Labiaplasty has been very popular in our office since we started to offer this cosmetic surgery procedure in 2006.  Although traditional Plastic Surgery procedures tend not to change dramatically over time, there are a few changes we’ve made to our labiaplasty approach since COVID.  Read on to learn what and why:

We now offer labiaplasty in the office under local anesthesia and Pro-Nox

Prior to COVID, we brought patients to the operating room at the hospital for surgery.   While that made for a quick and easy procedure (patients went to sleep and had a brief general anesthetic), it was more expensive, required more drugs and often resulted in nausea and vomiting the night after surgery.

In early 2020, after hospitals shut down all elective surgeries due to coronavirus, several of our patients scheduled for labiaplasty surgery inquired about having their procedure done in the office.  While we could certainly offer patients surgery under local anesthesia, this was not routine for us at that time.

We found that patients actually appreciated being awake for their labiaplasty!  After taking an oral anti-anxiety medication (Lorazepam, also known as Ativan) and breathing a 50-50 mixture of laughing gas (nitrous oxide) and oxygen called Pro-Nox, the numbing injections are not very bothersome at all.  Women appreciated not having to go to a hospital and repeat countless times out loud to unfamiliar faces, their name and date of birth, what procedure they were having, which side(s) etc. – instead feeling very comfortable with the office team of a woman Plastic Surgeon and female Nurses and office staff they had come to know and trust at their consultation and preoperative visit.

Going forward, we offer labiaplasty as a simple in-office, outpatient procedure for all our patients!  No general anesthetic, no intubation, no postoperative nausea and vomiting, and patients get to SEE their results (and the labia tissue removed, if they wish) immediately after we finish so there is less mystery about what was done during surgery and what is normal.

We use rapidly-dissolving sutures that go away on their own

Former sutures used for repair of mucosa in a labiaplasty were braided (Vicryl).  Braided sutures attract more fluid as they dissolve and they tend to “spit” through a wound during healing.  While this is not dangerous, it can be concerning to patients.  We have switched to less irritating monofilament sutures such as Chromic or gut that rapidly go away on their own and do not spit and cause wound healing delays.

Clitoral hood reduction is incorporated into nearly every labiaplasty

Patients’ eyes tend to widen when we mention the “clitoral hood”.  Women are concerned about losing sensation or the ability to become aroused or have orgasms.  We reassure patients that a labiaplasty only trims excess labia minora tissue and folds of skin overlying the clitoris, which is a deep constellation of nerves an inch or more deep to the surface.  Labiaplasty will not change sensation or interfere with erotic stimulation of the clitoris.

Some patients in fact claim that their sensation is improved after a labiaplasty and clitoral hood reduction, as there are less folds of redundant skin there – although this is a subjective self-reported observation only.  We don’t routinely measure sensation before and after surgery.  Clitoral hood reduction simply trims excess “drapery” in the front of the labia, and is analogous to trading in pleated-front pants for flat-front pants (if a labia were trousers).

Where can you see actual results?  A picture is truly worth a thousand words, and when someone asks me “Why would any woman want this surgery?”, I direct them to our website gallery.  Just seeing the before and after images tells them everything they need to know.

We have hundreds of labiaplasty before & afters on our website!

Unfortunately, we can’t share them on the @drkarenhortonbeforeandafters Instagram account.  While we share descriptive stories like this one, full NSFW (not safe for work) images and the full patient story are featured on our website labiaplasty gallery.

Interested in labiaplasty surgery and want to learn more in person?  Complete our online contact-us form and our office will get back to you STAT!