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Nymphoplasty (labiaplasty): reconstructive or cosmetic surgery? Indications, techniques, results, complicationsLabiaplasty: Plastic or cosmetic surgery? Indications, techniques, results and complications

Labiaplasty (nymphoplasty) is the reduction of the genital labia minora. This intervention has become a frequent request from plastic surgeons because physical discomfort is always accompanied by aesthetic discomfort. These patients are younger and younger and often experience a real complex since adolescence disturbing their love life. Surgically, there are several techniques with varying post-operative consequences. The classic technique (longitudinal resection) remains the most used, but it most often amputates the lesser lip, which is why the techniques with V-plasty seem more suited to this surgery. Advantages, technical details, postoperative effects and complications of the V-plastic technique are detailed by the author in this article.

Summary

Labiaplasty is the surgical term for labia minora reduction. This procedure has become popular with plastic surgery patients because physical discomfort and cosmetic concerns are virtually always combined. Demand for this procedure is becoming common amongst very young patients who appear to have nurtured a complex since their early adolescent years, disturbing their love life. There are several possible corrective surgical techniques, the postoperative courses of which vary significantly. The traditional method (longitudinal resection) remains the most widely used, but requires resection of the larger part of the labia minora, which is why in our opinion the V plasty technique seems more appropriate. The benefits, technical details, complications and postoperative course of the V plasty technique are detailed by the author in this article.

Labiaplasty: surgery for excessively large lips of the vulva

With the trend of full hair removal, women want to have perfect vulvas, with small vaginal lips that do not protrude. Nymphoplasty or labiaplasty consists of reducing their size. What does it consist of? Why do it? What results? Complications? Price?

Nymphoplasty (also called labiaplasty or labioplasty in reference to the English term labiaplasty) consists of reducing the size of the labia minora of the vagina , for aesthetic or functional reasons. "It's an operation that has exploded  today, before very little was done" , explains Dr. Diba Abrar, a gynecologist specializing in intimate surgery. In fact, before, the vulva was hidden by the hair, so the labia minora were not visible.Since the explosion of hair removal (we went from the simple bikini to the metro ticket, and now to the completely shaved vulva) this intimate part is revealed. When the labia minora are too long, badly shaped or when one is larger than the other, it annoys some women who become self-conscious. "It is not a disease, but a small ingratitude of nature. Women today want the labia minora to remain in the vulvar cleft and not protrude from the labia majora," he explains. In addition, hypertrophic (too long) lips can get stuck in underwear. "It's really a request from the patient,it is never the husband who pushes her to undergo the operation, it is herself who is embarrassed by this problem. It's both a fashion and a necessity: she does it for herself, to feel better, ” insists the specialist.

Indication

Sometimes, more than a cosmetic problem, a large size of the labia minora can cause a functional problem: it can make bumps under tight pants or small folds in swimsuits, or even become embarrassing when wearing thongs. It can even become disabling: "Because of the size of their labia minora, these patients cannot do certain sports: horse riding, rowing ... And sometimes, at the time of intercourse, the lips can turn and be sucked into the vagina, which is very painful, ”he adds. About 20% of women therefore undergo surgery for functional and non-cosmetic problems, according to the doctor.

What does a labiaplasty consist of?

Labiaplasty therefore consists of reducing the labia minora that are too protruding, with a precise protocol to be followed. "In the labia minora, there are two areas: a mucous area and a skin area.  The skin area can be removed, it is not a problem for intercourse, explains the doctor. But it is important not to touch. the mucous zone. We therefore pass two or three millimeters above this zone, called Hart's line , "he explains. The procedure was initially done with a laser, but there are other techniques. "Personally, I use a Colorado tip,which cuts very precisely without burning the skin and without damaging the remaining lip ".

How is the operation going?

Before the operation , the doctor meets the patient: "I explain the procedure to her in detail, as well as the instructions before, during and after the operation."   The patient must therefore have all the keys in hand and be fully informed of what she is about to do. If ever she wishes to change her mind, there is obviously a 15-day cooling-off period , as with any cosmetic surgery. On the day of the operation, the doctor operates in the operating theater. Doctor Diba Abrar performs spinal anesthesia (only the lower body is anesthetized, the patient is still conscious) but other doctors can use another technique, such aslocal anesthesia.The intervention lasts on average an hour, but it also depends on the importance of the nymphoplasty. The patient can then go out the same evening.

A painful operation?

"It's not particularly painful, usually first-degree drugs, like paracetamol, are given and often enough is enough. I estimate that about 2 to 10% of patients need second-degree pain reliever. , like tramadol ", explains the specialist.

Operative suites

"It is very important to follow the recommendations following the operation. Indeed, the vagina is a hot and humid place, so germs can quickly develop", insists the doctor. So there are specific instructions for patients on how to take care of the stitches:

• "It has to be very clean. Patients should therefore wash themselves with a foaming soap, rinse, and dry well using a compress, combined with a product like Cicalfate."
• In order for the stitches to hold, the most important thing is to dry the area welland wrap it in a sterile compress . In the days that follow, rest is essential and work strongly discouraged for a few days. For three to six weeks after the operation (the time for good healing), the practice of sports, sexual intercourse, wearing tight clothes and baths are contraindicated.

Complications and risks

"Sometimes there are labiaplasty failures, which are terrible for the patients. I have already operated on patients who have had a bad labiaplasty with another practitioner. With the technique I use, called longitudinal, there are normally very few failures ", he adds. It is therefore necessary to choose well who will do the operation: the doctor must have followed a specialized training in this form of surgery and have a certain reputation. Apart from the risks associated with the anesthesia, the complications can be bleeding , bruising , infections or poor healing: "Even if the stitches fail,normally healing takes place. But if the patient follows the instructions, it is very rare that they do not hold, " says the doctor.

Contraindication

There are no major contraindications to this operation, apart from the classic contraindications of a surgical operation (coagulation problems, allergy to an anesthetic product, history of phlebitis or pulmonary embolism, taking aspirin before the operation). Tobacco can also delay scarring and healing. It is obvious that all this must be discussed with the doctor in the first consultation: the patient should not hesitate to ask all her questions. "The doctor must also check if it is not an excessive demand" , notes the doctor.