OcBody.com is the online Impression of John Di Saia MD's Breast And Body Plastic Surgery practice

Vaginal Lip Reduction / Labiaplasty Facts from Dr D

A Little Humor
After assisting women with this issue for over a decade I understand it quite well. Most women do not talk about this openly and will certainly not mention it to family and friends. A cartoonist drew this for me and it seemed appropriate to share:

Private About Labiaplasty...Well Yes

Labiaplasty Basics: The results of this operation can take some time to mature. Swelling and bruising vary quite a bit and affect the maturation rate substantially. Patients may feel impatient or as if something is going wrong. Minor revisions have been helpful in improving the outcomes in less than 10% of Dr D's patients.

A basic labiaplasty reference diagram
"Are there different operations for labiaplasty?"

Yes there are. The two main types of surgery for the commonly performed Labia minora reduction are known as the Trim and the Wedge. Labia minora reduction accomplishes decreases in the size and shape of the inner vaginal lips. This area is also called the Labium minus in our diagram. The reduction operation when properly performed is quite safe and has significant benefits for properly selected patients. Dr D has a YouTube video in which he explains why he performs a modified Wedge operation in almost all cases. If you are considering this surgery, we recommend that you review the video. :)

"Are my labia abnormal? They are almost 2 inches."

Reduction labiaplasty obviously reduces the Labia minora, but that does not mean that patients are abnormal. The normal range of length for the Labia minorae is wide, so technically most labiaplasty patients have normal labiae before surgery. This does not mean that they like their normal lips or that those lips don't cause discomfort. Modern underwear and clothing hurts some women with technically normal sized vaginal lips. When those lips are modified properly this discomfort goes away. Suffice it to say not all women were built for modern clothing. :)

"Can I have labiaplasty on my period?"

Labiaplasty surgery involves work on your vaginal lips and while on your period the bacteria are in higher amounts in the area. So generally Dr Di Saia recommends planning the surgery if possible when your period is at least a few weeks away to keep the potential infection rate down.

"Do only porn stars get labiaplasty?"

A common misconception in public opinion is that vaginal lip reduction is an operation for adult entertainers. Over 95% of Dr D's patients are not porn stars or dancers. Whether or not the adult industry has encouraged women to have the operation is not known. The potential labiaplasty client should realize early on that the surgery differs in different hands. Different surgeons perform different operations. Make sure that the operation you want is that which is performed for you before you have it. :)

"What are my reduced lips going to be like right after surgery? How is recovery?"

The operated area will swell and become kinda firm and rubbery after surgery within hours to a day or two. This process may be pretty different from one side to the other which frequently makes patients nervous. As long as nothing swells rapidly over hours to a painful level, then this is pretty normal. Some spotting (bleeding) is normal for the first few days. This makes stocking up on female pads before surgery a good idea. You should not be using tampons again until cleared by the doctor. You will be applying antibiotic ointment to the area to keep it moist for the first week or two. The ointment only needs to go on the operated areas. Bleeding should pretty much stop 2-4 days following surgery. Bruising can take a week or two to resolve usually going from violet to yellow over days for each phase.

"Will I be stuck in bed after surgery? How about activity level?"

For the first few days it is best to just stick around the house. Vigorous activity particularly activity involving the legs (like on a bike) is not advised. After a few days when the swelling starts to come down, light walking is OK. You should try to avoid prolonged sitting for the first few days to avoid pressure on the area. The doctor clears you for increased activity as the time passes.

"What about the pain?"

Most patients experience more soreness than pain (in the modified wedge techniques) unless a suture comes loose or swelling causes tightness in the closure. In these cases, removing a suture and/or replacing it usually fixes the problem. The soreness resolves as the wound heals becoming less bothersome within the first few days in most cases. More mild soreness for a week or two is not uncommon afterward. The "Trim" operations are associated with much more pain. Patients requiring extension into the Labia majora to help with excesses frequently have more discomfort and take longer to have this discomfort resolve. Still all in all, most of my patients are off narcotic pain medication in a few days to a week.

"When can I have shower or take a bath?"

Showering is OK after the first day. Just let the water run off and pat the area dry. No scrubbing. Do not immerse the area in water until cleared by the doctor.

