Labiaplasty: A Quick Fix or a Risky Choice?

Labiaplasty refers to plastic surgeries performed on the labium, skin folds surrounding the urethra, and vaginal opening. There is an increasing demand for these surgeries for medical and esthetic reasons. But how much do we know about them? Are they safe, and when do some consider one?

Reasons for getting labiaplasty

Labia, or 'lips' in Latin, are a pair of skin folds on either side of the vaginal opening. The greater lips (labia majora) are more 'fleshy' or 'fatty' and are covered with pubic hair. They also cover the labia minora, the much smaller and thinner lips.

Although there are medical reasons for labiaplasty, patient awareness about the perceived concept of genital esthetic and what is considered 'normal' or 'beautiful' caused a drastic increase in the popularity and demand for these surgeries. Only within five years, the number of labiaplasty cases increased by 217.3% in the U.S.

Women, including those with more extended labia minora exceeding labia majora, prefer getting a labiaplasty for different reasons:

• Discomfort wearing tight clothes.
• Discomfort and pain performing sporting activities.
• Difficulties and pain during sex.
• Hygienic difficulties.
• Esthetic reasons. Women may find labia minora too long, asymmetrical, thick, or darker.
• Gender-affirming surgeries. As a part of a series of surgeries, labium is generated from existing genital tissue.

4 benefits of labiaplasty

Women mainly express their satisfaction after the surgery. The known benefits of this cosmetic surgery are:

1. Increased confidence about self-appearance.
2. Reduced pain, discomfort, and irritation.
3. Decrease in anxiety and embarrassment in sexual life, especially for those entering a new relationship.
4. Helps with better hygiene and prevents infections that may occur due to poor hygiene.

However, it should be remembered that there are no standards or norms for labia appearance, including size, thickness, and color, rendering different anatomical variations normal. Also, it is not scientifically proven that labiaplasty increases sexual pleasure.

Life after procedure

Following the surgery, you may experience some symptoms for a few days:

• Swelling
• Mild pain
• Discomfort
• Mild bleeding

You may use over-the-counter painkillers and home remedies, such as cold compresses, for pain control. However, if you experience increasing pain, bleeding, swelling, fever, or opening of the wound, you should contact your doctor.

After the procedure, it is recommended to wear loose undergarments and clothing to allow the wound to heal without delay. You may wash the wound with lukewarm water, but avoid using soap or rubbing. Sutures are generally self-absorbing, and no removal of sutures is required. Mostly, it takes 4–6 weeks for the swelling to go away. Generally, the scarring is minimal or none.

When to go back to your daily activities?

After surgery, it doesn't take long to go back to daily activities and work. However, you should refrain from these activities for up to 4–8 weeks:

• Heavy physical activity
• Sporting activities, such as cycling or running
  
• Sexual activity
• Hot tubs and sauna

Early resuming of these activities may open the sutures and delay wound healing. Also, you may experience bleeding from the wound. In women, especially with reduced immunity, when proper hygiene is not followed, the wound may get infected.

Does it hurt to pee after labiaplasty?

The opening of the urinary system is very close to the surgical area. Also, urine is acidic in nature, and when it touches the wounded skin, it might have a burning sensation. To avoid this discomfort, you may gently wash the area using a squirt bottle. However, if you feel a burning sensation even without urine touching the surgical area, this might be a sign of a urinary infection. If discomfort persists, it is recommended to contact your doctor.

When can you get pregnant?

Labiaplasty is a surgery performed on the outer genitalia. Therefore, it does not interfere with your fertility or reproductive organs. However, since intercourse is not advised during the first 4–6 weeks, it naturally may delay the possible conception.

Different techniques of labiaplasty

Several surgical methods are used to remove the labial tissue.

• Edge resection. The extra tissue is cut from the outer edge.
• Wedge resection. A pie slice-shaped cut in the labia and merging of their remaining parts.
• Central cut and merge the remaining tissues.

Surgery is performed either with local anesthetics while the patient is asleep with sedative injections or under general anesthesia. The duration and the extent of surgery depend on the procedure and case.

As a common practice, the incision of marked tissue is done using scissors or a surgical knife (scalpel). Some surgeons prefer using laser labiaplasty. In this method, the laser instrument uses light to cut the tissue and also closes the blood vessels. The advantage of the method is that after cutting, no sutures will be required to stop the bleeding.

Risks to be aware of

Although labiaplasty is surrounded by controversial opinions on ethics and medical reasoning for performing the surgery, studies report as high as above 90% satisfaction and low complication rates after the surgery. However, these studies were found to have a low level of evidence, and outcome evidence is considered insufficient.

Common complications following surgery include:

• Opening of the sutures
• Hematoma
• Bleeding from the wound
• Difficulties during urinating

Because of the wound healing and bleeding issues, 4.1% of patients need secondary surgery. Almost 2% of women were not satisfied with the results and requested a second surgery.

Women may feel insecure, uncomfortable, and self-conscious about their genital appearance, which may further affect their personal and sexual lives. Regardless of the starting point, spousal, family, or social pressure, images of 'near-perfect' genitalia all around the media and internet, discomfort in daily life, or desire to increase sexual experiences, all pros and cons of an invasive procedure should be considered, and under no circumstances these feelings and thoughts should be neglected, ignored, or dismissed.