Labiaplasty

Labiaplasty is a procedure performed to reduce and reshape the labia majora and labia minora.  While there is a wide range of what constitutes a “normal” size and appearance to these structures, they occasionally can become enlarged due to congenital factors, age, and with significant weight loss.  Reduction and reshaping of the labia can reduce functional problems (infections, irritation, etc.) as well as improve the overall appearance.

Plastic surgeon or OB/GYN; maybe both?

 When choosing a surgeon for this procedure, many patients are confused as to whether they should see a plastic surgeon or their OB/GYN physician.  Actually, there are surgeons within both fields that are very capable of performing this operation with excellent results.  Plastic surgeons gain a great understanding of the anatomic considerations in this area as we are often called upon to perform reconstructive surgery following ablative surgery for cancer, repair of traumatic injuries, etc.  In addition, we bring to this our sense of cosmetic considerations, recognizing that it is not enough to simply remove some troublesome tissue but also to do so in such a way that is cosmetically acceptable.

As the procedure of labiaplasty has evolved in recent years there have been excellent contributions made by both Plastic Surgeons and OB/GYN’s.  The key to a good outcome is choosing a surgeon that understands the nuances of the procedure and takes in interest in performing it well.

If your gynecologic concerns go beyond the external genitalia we will collaborate with a gynecologist to manage your case for the best possible care.

The operation

Reduction of the labia minora, whether for cosmetic or functional reasons, can be done under local anesthesia, although most patients prefer a short general anesthetic in the operating room.  During this outpatient procedure, a wedge of the excess tissue is excised, reducing the overall size of the labia and leaving sensitive and functional structures intact.  Incisions are placed so that scars will lie in areas where they are least visible.  The procedure takes about 1 hour.

We have performed reduction and reshaping of the labia majora most frequently in our massive weight loss patients.  After weight loss, there may be redundant skin and fatty tissue that impairs hygiene and results in an unattractive appearance.  Correction of this may involve a “lift” of the entire pubic area, liposuction, removal of excess skin or a combination of these procedures.  This is performed in the operating room under a general anesthetic and can take 1-2 hours.

Recovery

Recovery time varies depending on the particular procedure performed.  Most patients will require strong pain medications for 1-2 days and can return to work in 3-7 days.  Sutures placed during the operation are the dissolving type that do not need to be removed.

Insurance coverage

We have had patients referred to us with significant abnormalities that have caused ongoing problems with infection, irritation, etc. that represent a significant medical problem.  In these cases, we have submitted the information to their insurance company prior to surgery and have been able to obtain coverage for labiaplasty as a medically necessary procedure.

However, in most cases the procedure is regarded as primarily a cosmetic procedure and therefore not covered by insurance plans.  After we have evaluated you and determined the procedure to be performed we will be able to give you the information regarding the cost of the procedure.

Summary

An estimated 10,000 labiaplasty procedures were performed last year and it’s rapidly growing in frequency in both our practice and nationwide.  If you are considering labiaplasty, chose a practice and surgeon that understands the nuances involved in this operation from both a cosmetic and functional point of view.