Labiaplasty (labia minora reduction) has become more popular in the last 5 years, especially for women who are concerned with the appearance of their vulva region due to asymmetry or disproportional enlargement of the labia minora. The procedure is very effective and rates with high patient satisfaction. Large majority of patients performing this procedure are between 20 to 50 years old, and some of them even after several child deliveries.
One of the reasons that patients want to have this procedure is due to the popularity of laser hair removal in the pubic region. With laser removal, the protrusion or asymmetry of the labia minora has become more visible. The bulge in this area can restrict activities or can be seen through underwear which can cause discomfort.
The procedure is performed by trimming the labia and clitoral hood in a specific way to preserve symmetry and a nice appearance. There are several technical options to perform the operation (direct excision, wedge resection, deep reepithelization). Planning the specific one depends on patient’s needs. The closure of the skin or labia after surgery should be done without any tension to avoid splitting of incision line in the future. Dr. Roberts performs Labiaplasty in his operation theatre (day surgery centre) in a fully sterile environment under intravenous sedation and local injections. However, before the patient is taken into the operation theatre, he prefers to apply a numbing cream in the area for about 30 minutes to give the patient totally painless local anaesthesia.
The labia is a very vascular and it is better to perform the procedure by using a laser as a cutting tool, which requires skill and experience, as well as an artistic approach. The old methods of using scalpels (knife) or electrocautery are no longer used in modern clinics. The operation is much quicker and there is no bleeding or bruising after the surgery because the laser beam seals the small blood vessels. Another important issue is the stitching which should be done is a specific way in different plains. This is the most time-consuming part of the procedure itself.
All surgeries theoretically have a risk of problems. However, with modern techniques the risk is very low. Scars are not usually visible but if there is splitting of the incision line then there is a 2% chance for re-operation. Bleeding, burning, scar contracture and infections are less than 1% chance. Following the old method of electrocautery and knives, bleeding was more common. But with a laser, we never have had any bleeding.
The process of healing takes about 3 weeks, but to achieve a full strength of the tissue, we need about 6-8 weeks. It is recommended to resume sexual activities after this period. After the operation, Dr. Roberts prefers to use antibiotic cream or Vaseline with a sanitary pad on the top. The area should not be dry; it should be moist with Vaseline which can protect the incision line from vaginal bacteria and help with healing. To allow for quick healing, it is important to not smoke cigarettes, to stop drinking alcohol, and to not take supplements (such as digestive enzymes, aspirin, fish oil, etc.) as this can prompt bleeding or cause very excessive swelling after the surgery.