Labiaplasty

Labioplasty is a surgical procedure to reduce the size of the labia minora skin folds that usually surround your urethra and vagina.

Labiaplasty

Excess skin can twist and pinch, causing discomfort during exercise, physical activities, and sexual intercourse.
You may also have labiaplasty for cosmetic reasons or as part of gender confirmation surgery.

OVERVIEW

What is labiaplasty?
Labioplasty is a surgical procedure to reduce or increase the size of your labia. People often receive this procedure to reduce physical discomfort or as part of gender-affirming surgery.
Sometimes you may want this for cosmetic reasons, but there is a wide variety of normal labia.
Everyone’s labia are unique and they do not have an ideal or “normal” appearance.
Your labia are the folds of skin around your vaginal opening. You have two layers of skin there.
The outer folds are called labia majora, which means large lips.
These are larger fleshy folds that protect your external genital organs.
After puberty, they are covered with pubic hair. The inner folds are called labia minora, which means small lips. These skin folds protect the opening of your urethra (where your pee leaves your body) and vagina.

During labiaplasty and depending on why you are having it done, your surgeon will:
remove some tissue from your labia to reduce its size.
inject filler or fat to enlarge your lips.
reconstruct your lips from other tissues.

Why does a person have labiaplasty?
There are medical reasons for labiaplasty. There are also physical, cosmetic and emotional reasons.
Sometimes labiaplasty is part of gender confirmation surgery.

Medical and physical reasons
To reduce the size of your labia majora so they don’t protrude beyond the edges of your labia minora. Excess lip tissue can twist, twist, pinch, or pull during exercise, physical activities (such as cycling or running), and sexual intercourse, causing physical discomfort and irritation.
To improve hygiene and health, as excess tissue can make cleaning difficult and can harbor bacteria that can cause urinary tract infections (UTIs).

Cosmetic and emotional reasons
To reduce asymmetry (irregular shape) of the labia minora or labia majora when one side is longer or differently shaped.
To increase comfort, confidence and sexual well-being regarding the appearance of your genitals during intimate contact. Remember that people have a variety of lip sizes and shapes, and there is no one lip appearance that is considered normal.

Gender Confirmation Surgery
If surgery is part of the gender determination process, your surgeon may create labia using existing genital tissue. You can also have labiaplasty before or after other reconstruction surgeries.
What causes a labia to become overly large?
Puberty can cause a growth spurt in your labia.
Menopause or other hormonal changes can thin the tissue of the labia majora.
Pregnancy and birth.
Changes in your weight.
Genetic.

What is the average age for labiaplasty?
Most people who have labiaplasty are between the ages of 18 and 50. However, since your labia may become stretched during pregnancy and birth, you may want to wait until you’re done joining your family. A child may have labiaplasty, but only to correct problems with daily function and activity.

PROCEDURE DETAILS

What happens before surgery?
First, you and your surgeon will discuss why you want to have labiaplasty. You will discuss your expectations and goals, as well as the risks of surgery. They will do a psychological exam and ask questions about depression and anxiety.
Your surgeon will then explain the details of your surgery, including where they will make the incisions and what to expect regarding changes in the size and shape of your labia.
You may undergo preoperative tests, including blood work, urinalysis, and chest X-ray. Your surgical team will also give you instructions about:
What to wear?
When to cut down on food and drink?
When to adjust or temporarily stop certain medications.
They will also give you other information on how to prepare for your surgery.

What happens on the day of surgery?
You’ll change into a surgical gown. A healthcare professional will take your vitals (temperature, pulse, blood pressure, oxygen level, and breathing rate). You can have blood tests and urine tests again. They will insert an intravenous line (IV) into your arm or hand and may insert a urinary catheter into your urethra.
Next, your provider will clean your labia and surrounding skin and shave your pubic area if necessary. Then they will start anesthesia. Depending on your procedure, you may receive IV sedation with local anesthesia or general anesthesia. Your provider will discuss the best type of anesthesia for you during the planning phase of your surgery.
Your provider chooses the surgical technique based on how your labia (labia majora and/or labia minora) will be resized or reshaped. They usually perform this surgery with a scalpel, scissors or laser.

Mitigation procedures
There are two general approaches to reducing the size of your labia minora (outer lips and/or inner lips):
Trimming procedure. With this approach, your surgeon removes excess tissue from the outer edge of one or both sides of your labia minora, flush with the edges or borders of your labia majora.
Wedge procedure. With this approach, your surgeon removes a wedge- or pie-shaped piece of tissue from the inner areas of one or both sides of your labia minora. They leave the submucosa intact, so the wrinkled edge of your labia remains intact after being sutured (sewn). This provides a more natural look for your labia minora. Similarly, if you are having surgery to reduce the size of your labia majora, your surgeon will remove the inner part of each labium in your labia majora.
Your surgeon may have other preferred approaches depending on his surgical expertise or your desired outcome. You and your surgeon will work together to choose the best surgical approach to meet your goals and concerns.

Magnification procedure
To enlarge your labia majora, your surgeon removes a small amount of fat from another body area, such as the abdomen or thighs (in a liposuction procedure) and injects it into the labia majora. Injecting hyaluronic acid into your labia majora is an alternative option.

Gender Confirmation Surgery
Your surgeon may use tissue taken from the penis to create your labia. Labioplasty is one step in the entire process of gender-affirming reconstructive surgery.
All incisions in the procedures described above are closed with absorbable stitches (stitches) that will dissolve on their own over time. Finally, your surgeon covers the area with a surgical dressing.

