Preface. Aesthetic medicine and cosmetology, which brought us facelifts, lipomodelling of the buttocks and pumping out fat from problem areas, eventually found its way into our panties. For a long time, gynecological operations were associated only with the practice of complete or partial removal of female genitalia. And only in the last two decades in the field of aesthetic surgery, the demand for medical interventions in the intimate area and, first of all, for labiaplasty of the labia has increased and is steadily increasing among women and even teenage girls of 15, 16, 17, 18 years of age.
Myth 1. After plastic surgery of the labia minora, the erogenous sensitivity of the intimate zone decreases
This is not true; correctly performed labiaplasty is, on the contrary, an exposure of sensitive areas that were lost due to excess tissue in the clitoris, clitoral crura and upper segment of the labia. If the operation is performed by a professional, then erogenous sensitivity will only become higher! The fact is that there are areas that, even with a good aesthetic result, cannot be touched. A knowledgeable doctor will definitely point this out to you and take it into account when applying preliminary markings. When performing labiaplasty, under no circumstances should you completely excise, much less significantly expose, the clitoris. Otherwise, the patient will face chronic discomfort.
The rehabilitation period after labiaplasty
The recovery period for a woman after correction of the intimate area goes quite quickly. Already on the first day you can return home. Since self-absorbable suture material is used in these operations, suture removal will not be necessary in the future. However, this does not eliminate the need for daily toileting of the postoperative field, which should consist of treating with an antiseptic, changing underwear and using a daily gynecological pad. In the first days, swelling of the labia may develop and discomfort may occur while walking or sitting.
You should begin sexual activity no earlier than 2 weeks after surgery. You should also refrain from going to the pool or sauna for at least 14 days. These precautions are necessary to eliminate the risk of infection.
Myth 4. Surely there are consequences!
I repeat that by turning to a trusted specialist who has been practicing for many years, your risks are minimized. However, to ensure a 100% positive aesthetic result, the patient must also strictly follow the doctor’s instructions in the postoperative period.
In general, choosing a surgeon is the main stage of the operation. Consequences can arise from incorrectly chosen method and suture technique, deep excision of the lips, inadequate hemostasis during surgery, trauma to the clitoris and its legs, and complete exposure of the clitoris. The labiaplasty operation is not a heart transplant, but it must also be done efficiently and without consequences.
Labiaplasty: subtleties and nuances of one of the most delicate procedures in intimate plastic surgery
A plastic surgeon with more than 22 years of experience, a specialist in intimate plastic surgery, Sarvar Kazimovich Bakirkhanov spoke about the details of labia plastic surgery, and also shared his opinion on the reasons for the popularity of this procedure among modern women and the diversity of their aesthetic preferences.
Sarvar Kazimovich, what do you think is the reason for the increased interest in the labiaplasty procedure in recent years?
Well, firstly, it became widely known about the possibility of carrying out this operation. Many mature women did not even know about such a possibility before - but they always wanted to have such an operation. Secondly, over the past few years, a woman’s lifestyle has changed - fitness, yoga, and exercise in the gym have become very popular. And it happens that it is during these activities that enlarged labia minora cause women physical discomfort. In addition, there may be comparisons of oneself with others in a common shower, bathhouse, or sauna.
The linen has also changed. Nowadays, tighter underwear has appeared - when wearing such underwear, as well as tight jeans, patients may complain of discomfort in the case of enlarged labia minora. Of course, all this also arouses interest in this operation.
Plus, women have become more strict about the aesthetics of all areas of their body, including intimate ones. And if plastic surgery used to be a “top echelon” surgery, now it has become more accessible. All this contributes to the fact that women want to improve the area of the body that they consider problematic.
Are there any “beauty standards” in this matter? As in breast surgery, for example. What do your patients strive for, what do they want to get as a result?
There are no beauty standards in this matter. Everything is a variant of the norm. If we turn to standards or standards, then neither in painting nor in sculpture there have ever been standards in this matter - unlike the breast, for example.
The opinion that the labia minora should not protrude beyond the labia majora, be of a certain length, and, moreover, that this is some kind of pathology, is all untrue. If you do not experience discomfort, then any structure of the labia minora is always a variant of the norm.
It’s another matter if there is physical discomfort in certain cases, or there is aesthetic dissatisfaction in the woman herself. Not often, but it happens: a girl comes and wants to change the shape of the labia minora, but has no idea how exactly. To the question, how do you see the result of the operation? She answers: at your discretion. But in my opinion, what exists initially is already the norm! On the chair, I can show the patient what absolutely cannot be done, so as not to decrease sensitivity or damage the barrier function.
However, if a woman deliberately wants to change something, I will do it as she wants, in accordance with medical standards, of course. After all, a woman has to live with this today and in the future. I cannot impose my personal aesthetic perception.
All forms of the labia minora are a variant of the norm, and I’ll tell you a big secret: the larger the labia minora, the more temperamental the woman is! Because this zone depends on the male sex hormone (testosterone). And the more of this hormone in the blood during puberty, the more temperamental the girl will be. For some, this hormone gives increased hair growth, for others, increased sweating, for others, enlarged labia minora.
Do you yourself recommend anything to the patient? And how do you react if they want to cut off “everything”?
I definitely won’t cut off “everything,” I won’t go for it, because in this case, aesthetic labiaplasty becomes a mutilating operation. I had a patient who wanted everything there to be like a Barbie doll. In such cases, I refuse. I tell such patients: in addition to aesthetics, it is important that the operation does not have negative consequences for the functions of the genital organs! So that your sensitivity does not decrease and the protective barrier does not suffer. If you cut off “generally everything,” then in the future this is fraught with chronic infections or dryness/bleeding of the vaginal mucosa. And these phenomena will accompany you throughout your life!
