Labial Reduction (Labiaplasty)

Labiaplasty Case Study

I have been performing labiaplasty now for more than 5 years and I am acutely aware of what a sensitive  subject it is for my patients. I am humbled when people feel that they are able to discuss such a personal thing with me.

Patient Background

This is a report of about Louise* who came to see me in 2017 for a Labiaplasty procedure.

She described how since puberty she had been troubled with having prominent labia and this had made her self-conscious. She had always been careful about what underwear or clothes she wore and she found tight pants would rub and cause her significant discomfort. She was also a fan of horse riding and was finding that she got a lot a pain that was ruining her enjoyment of something she loved.

She had had 2 children and had noticed that since then things had got a little worse with more pigmentation and more pronounced thickening and this had made her more upset. She was in a stable marriage and I always ask about problems with intercourse and she said that it could at times be uncomfortable but her husband was not upset with her appearance and it was all driven by her own desire for improvement.

First Consultation

I always examine my Patients with a female chaperone and I know it is a time when Patients feel very vulnerable, so I make sure I have an understanding Nurse at hand who helps the Patient feel at much at ease as possible. In order to examine her I have to ask her to remove her underwear and then I ask her to lie on the couch covered by a sheet in a position which is very similar to having a smear test, when asking the Patient to draw her feet up to her bottom and I look to see what areas are troubling the Patient and check that there are no abnormalities or unusual anatomy.

I also have to look at each case individually as every Patient is different with some ladies having just a small central area that is prominent but others having folds of tissue at the back towards the bottom or up next to the folds around the clitoris.

I always reassure my Patients that they are not abnormal and that this is surgery that they choose to have but do not have to pursue. I explained to Louise* the different ways that the operation can be performed with either a wedge of tissue being removed, which keeps the natural edge of the labia or by trimming the labia, which is the most frequent technique in my practice and generally gives the best results.

I explained how the operation can be done comfortably under Local Anaesthetic (ie with the area numbed but the Patient is awake). The, majority of my Patients opt for this and I explain it allows the Patient  to view the result just after the procedure is performed and they can then let me know if they are happy with their new appearance or would like a small alteration. to ensure that they achieve a result they are delighted with.

Second Consultation

I provided her with written information all about the pros and cons of the operation and arranged to see her a second time with her husband so that we could all go through any questions she might have. At the second consultation I met her husband and most of her questions were around recovery and removal of stitches. I explained that I Use all dissolving stitches so nothing has to be removed and that in the first few days there is often a lot of swelling but tis settles very quickly I explained how it was important to wear loose fitting garment in the first few weeks post op and that it was important to avoid intercourse until everything was fully heled w, which is usually by about 4 weeks.

The Day of Labiaplasty Operation

On the day of surgery I saw her in the room and had the nurse apply a numbing cream so that the injections would be more comfortable and then in theatre I make sure only the minimal number of people are allowed in and the doors are locked to prevent any staff wandering in as I want my patient to feel as comfortable as possible . I the carefully made my markings and let LR check that she was happy about the amount of tissue to be removed. I then very slowly put the injection in to numb the area and while it is working I wash my hands and get prepared. The operation only take about 40 mins and I use a machine that seal the vessels as I go then the pt is given some disposable hospital underwear with a non-stick pad so that she is comfortable and then she is discharged  later that day

Post Operative Care

I saw her 10 days later when all was healing well and most of the swelling had resolved. She was coping well and had gone back to work and I then saw her again 4 weeks later when all had healed and she was delighted with the result and said she felt like a new woman.

I am always amazed at the difference in a woman’s confidence that a Labiaplasty operation makes . I saw her for her final review 3 months ago and she was looking great and back to all her normal activities.

Patient Feedback

Fantastic, life changing service. I had seen a couple of surgeons before deciding to use Mr Lambe, he immediately put me at ease, explained all the pros and cons to my surgery and his care has been superb. Nothing has been too much trouble for him and all my questions were answered immediately.

Mr Gerard Lambe  MD, FRCS (Plast)
Consultant Plastic and Reconstructive Breast Surgeon
Clinical Lead for Plastic surgery