Labiaplasty - The Patient

The Patient

Indications

I. Oversized labia

The woman afflicted with labial hypertrophy presents labia minora that are disproportionately oversized in relation to the size of the labia majora, which to her have an aesthetically displeasing appearance and cause her problematic hygiene, commonly reported as a diffused or a disrupted urinary stream; chronic irritation of the pudendal skin; painful sexual intercourse; and pubic pain when wearing tight clothes. Anatomically, like all the paired structures of the human body, it is uncommon for the labia minora to be perfectly symmetrical. Usually, the size discrepancy is slight, yet some women present one labium minus (minor lip) considerably larger (longer, wider, thicker) than its pair; some women also present redundant folding (either unilateral or bilateral webbing) between the labia majora and the labia minora that can be surgically resolved.

Therapy

• Medical — Labial hypertrophy, the overdevelopment of the vaginal lips, is not managed medically.

• Surgical — The woman’s specific clinical indications determine the appropriate labiaplasty technique. The correction of hypertrophied labia minora can be performed upon a patient either as a discrete labiaplasty (single surgery procedure), or in conjunction with a gynecologic surgery procedure, or in conjunction with a cosmetic surgery procedure (genitoplasty).

Contraindications

• Absolute — There are no absolute contraindications to labioplastic surgery, either for altering or for reducing the labia minora or the labia majora.

• Relative — Labial reduction surgery is relatively contraindicated for the woman who has an active gynecological disease (i.e. an infection or a neoplastic malignancy); for the woman who is a tobacco smoker unwilling to quit (either temporarily or permanently) in order to optimize the capability of her body to heal a surgical-incision wound; and for the woman who holds unrealistic aesthetic goals (ideal self-image and body image), and expectations for the outcome. Such a woman (patient) should either be psychologically counselled or excluded from labioplastic surgery.

II. Sexual reassignment

In sexual reassignment surgery, in the case of the male-to-female transgender patient, labiaplasty usually is the second stage of a two-stage vaginoplasty operation, wherein labiaplastic techniques are applied to create labia minora and a clitoral hood. In a male-to-female procedure, the labiaplasty usually is performed months after the first-stage of the vaginoplasty. As required by the (transgender) woman’s indications, after a one-stage vaginoplasty, the labiaplasty — which creates the labia majora and the labia minora — can be an elective surgery procedure for refining the aesthetics of the woman’s vulvo-vaginal complex. (See: Male-to-female sex reassignment surgery)