Is the procedure painful? Is there a high risk of complications?
Labiaplasty is performed under local anesthesia, which has many advantages over general anesthesia. This operation is not a heart transplant to give an extra general anesthesia. The first day after labiaplasty there may be some pain, so we recommend taking any painkiller at night. On the second day, such measures, as a rule, are no longer required. It is also recommended to be less active in the first days after plastic surgery of the labia minora - this will prevent the increase in postoperative swelling, and rehabilitation will be faster. If you follow proper care (antiseptic treatment up to 10-15 times a day) and rest for this area, then there will be no complications.
What methods exist for performing labiaplasty? In what cases are they suitable?
The surgical cliché (which novice surgeons are now so fond of talking about) actually does not exist. Each woman has her own individual structure, therefore surgical tactics must be individual. You cannot use only one method or another. Sometimes even a combination of several techniques is used in one operation.
During the examination, I show the patient how and where the incision lines will be, what can be done specifically with her labia, taking into account the anatomy, and how it will be more aesthetically pleasing, based on my many years of experience.
What suture material is used? Is it better to use absorbable/non-absorbable threads?
When plastic surgery of the labia minora, only absorbable suture material is used. It is called “Vicryl” or “Monocryl” - it is well accepted by tissues and dissolves after the allotted time (usually a couple of weeks).
There are areas where the threads do not dissolve - then on the 14th day the patient comes to the surgeon to have the stitches removed. Thanks to this, no traces of the operation will remain.
How long is the recovery period after labiaplasty? How quickly can you return to normal life? How long should it take to evaluate the result of the operation?
The recovery period lasts about three weeks. On the 14th day, the remains of the sutures are removed and a week after that, all restrictions are lifted, including those on sexual activity.
As for everyday activities, the first day after the operation is best spent at home, and after a day or two you can safely go to work or study. After three weeks, you can see the primary result of the operation, and the final result is best assessed after two to three months. This is necessary in order to exclude possible hidden swelling, and during this time the lips will already take on their final appearance.
What do you think about the laser version of labiaplasty?
The term “laser labiaplasty” is very fashionable now. About 15 years ago, I used a surgical CO2 laser in my practice for various gynecological operations, including labiaplasty. And I encountered the problem of wound healing after the laser technique. With a sufficient sample of results, I came to the conclusion that the burn surface caused by a laser beam on the labia minora initially heals worse, due to the border between the mucous and skin tissues of the lips.
After practice, I abandoned this technique, although the laser turned out to be indispensable for many other operations. The term “laser labiaplasty” is often used as a marketing ploy, and many surgeons have not yet “played enough” of it, although the laser is very convenient for the surgeon - the operation is bloodless and lasts only 15 minutes. Therefore, if we weigh the aesthetic result for the patient or the convenience for the surgeon, then the first option is, of course, more important. And, I want to note that most of the alterations that I have been doing lately are carried out after laser labiaplasty.
Do you often get repeat operations from other surgeons? And can everything be fixed?
Unfortunately, there are situations when it is almost impossible to change something. Over the past 3-4 years, there have been more and more alterations. Every third operation on female intimate plastic surgery involves redoing the work of others, and this is due to the fact that many doctors undertake this procedure (both gynecologists and plastic surgeons) considering labiaplasty a trivial operation. At the same time, not everyone understands the responsibility for the result, which can ruin a girl’s whole life. Believe me, quite a few tears were shed.
In case of complete excision of the labia minora, we, if possible, take a flap from the paraclitoral area and transplant it to the area of tissue deficiency for external cosmetic adaptation. And, as far as possible, restoration of barrier function, of course.
You can also inject high-density fillers into the remnants of excised lips for a long time, under strong pressure. Due to this pressure, the filler stretches the skin like an expander. It itself gradually dissolves, and the skin remains in an enlarged state. From these excess skin we can already form a semblance of the labia minora. The labia minora may also become slightly enlarged during pregnancy, especially if a boy is expected.
Please tell us about installing fillers. Is this more of an aesthetic procedure?
If we talk about the installation of fillers, they are most often used for plastic surgery of the labia majora, in order to increase their volume. Loss of volume in the labia majora can occur with age or due to sudden weight loss. Fillers are an excellent solution in such situations - they help not only to restore the former aesthetics of the intimate area, but also self-confidence. But it should be noted that the labia area is mobile and during sexual intercourse is exposed to active influence, which naturally accelerates the process of degradation of hyaluronic acid and reduces the aesthetic function of the filler. Therefore, I call the introduction of fillers into the labia majora the “holiday romance technique,” designed for a short but pleasant period.
Are there situations when you refuse surgery? In what cases does this happen?
There are. When the patient has absolutely inappropriate desires. For example, completely cutting off the lips or clitoris. Or if the patient has hyperexpectations, and due to the initial structure of her labia minora this is simply impossible to do - of course, in such cases I will not take responsibility. And also in cases where the decision to undergo labiaplasty is imposed on a woman by someone.
If she wants to change something in this area, then she should want this solely on her own initiative, and not because of someone else’s subjective opinion.
And motivation should, of course, not be imposed, under no circumstances. The labia minora is an intimate area in a woman’s body, i.e. that part of him that belongs and should be liked, first of all, by herself. Consultation with plastic surgeons with over 20 years of experience is free! Make an appointment by phone. Waiting for you!
