Learn about Labiaplasty and vaginal rejuvenation from Dr. Jacobson, in Connecticut

THE LABIAPLASTY PROCEDURE

Labia reduction is done under twilight anesthesia along with long acting local anesthesia that will provide six to twelve hours of pain relief after surgery. I can contour the labia to form either a tapered, Natural Look or make the edges very narrow to produce a Thin Look. It’s your choice. Examples of the Natural vs.Thin Look can be seen in the Photo Gallery on the website. Reduction of the clitoral hood can be undertaken if needed. Next the skin is marked according to the planned surgery. I follow the markings on your labia with the minimally traumatic Ellman Surgitron. It is a unique instrument because it has a cool tip so thermal damage to the underlying tissue is measured in microns instead of in millimeters. Compared with the laser you read about for vaginal rejuvenation high frequency (no scalpel) surgery produces far less post-operative swelling, inflammation and pain yet achieves superb cosmetic results. I have used a laser for many years but now my patients experience the remarkable difference the Surgitron makes. It is without comparison in its finesse and ‘no touch’ technique. To help with occasional bleeding sites I use fine point electrocautery.

There are two basic techniques used to sculpture the inner lips. I have already mentioned the first method above. The second, known as the wedge or V technique is the one preferred by plastic surgeons which removes a horizontal wedge of labia tissue. The edges of the V are brought together horizontally with fine sutures. Unfortunately it has the potential for many complications and can often pull apart. There can be too much tension and not enough suture strength to keep the edges together. A variable blood supply can also impair healing. Most gynecologists, including myself, use the technique that vertically contours the edges to the size desired without the high-tension wedge incision. There is less wound breakdown and fewer problems with restoration of blood flow. I favor this technique because of its precision and flexibility. You do not have to guess how the top will line up with the bottom. The edges always line up.

Once all the excess labia tissue is removed meticulous suturing begins. Very fine dissolving sutures are used in several layers to ensure proper alignment of the edges and wound healing. Various suturing methods can be used but I prefer to stay with a tried-and-true technique developed over the years. It is the safest method of all to ensure wounds do not open up and at the same time preserves the most natural of looks. If excess friction against the healing labia causes separation of the edges, the good news is that they come together again naturally with excellent cosmetic results. The key to a successful labiaplasty is to blend the upper portion of the labia and skin next to the clitoris into the reconstructed lips so the edges flow evenly. This is where the art and experience of the repair come together.

When your surgery is completed you wake up within two to three minutes, transfer to the recovery suite and go home or to your hotel shortly thereafter, pain free for hours. On rare occasions slight irregularities or small skin tags may develop during the healing process. If this occurs, as part of your overall care ‘touch-ups’ can be done in the office painlessly with local anesthesia.