Plastic Surgeon

Labiaplasty

Although there is a wide normal variation in size and shape of the inner labia, some women find it cosmetically unacceptable if the (inner) labia minora protrude past the (outer) labia majora. Enlarged or protruding labia minora can occasionally be an embarrassing problem, particularly in sexual situations where physical discomfort may be experienced, when wearing tight clothing or swimwear. Patients may also seek help for hygiene reasons.

Techniques

Previously, the surgical treatment was simple excision of the protuberant tissue, which results in a scar along the free edge of the labia. In addition, the natural contour and colour of the labial edge is removed using this procedure. This technique of labial reduction is still widely practiced today.

In 1998, Dr Gary Alter, an American board certified plastic surgeon & urologist occasionally seen on the TV program “Dr 90210”, devised a more elegant operation to deal with this problem, and it is his technique, and subsequent modifications thereof, that I now use. In 2006, a team from Brasil published a modification of Dr Alter’s technique which has proven to be very effective in selected patients and which I now tend to favour. The demand for labiaplasty has grown signifcantly over the past several years. Sadly, it is too often viewed as a very simple operation and as such, carried out by many doctors who are inexperienced and inadequately trained to perform such surgeries – the results of which can be devastating. I am pleased to advise that I have done over 300 of these surgeries and can therefore reassure patients of this experience.

THE LABIAPLASTY SURGERY

The operation is usually done under local anaesthetic with light, oral sedation in my office procedure room. Should you want deeper sedation, an anaesthetist can be arranged for the procedure, but this is rarely necessary, and is then done in the main operating rooms in the hospital. It is generally very well tolerated under local anaesthetic, and the discomfort only minimal.

The surgery takes about 1-1.5 hours, and all patients are discharged on the same day. The surgery, broadly speaking, involves removing a wedge of tissue from each labium, thus largely preserving the natural free border, and leaving an almost imperceptible short oblique scar on each inner labium. The surgery is done using loupe magnification, to ensure very precise repair of the labial edges.

LABIAPLASTY RECOVERY (POST OP)

All the stitches are dissolving, and aside from some antibiotic gel that needs to be applied for a few days, no special post op care, other than perhaps bed rest for a few days, is needed. Abstinence from sexual activity for 6 weeks post op is advised, to allow the tissues adequate time to heal completely.

Smoking is a potent cause of poor wound healing, especially in labiaplasty, and you are strongly advised to quit for a month pre- and post op, if you are a smoker and considering this surgery.

FINAL WORDS

Of note is that the erotic sensory nerves to this region are well away from the operative site, and therefore no disturbance in erotic sensation will result from this operation, if done correctly. I think it is also important to realise that not all “labiaplasties” are done this way. Still today, the most commonly performed technique involves some sort of amputation of the protuberant tissue along the free edge, whether by laser (“designer laser labiaplasty”), scalpel or scissors. I almost never do simple labial “edge” reductions, but instead have been using the techniques described above since 2003, and I am pleased to report that patient satisfaction has been very high indeed.

Rediscover your comfort with labiaplasty Surgery

Seeking greater comfort, confidence, and peace of mind? Schedule a private consultation with Dr. Paul Skoll, an experienced labiaplasty surgeon in Cape Town. We’ll discuss discreet and personalized labiaplasty solutions, designed to address your unique concerns with exceptional care and natural-looking results.

A few commonly asked questions

You might be a suitable candidate for labiaplasty if you experience discomfort, pain, irritation, or self-consciousness due to the size or shape of your labia. Ideal candidates are generally in good overall physical and mental health, have realistic expectations for the outcome, and are non-smokers. During your confidential consultation, we will thoroughly discuss your concerns, medical history, and goals to determine if labiaplasty is the right option for you.

Labiaplasty is highly effective in addressing a range of concerns. Physically, it can alleviate chronic irritation, chafing, and pain experienced during activities like cycling, horseback riding, or wearing tight clothing. It can also improve hygiene by making cleaning easier. Emotionally, many women find increased self-confidence, comfort during intimacy, and feel less self-conscious about their appearance in swimwear or fitted clothing.

There isn’t a single “ideal” age for labiaplasty, as it’s a very personal decision driven by individual needs and discomfort. The procedure can be performed once the labia are fully developed, typically after puberty. We treat adult women of all ages who are experiencing the physical or emotional concerns that labiaplasty can resolve. What’s most important is that the patient is mature enough to understand the procedure and its implications and has realistic expectations.

There are two primary surgical techniques for labiaplasty: the trim method and the wedge method. The trim method involves removing the excess tissue along the edge of the labia minora, resulting in a linear scar. The wedge method removes a pie-shaped section of tissue, preserving the natural edge of the labia, and can result in a more natural appearance with the scar hidden within the labial folds. We will discuss both techniques during your consultation, recommending the one that best suits your anatomy and desired aesthetic for a natural-looking and harmonious result.

A primary concern for many patients is the impact on sensation and sexual function. Our surgical techniques are meticulously designed to preserve nerve sensitivity in the labia and clitoral hood area. While temporary changes in sensation (numbness or increased sensitivity) can occur immediately after surgery due to swelling, these typically resolve as healing progresses. The goal of labiaplasty is to enhance comfort and confidence, which often leads to an improvement in sexual comfort and enjoyment for many women once fully healed.

Your initial consultation is a confidential and compassionate space. We will begin with a discreet discussion about your specific concerns, medical history, and aesthetic goals. A gentle physical examination will be performed to assess your anatomy. We will then thoroughly explain the different surgical techniques, discuss the expected outcomes, potential risks, and answer all your questions, ensuring you feel completely informed, respected, and comfortable with your choices.

The results of labiaplasty are generally considered permanent. Once the excess tissue is carefully removed, it does not typically grow back. While natural aging and significant weight fluctuations can slightly alter tissue over many years, the primary aesthetic and functional improvements from labiaplasty are long-lasting.

As with any surgical procedure, there are potential risks, although serious complications from labiaplasty are rare. These can include temporary swelling, bruising, infection, temporary changes in sensation (usually resolving), asymmetry, or unsatisfactory cosmetic results. We take every precaution to minimize these risks and will discuss them thoroughly during your consultation, ensuring you are fully informed and confident in your decision.

The cost of labiaplasty in Cape Town varies depending on the complexity of the procedure, the surgical technique used, anaesthesia fees, and facility charges. Following your detailed consultation, we will provide you with a transparent and comprehensive quote that outlines all associated costs, allowing you to make an informed decision.

Most patients can resume light, non-strenuous activities within a few days. However, strenuous exercise, heavy lifting, and activities that put pressure on the surgical area should be avoided for at least 4-6 weeks to allow for proper healing and to minimize swelling. Sexual activity should also be avoided for a minimum of 6 weeks, or until you are fully cleared by our surgeon, to ensure optimal healing and prevent complications.

Yes, as with any surgery, there will be scars. However, our techniques are designed to make these as inconspicuous as possible. With the wedge technique, scars are often hidden within the natural folds of the labia. With the trim technique, the linear scar typically runs along the edge of the labia. Over time, these incisions usually heal very well and fade, often becoming barely noticeable. We will discuss scar expectations specific to your chosen technique during your consultation.

We will provide you with detailed pre-operative instructions. Generally, preparation involves avoiding certain medications (like blood thinners), refraining from smoking, arranging for a trusted person to drive you home after surgery, and ensuring you have a comfortable, clean recovery space at home. Maintaining good personal hygiene before surgery is also important. We will guide you through every step of your preparation.

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