Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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The consultation is the foundation of a successful surgical outcome. It is a confidential space where the patient feels safe discussing intimate concerns without judgment. Open communication about what physically and aesthetically bothers you is vital.
The surgeon will ask specific questions about sexual function, physical discomfort during activities, and urinary symptoms. Honest answers help the surgeon determine whether the issue is purely aesthetic or involves functional components that need to be addressed.
A physical examination is necessary to assess the anatomy and determine the appropriate surgical plan. This is typically done in a standard gynecological position. The surgeon will evaluate the symmetry, size, and quality of the tissues.
They will check for muscle separation (if vaginoplasty is considered), assess the clitoral hood, and measure the labial hypertrophy. This exam allows the surgeon to explain the specific anatomical factors contributing to the patient’s concerns.
A comprehensive medical history is taken to ensure safety. Patients must disclose all medications, supplements, and previous surgeries. Conditions such as bleeding disorders, diabetes, or active infections can affect healing and must be managed.
A history of herpes simplex virus is important; prophylactic antiviral medication will be prescribed to prevent an outbreak triggered by surgery. Smoking status is also critical, as nicotine severely impairs wound healing in delicate mucosal tissues.
The surgeon will discuss what surgery can and cannot achieve. While significant improvements are typical, perfection or perfect symmetry is biologically impossible. Patients are shown before-and-after photos of similar cases to gauge realistic outcomes.
The discussion includes the timeline for healing and the return to normal activities. Understanding that swelling and distortion are normal in the early stages helps prevent postoperative anxiety.
Standard preoperative blood work is ordered to check for anemia, clotting ability, and infection. A pregnancy test is mandatory for women of childbearing age. For patients over a certain age or with medical history, an EKG may be required.
If vaginoplasty is planned, a recent Pap smear and negative vaginal culture may be requested to ensure there are no active bacterial or yeast infections that could complicate surgery.
Patients are advised to stop taking blood-thinning medications such as aspirin, ibuprofen, and Vitamin E for at least two weeks before surgery. These increase the risk of hematoma (blood collection) in the highly vascular genital tissue.
Herbal supplements that affect bleeding must also be paused. Essential medications for chronic conditions are typically continued, often with a sip of water on the morning of surgery.
Nicotine causes vasoconstriction, reducing blood flow to healing tissues. In the genital area, poor blood supply can lead to wound dehiscence (opening) and tissue necrosis.
Surgeons typically require patients to stop smoking or vaping at least 4 weeks before and 4 weeks after surgery. This is a strict safety protocol to ensure the best possible aesthetic and functional result.
Patients are instructed on hygiene protocols before surgery. This may include washing with a specific antibacterial soap. Regarding hair removal, patients are usually advised not to shave the area within 48 hours of surgery to prevent micro-nicks that could harbor bacteria.
If hair removal is necessary for the incision lines, the surgical team will perform it in the operating room with sterile clippers. Waxing should also be avoided in the week leading up to the procedure.
Recovery requires logistical preparation. Patients need to arrange for a ride home and for someone to stay with them for the first 24 hours. Supplies such as ice packs, loose cotton underwear, sanitary pads, and a peri bottle (for rinsing after using the toilet) should be purchased in advance.
Planning for time off work is essential. While desk jobs may allow a return in a few days, jobs that require physical activity will take longer. Childcare and household help should be arranged to allow for strict rest.
Elective surgery requires a stable mental state. The surgeon assesses the patient’s motivation to ensure it is internal and not due to external pressure from a partner. Patients with body dysmorphic disorder may be referred for counseling rather than surgery.
Feeling nervous is normal, but patients should feel confident in their decision. The consultation is the time to address all fears and ensure the patient is emotionally prepared for the recovery journey.
The day before surgery, strict adherence to fasting guidelines is required. Typically, no food or drink is allowed after midnight. Patients should shower and remove all jewelry and piercings.
Hydration in the days leading up to the fasting period is encouraged to help with IV access and recovery. A good night’s sleep is recommended to reduce stress levels.
During the consultation, anesthesia options are discussed. Many labiaplasties can be performed under local anesthesia with oral sedation (awake but relaxed) or IV sedation (twilight sleep). Vaginoplasties typically require general anesthesia or deep sedation.
The choice depends on the patient’s comfort level, the extent of the surgery, and the surgeon’s recommendation. Understanding the anesthesia plan helps reduce anxiety about the procedure itself.
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No, you typically do not need a referral to see a plastic surgeon for aesthetic genital surgery. However, ensure your annual gynecological exams are up to date and bring any relevant records to your consultation.
Ideally, surgery is scheduled when you are not menstruating. Menstrual flow can make keeping the surgical site clean and dry more difficult and uncomfortable. However, if it happens, surgery can usually still proceed; it just requires more diligent hygiene post op.
Wear loose, comfortable clothing. A skirt or loose sweatpants are ideal. Avoid tight jeans or leggings that will rub against the surgical site. Wear easy-to-slip-on shoes.
For a labiaplasty, many patients return to desk work in 3 to 5 days. For vaginoplasty or combined procedures, plan for 1 to 2 weeks off. If your job involves heavy lifting or active movement, you may need more time.
Most patients find the pain manageable. You will likely be prescribed a few days of narcotic pain medication, but many patients switch to extra-strength Tylenol within 2 to 3 days. Ice packs are very effective for pain relief.
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