How long does labiaplasty take?
Labioplasty is an outpatient procedure. Labiaplasty typically takes less than two hours. Gender determination surgery requires more time.

What happens after labiaplasty?
After surgery, your provider will remove your urinary catheter (if you have one) and you will become more alert as the anesthesia wears off. Your healthcare team will check if you are bleeding more than expected. Before you are discharged, your providers will give you instructions on how to care for your wound while it heals. They will also talk about pain control, activity restrictions, and follow-up appointments.

RISKS / BENEFITS

What are the risks and complications of inner lip surgery?
Complications are rare, but may include:
Too much tissue removed or not enough tissue removed.
Bleeding.
Bruising (hematoma).
infection.
Wound breakdown.
scar
Ongoing pain, pain with sex, or loss of sensitivity.

RECOVERY AND VIEW

Is labiaplasty really painful?
You will have some swelling, discomfort, and pain, but it is usually easy to manage with over-the-counter (OTC) medications such as acetaminophen (Tylenol®) or prescription medications for a day or so. If your discomfort is not managed well with recommended medications, contact your surgeon. Home remedies such as cold compresses or ice packs are also helpful. Apply an ice pack to the surgical area (over a cloth undergarment) on a 20-minute work/20-minute rest schedule to reduce pain and swelling. Most people report only mild pain or tenderness for a few days.
Your healthcare team may give you a prescription for oral antibiotics or topical antibiotics to apply to your surgical wound to prevent infection.
Wear loose pants and underwear during the recovery period. Tight clothing or underwear can cause friction on the wound and prevent or delay healing.

Will there be a lot of bleeding?
You may have some bleeding for about a week. You can wear a pad to absorb this minor bleeding.

When will the results be at their best?
Initial swelling, pain, and temporary discoloration subside within the first few weeks after surgery. Most swelling disappears after six weeks. However, it may take up to four to six months of healing time for the swelling to completely disappear before you see the final results of your labiaplasty. There is usually little or no scarring.

How do I wash my labia area after surgery?
Use only warm water (no soap) to wash your wound. Gently wipe or dry the area after urinating; Do not rub the surgical area.
Your surgeon may give you medication or recommend a diet to prevent constipation so that you do not stretch, which could stretch or break your stitches.
Follow all your provider’s postoperative instructions regarding:
Don’t pee or poop.
Keeping your surgery area clean and free of bacteria.
To ensure healing of the surgical area.

When can I return to work, physical activity and sexual activity?
You should be able to return to work and other light activities after a few days. However, if your job involves physical activity or weight lifting, you may need to stay home longer. You should avoid the following for four to six weeks or until cleared by your surgeon:
Strenuous exercise.
Physical activities such as cycling, running and swimming.
Sexual intimacy.
Returning to these activities too soon can put pressure on the wound, tear the stitches, and delay healing.

How long do labiaplasty results last?
Labioplasty, performed as a reduction surgery, is a one-time, long-term procedure. If complications do not develop, you may never need this surgery again. Enhancement labiaplasty with fat or filler injections may require additional “touch-ups” over time.
You should know that choosing to have children after your procedure may affect your labiaplasty. Many people choose to wait until they have completed their families to have labiaplasty.

WHEN SHOULD I CALL THE DOCTOR?

When should I call my surgeon?
Call your surgeon’s office if you experience the following:
Excessive swelling or worsening pain.
Increased bleeding or seeing clumps of blood.
Colorless pus or discharge.
Severe pain when peeing or pooping.
Fire.
Opening of the surgical site.

ADDITIONAL DETAILS
What questions should I ask my surgeon?
Am I a good candidate for surgery?
How much recovery time should I expect?
How will you perform the procedure?
What are the risks and complications?
What results should I expect and how long will it take to fully see them?
How long do the results last?
How much does the surgery cost?
Is the surgery covered by insurance?
Does labiaplasty cut nerves?
No, your surgeon will not cut or move any nerves as part of labiaplasty.

Does labiaplasty increase pleasure?
Although some people think that labiaplasty may increase sexual satisfaction, there is limited evidence to support this. Research shows no significant change in sensation, lubrication, or orgasm. But labiaplasty can reduce pain associated with sex for some people, which can increase your enjoyment of sex. Additionally, changes in self-esteem and satisfaction with the appearance of your genitals can positively impact your sexual experiences.

Can you still get wet after labiaplasty?
Labioplasty changes how your genitals look, but does not change how they function. If you do not have a vaginal dryness problem before the procedure, your vaginal wetness should continue with sexual stimulation. You should avoid sexual activity for four to six weeks to allow your genitals to heal. When you see your surgeon for a check-up, ask them what type of lubricant you can use and when you can start using it.

Can skin grow back after labiaplasty?
Your skin will not grow back after labiaplasty. However, it can still be stretched, especially during birth.

Information from Gazi Hospital
If you are uncomfortable with the appearance of your lips or feel uncomfortable wearing tight clothing, performing certain exercises, or experiencing sexual intimacy, labiaplasty may be an option you should consider. If you are having gender-affirming surgery, labiaplasty is part of the surgical reconstruction process. Talking about your genitals can be uncomfortable. For all the reasons you are considering labiaplasty, know that your surgeon is here to support you. Don’t hesitate to discuss your goals and concerns with your surgeon. Your surgeon will listen to you, give you extensive details on how they will perform the procedure and what results you can expect, and answer all your questions.

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