Lori L. Cherup, M.D., F.A.C.S.

Aesthetic Plastic Surgery and Advanced Skin Care

Labiaplasty Surgery by Dr. Cherup

Labiaplasty is a plastic surgery procedure for altering the labia minora (inner labia) and the labia majora (outer labia), which are the folds of skin surrounding the human vulva.

On some level, the aesthetic appearance of the female genitalia deserves as much consideration as the aesthetic appearance of any other part of the body. Many textbooks have been published on the principles of breast, eyelid, and facial plastic surgery, but there are no textbooks on perineal (that which encompasses the labia, clitoris, and vagina) rejuvenation. It is a fairly new subject. The articles that have been written are mostly in the gynecological literature, with very few in the plastic surgery literature. Plastic surgeons, in general, would like to learn from their GYN colleagues, but do not trust them, because, we believe, they do not consider sensation, nerve and arterial supply, and tissue viability as seriously as we do. Therefore, we are hesitant to experiment with unproven techniques. I would like to stick with basic principles of tissue rearrangement and healing.

In general, the female perineum, which includes the vulva (labia majora and minora, and clitoris), perineal body (muscle between the vagina and anus), the vagina, and the anus should look normal to a woman. Enlargement or stretching of any of these tissues can lead to sexual dysfunction, difficulties with hygiene, and a less than feminine appearance. With menopause, there is thinning and atrophy of the structures. Plastic surgeons, in general, want to leave vaginal reconstruction to the gynecologist, and usually confine themselves to repairing the labia majora, labia minora, and the clitoral hood. These structures can be altered by shortening them, and also by filling them out to a more plump and youthful shape with fat. Various techniques have been described. I believe those that preserve the most sensation and utilize scars that are the least visible should be employed. Notice that I did not say completely invisible to all observers. Suffice it to say, when normal pubic hair grows over most surfaces, no scars can be seen. With today’s trend for no hair on the perineum, no scars is a very tall order to meet.

The Labiaplasty Consultation

Patients who seek consultation for labiaplasty feel that their labia minora or majora are enlarged, droopy, asymmetric, or deflated. They want the perineal area to look and feel normal and feminine and not aged. Sometimes, their labia get pinched, torn, or abraded by exercise activities or clothes. Your labiaplasty consultation with Dr. Cherup will be private and quiet. She will listen to your concerns. She will examine your external perineum and diagnose asymmetries and abnormalities of proportion. She will propose a plan to remove excess tissue or plump up tissues that need to be improved.

The Labiaplasty Surgery

The labiaplasty surgery usually lasts one to one-and-a-half hours. Our anesthesiologist will use IV sedation anesthesia to put you to sleep before injections numb the perineal tissues. Dr. Cherup uses the trimming technique for the labia minora tissues and clitoral hood. She uses a central wedge excision technique for the labia majora tissues. All sutures are absorbable and only a few knots need to be removed at 10 days. Ointment, perineal gauze, and an ice pack will be used as dressings as you move to our comfortable recovery room.

Recovery after Labiaplasty Surgery

Discomfort will last for two to five days. Lying horizontal, with an ice pack on your perineum to keep swelling to a minimum, is the most important maneuver you can do for the following two to five days after surgery. Sitting is terrible for the swelling. Bruising resolves in one week. Your perineum must be washed each time you urinate or move your bowels. You may return to work in one week. The final size and shape will be apparent at about three weeks. I cannot emphasize enough that taking a week off of work, and lying in a horizontal position, will greatly reduce the swelling and make your recovery much more tolerable.

Problems after Labiaplasty Surgery

The problems that Dr. Cherup sees after her labiaplasty techniques are few. Prolonged swelling is usually caused by too much activity in the five days immediately after surgery. The swelling will eventually go down. Those who have a job where they sit probably will take the longest to recover from the swelling. It is very important that ice packs are used, and snug fitting underwear that almost acts like a girdle is used to help put compression on the tissues.

Irregularities along the suture line can occur, because these tissues are very soft and floppy when one is suturing them. Any irregularities that are palpable or visible can be addressed at three or four months after surgery. This is usually unnecessary. Resulting asymmetries, meaning one side being larger than the other, could happen. Frankly, a little bit of asymmetry looks normal. If the asymmetry is causing you problems, Dr. Cherup and you will discuss any revision surgery needed. Decreased sensation in your labia will happen in the initial week after surgery. It eventually should return to normal.

Dr. Cherup has never encountered decreased sensation in the clitoris as a postop problem.

Schedule a Labiaplasty Consultation

If you have any further questions regarding this surgery, please consider making a consultation with Dr. Cherup to discuss your specific situation. Call Radiance Plastic Surgery at (412) 220-8181 or (877) 441-0639.

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Dr. Cherup is the medical director for Invisible Ink
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Unlike older lasers which deliver heat to the pigment and surrounding tissue, the newly FDA approved PicoSure laser uses PressureWave Technology to shatter the ink into tiny particles that are easily eliminated by the body. The result is clearer skin after fewer treatments without injuring the surrounding skin. It also allows for the removal of stubborn blue and green inks as well as previously-treated, difficult tattoos.

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Testimonial 1"I have had both tummy tuck and a back lift surgeries at Radiance. The outomces far surpassed even the most imaginative dreams. I couldn't be more thrilled!...

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