Secret Women’s Biz

Posted: Monday 20 September 2010 09:00am

By Dr Michael Miroshnik, Plastic Surgeon

Labioplasty is becoming more commonly requested in my practice and the plastic surgical world as whole. Women are slowly recognising that it is a procedure that is both safe and enjoys a high patient satisfaction rate.
Although, understandably it is a topic that many are too shy to mention to their doctor for fear that their request is somewhat unusual or embarrassing, patients can rest assured that the issue is common, and one that we see as plastic surgeons frequently.

What is labioplasty?
Surgical labioplasty (also called labiaplasty or ‘the designer vagina’ by the media) is a plastic surgical procedure designed to reshape and usually reduce the size of the external lips of skin (labia) comprising the female vulva. The term has been expanded these days to refer to almost any plastic surgical alteration of the external female genitalia.

The outer lips (labia majora) or more commonly the inner lips (labia minora) can be refashioned to make the region both aesthetically more pleasing, as well as functionally improved. Additional procedures such as liposuction of the mons pubis and reduction of clitoral hooding, as well as other external rearrangements, can be performed simultaneously if required.

Common Complaints
The labia minora are the inner lips surrounding the vaginal orifice and are subject to the greatest variation in size, shape and pigmentation. Indeed, like noses, these inner lips come in a wide variety of shapes and sizes! The usual complaint by women is that their labia minora are excessively long, not symmetrical or too pigmented. Some women were born with enlarged labia, whereas others develop the enlargement with age or after childbirth.

Physical and Psychological Benefits
Large labia minora, apart from being unsightly to some and causing significant psychological distress, have also been well documented to interfere with good hygiene and sexual intercourse, as well as cause discomfort in tight pants and certain sports, such as cycling.

For many years, women have coped with their condition and lived with the discomfort or psychological distress. They have felt embarrassed to seek medical advice and adopted various strategies, such as avoiding tight clothing, to minimise problems. Today, however, due to various media portals, the condition has been well exposed, barriers broken and consequently many more enquiries have been generated by the public. The good news is there are highly effective and safe techniques available to plastic surgeons to correct the condition.

What is involved in the procedure?
The procedures themselves are as vast as the variations in labial shape, size and pigmentation. They vary from simple resection of the excess labial tissue to sophisticated flaps which are designed to make scars extremely inconspicuous while preserving the sensation in the region.

Simple surgical excision or ‘trimming’ of the labial tissue, although a time-honoured procedure practised by many, may not be ideal as the natural contour and colour of the labial edges are eliminated. Instead, they are replaced with a paler, stiffer scar line that may not look natural.

For this reason, I favour a wedge-like ‘V’ resection to remove the excess tissue and simultaneously develop a flap to reconstruct the labia. Extreme care must be taken to preserve any nerves that are encountered within the region, as sensation preservation is obviously of paramount importance.

How do I prepare for surgery?
Preparation for the surgery is an important factor which aids in a speedy recovery. It is usual to get a full Brazilian wax, or at least completely shave the region to remove any pubic hair around the labia. This will greatly help with hygiene over the ensuing weeks of healing. Stitches used are mostly dissolving so there is no need for their removal.
After the procedure, patients are instructed to have regular baths and apply a topical antibiotic ointment to keep the area as clean as possible. In our practice, we try to time the procedure so that it does not fall during menstruation to again assist with hygiene and make recovery more comfortable.

Is there any down time?
Although the procedure is day surgery, it is best the patient prepare themselves for at least four to five days off work to have a comfortable recovery. Using ice in the pubic region also helps greatly with the control of swelling and pain in the first 24 hours. It is important to note that although most feelings of swelling and discomfort are gone after two weeks, women undergoing the procedure are to abstain from any sexual activity for at least one month after surgery to avoid healing problems.

What Results Can I expect?
From my experience, this procedure has an extremely high patient satisfaction rate. It is usually performed under general anaesthesia as a day surgery and yields excellent results with an imperceptible scar. Patient satisfaction with the procedure is extremely high, most women reporting a vast improvement in both the physical and psychological aspects of their lives after the procedure and wondering why they didn’t address the problem earlier.

Approximate cost?
Expect to pay approximately  $5000 to $7000, depending the extent of the work you are having done and the extent of your private health insurance coverage.

by Dr Michael Miroshnik

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