"When do I need my sutures out?"

The sutures used dissolve in most cases. At times we need to remove some. Some patients may develop pain as the tissues swell. At other times patients have a tissue reactions or discomfort around one or more sutures. The solution has been to either remove or replace a few sutures. This is all accomplished in the office under local or has been in all cases to date.

"How long until the result has matured appearance-wise?"

Healing from this operation takes time. Firmness can develop as the wounded area moves through the stages of healing. This firmness over time softens and things that look pretty different (or stick out) usually settle in and look normal. The area where the Labia minora (Labium minus in the diagram) meets the Labia majora (Labium majus in the diagram) can develop "lumps" after surgery that can alarm patients. Unless these "lumps" are really large, as the softening starts to occur with the healing over the first few weeks, they improve substantially. Reduction labiaplasty best addresses the size of the Labia minora. Excesses in the Labia majora when large may require thigh lift surgery to address more completely. This has not yet been performed in any of my patients to date. Patience as the healing process progresses is a frequent source of dismay however.

"When it is all healed will the sides be exactly the same?"

No. Similarity is possible. Exact evenness is not.

"When can I have sex?"

As long as the healing is on schedule, gentle intercourse is usually possible in 4-6 weeks. Dr D prefers to examine his labia surgery patients as the healing progresses to give the "green light" for such activity. :)

"Should I wait until after pregnancy to have labiaplasty?"

Labiaplasty surgery sites heal to regain full strength over months after surgery. Women planning the vaginal delivery of a child sooner than a year from a prospective surgery date are probably better off waiting until they have finished planned pregnancies before labiaplasty. If you are planning pregnancy in the distant future, you are probably OK but this should be discussed with your surgeon relative to the technical aspects of your specific procedure.

"Will I lose feeling 'down there' having this surgery?"

The modified wedge preserves sensation. This is amongst the reasons why Dr D essentially stopped doing Trim procedures years ago. We have had no complaints in over ten years that sensation was reduced.

"Will a man be able to tell afterward that the surgery has been done?"

Usually not; unless he has seen the area beforehand. :) Keeping the operation a secret is a big issue for many patients some of whom seek the surgery when they are "between boyfriends or husbands" for this reason.

Dr D's "Why Choose A Good Wedge Labiaplasty" Video

"How is sex after labiaplasty?"

For women in whom larger sized labia minorae have been an obstacle to comfort either for physical or psychological reasons, sex is almost always better after labiaplasty. This of course depends upon exactly what is corrected and the technical aspects of the surgery. Dr D's Modified Wedge has performed well for our patients many of whom specifically choose Dr D for their surgery for aesthetic and functional reasons. A YouTube video by a Dr D Modified Wedge labiaplasty patient features a segment in which the patient (identity protected) tells you exactly how she feels sexually since the operation.

"How long after surgery will it be until I am completely healed?"

Healing after surgery is a gradual process. Things look pretty healed after a 4-6 weeks, but internally the surgical site is slowly completing the healing process over a much longer period of time....months. A few patients have returned to allow their results to be imaged for the office book or the site here years after surgery and reviewing their images shows how things continue to get better over a year or more.

"Does it make a difference who I choose as my labiaplasty surgeon?"

Well of course. Labiaplasty is not a commonly taught operation in any residency. It is performed differently by different doctors. Some treat it as a small insignificant operation, just chopping off the lips and this can be very difficult on the patient. With Dr Di Saia, you get a published expert in labiaplasty surgery with over ten years of experience who treats the operation with the respect it deserves. He is not the cheapest, but he is amongst the best.

Who Should Not Have This Surgery:
Women that want absolute perfection and/or have little patience in waiting for the result to mature may wish to pass on this surgery. Swelling takes time to resolve and healing at first forms thickening that later softens. The complete process frequently takes months. Patients should understand this going in.

This page is specifically designed for Dr Di Saia's patients. Patients of other surgeons should get the advice of their own surgeon before doing anything listed here. Follow your surgeon's plan. This is not medical advice.

Back To Labiaplasty Main

© John Di Saia, MD... an Orange County California Plastic Surgeon John Di Saia, M.D.

Serving Southern California since 1997 * (949) 369-5932