or sickle shape. The skin is then tightened and sutured. This lifts the hood and reduces the bulk without directly exposing the sensitive clitoral glans, maintaining protection while improving aesthetics.
Often, a combination is used. A surgeon might perform a wedge on one side and a trim on the other to correct asymmetry, or use a “hybrid” technique that combines elements of both.
This customization enables optimal treatment of complex anatomy. For example, an extended wedge might be used to remove length, while an edge trim refines the remaining border. The surgery is fluid and adapts to the tissues in real time.
The choice of suture is vital. Surgeons use fine, rapidly dissolving sutures (like Vicryl Rapide or Monocryl). These stitches fall out on their own in 3-4 weeks, eliminating the painful need for suture removal in a sensitive area.
The sutures are placed meticulously to ensure the edges are everted (turned slightly out) rather than inverted, which promotes better healing and a smoother scar. The goal is a closure that is strong enough to hold but fine enough to leave minimal scarring.
Once the surgery is done, antibiotic ointment is applied, and a soft, absorbent pad is placed in mesh underwear. Ice packs are applied immediately to start controlling swelling.
The patient is monitored for a short period to ensure there is no immediate hematoma (blood collection). Because local anesthesia is long-acting, the patient is pain-free upon leaving the clinic. They are discharged with an escort.
The first 24 hours are critical for controlling swelling. Patients are instructed to lie flat with their hips elevated on a pillow (“bottoms up”). This uses gravity to drain fluid away from the surgical site.
Icing is mandatory: 20 minutes on, 20 minutes off. Frozen peas or crushed ice in a ziplock bag work best as they mold to the anatomy. Activity must be strictly limited to bathroom breaks only.
Pain is typically manageable. Patients are prescribed a few days of narcotic pain medication, but often switch to Extra Strength Tylenol within 48 hours. Ibuprofen (NSAIDs) is usually avoided for the first few days to prevent bleeding.
The most common sensation is stinging or burning, especially when urinating. Using a peri-bottle to spray warm water over the area while urinating dilutes the urine and prevents it from stinging the incision lines.
Hygiene involves keeping the area clean and dry. Patients gently pat the area dry or use a hair dryer on the cool setting after using the peri-bottle. No scrubbing or rubbing is allowed.
Antibiotic ointment is applied to the suture lines a few times a day to keep them moist and prevent infection. Sitz baths (soaking in shallow warm water) may be permitted after a few days to soothe the area and dissolve stitches.
Walking should be limited to a “waddle” or shuffle to prevent friction between the legs. Sitting upright can put pressure on the vulva and increase swelling, so reclining or lying down is preferred for the first 3-5 days.
Work can usually be resumed in 3-5 days if it is sedentary. Physical exercise, lifting heavy objects, and prolonged standing are restricted for 4-6 weeks to allow the delicate tissues to heal without tension.
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Yes, there will be soreness, stinging, and swelling once the anesthesia wears off, usually 4-6 hours after surgery. However, taking your pain medication before the numbness fades helps manage this transition smoothly.
Swelling can be significant. It is normal for the labia to look like a “hamburger” or very puffy for the first week. It may look worse than before surgery initially. This is temporary and will subside rapidly after the first week.
Minor separation of the wound edges can happen. It usually heals fine on its own with antibiotic ointment. If a large gap opens up or you see active bleeding, call your surgeon. Do not try to tape or glue it yourself.
Yes, but wear loose, cotton underwear or the mesh panties provided. Avoid thongs or tight lace underwear for at least 6 weeks. You want to avoid any fabric that could rub or catch on the stitches.
You can usually shower 24 to 48 hours after surgery. Let the water run gently over the area, but do not aim the showerhead directly at the labia. Do not scrub. Pat dry gently or use a blow dryer on cool.
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