Color of the genital area compared to the surrounding skin n Same color Color of the genital area compared to the surrounding skin n Darker color Rugosity of the labia n Smooth unwrinkled Rugosity of the labia n Moderately wrinkled Rugosity of the labia n Markedly wrinkled Surgery Contraindications Labia reduction surgery is relatively contraindicated for the woman who has active gynecological disease, such as an infection or a malignancy ; the woman who is a tobacco smoker and is unwilling to quit, either temporarily or permanently, in order to optimize her wound-healing capability; and the woman who is unrealistic in her aesthetic goals. The latter should either be counselled or excluded from labioplastic surgery. Davison et al write that it should not be performed when the patient is menstruating to reduce potential hormonal effects and the increased risk of infection. In this procedure, the labiaplasty is usually performed some months after the first stage of vaginoplasty. Anaesthesia Labial reduction can be performed under local anaesthesia , conscious sedation , or general anaesthesia , either as a discrete, single surgery, or in conjunction with another, gynecologic or cosmetic, surgery procedure. One resection-technique variation features a clamp placed across the area of labial tissue to be resected, in order to establish hemostatis stopped blood-flow , and the surgeon resects the tissues, and then sutures the cut labium minus or labia minora.
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However, the most common procedures are the wedge resection and the curvilinear resection. The wedge resection is a safe and effective method of reducing the labia minora. Done correctly, the wedge resection spares critical nerves and preserves arterial supply to the labia minora. However, probably the best approach is using low-temperature radiofrequency cautery. This helps in the healing and early recovery of such a procedure. The patient should be aware that with this procedure the edges of the labia minora remain pigmented and irregular.
Who are the patients that desire a wedge resection of the labia minora? These are usually patients who want to maintain the natural edging and architecture of their labia minora and who want a shorter scar, as well as less scar sensitivity. Smokers, unfortunately, have a far greater incidence of scar dehiscence secondary to poor vascularization.
Other causes of incision dehiscence are if the surgeon too aggressively generic aldara creates the wedge resection impacting the external pudendal artery which can result in ischemia. There must be an adequate length of the labia minora in order to perform a successful labiaplasty. Inadequate length would be a contraindication for this procedure. It is imperative that the surgeon has a great amount of experience performing wedge resections. This procedure requires a precise closure of the incision as well as a clear understanding of the anatomy in this area of the vulva.
A brief sexual and gynecologic history must be taken of the patient with a discussion of basic anatomy. It is important for any surgeon to review all risks and potential complications with the patient.
The labia minora must be assessed for any redundancy, asymmetry and pigmentation. Some asymmetry may remain postoperatively and this must be discussed with the patient preoperatively. Combined procedures such as clitoral hood reduction and labia majora reduction should also be discussed prior to surgery. It is important for photos to be taken both front and back showing the degree of extension of the labia minora so that there is a good record of before and after results.
Labiaplasty of the labia minora can be performed either with local anesthetic or with general anesthesia. Curvilinear Resection Labiaplasty This procedure is the most common of the labiaplasty performed. It can be performed using a diode laser or a radiofrequency device, as well as cold knife approach. The radiofrequency thermal energy approach is probably the most satisfying in terms of healing as is the diode laser.
The curvilinear resection procedure leaves a long horizontal scar versus a small midline scar with a wedge resection. Most scars soften in six months and there is rarely any scar or pain involved in the healing process. The curvilinear approach allows for a more aggressive reduction of the labia minora, as well as more flexibility in the patient choosing of reduction.
The linear reduction seems buylyrica. Area of dehiscence, as seen with the wedge resection technique simply does not occur with a curvilinear incision. Healing is faster compared to the wedge resection, which is 4 to 6 weeks and bleeding and hypersensitivity is reported last with curvilinear resection. However, it is possible that scar contracture and pain with intercourse can result.
Fortunately this is a rare occurrence especially in the hands of a skilled surgeon. It is important that the surgeon discuss the lack of preservation of the pigmented perimeter of the labia minora, as well as the so-called natural notched appearance of the labia minora.
This is easily accomplished with the use of a radiofrequency thermal generator. Labia Majora Reduction For many women aging includes the beginning of the sagging of the vulvar structures. The labia majora tend to go through relaxation after childbirth and post childbearing years. This sagging of the labia majora causes a great deal of consternation for women who wish to wear tight filling clothing.
Aside from the aging and relaxation, the labia majora can also have an excessive amount of fat content. This is something that they see in magazines such as Penthouse and Playboy. Reduction of the labia majora involves a linear incision in the folds between the labia minora and labia majora and then extending out laterally to the apex of the labia majora extension once this is accomplished and the vulvar skin is removed, the surgeon can decide how much fat, if any, should be removed following the reduction of the fat content the margins are closed without tension and the scar is hidden in the labial fold.
It is imperative that the labia are hemostatic before closing the skin as hematoma is a common complication along with infection, but once again still rare in light of the numerous surgeries performed.
Once again, it is imperative for the surgeon to obtain accurate phots of the labia majora from all different angles of perspective, so that an adequate comparison can be made between pre-op and post-op photos. Read more about labiaplasty recovery and healing time. It is important to explain to the patients that even though there is little tension upon closure of the vulvar incision there can be a slight lateral tension on the opening to the vaginal introitus this may give a bit of a gaping appearance.
Patient should be aware of this other contraindication to this procedure is an active HPV or herpes infection. If the patient is anticipating bariatric surgery or a great amount of weight loss in the immediate future, it is advisable to hold off on the labia majora reduction, as more tissue may later need to be removed.
Once again, success depends a great deal in part of the experience and skill of the cosmetic surgeon. Read an article on how to avoid a botched labia surgery , article contains botched photos and revisions. Blog Categories.
LABIAPLASTY SURGERY TECHNIQUES
Think again. Things like who is better than whom. So, where do you find an expert labiaplasty surgeon who has mastered a surgical technique, or one who knows many techniques? So many terms, so many different techniques to consider.
Your guide to labiaplasty surgery Labiaplasty Techniques Trim vs Laser vs Wedge: A Comparison of Labiaplasty Techniques Labiaplasty is a cosmetic surgery procedure that reshapes or reduces the labia minora the small inner lips of the vagina. This is done to perfect the appearance of the vagina, reduce discomfort and pain and enhance sexual gratification. Depending on your anatomy and desired results, as well as the experience and preference of your surgeon, there are three different labiaplasty techniques that can be used. The trim technique simply removes excess tissue by cutting away the edges of the labia minora. While this technique can successfully reshape and renew the labia minora, it can also lead to stiffness and discomfort along the incision, and even a loss of sensation  if not done by an experienced surgeon.