The "V" Wedge Technique Demonstrated

 

 

 

The wedge technique of labia minora reduction is demonstrated. On the left the patient is shown with a very redundant labia minora. The picture next to it demonstrates the markings used to plan the surgical resection of excess tissue  

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This picture demonstrates the intra-operative appearance of the labia minora just before resection of redundant tissue and then immediately after. Please note that the tissue is swollen and the stitches quite visible. The swelling resolves rapidly and the visible stitches all dissolve within 10-14 days of surgery

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In this picture, the surgery is complete and the patient is now one month out from the procedure. The black dot on the right hand picture points to the visible suture line. Note that the swelling has completely resolved and the stitches are gone. All that is visible at this point is a small pink line to mark the site of surgery. Within 3 months this line blends in to the surrounding tissue and becomes almost invisible

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More Labiaplasty Before and After Pictures
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Labiaplasty with central redundancy before and after

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Labiaplasty with anterior redundancy before and after

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Typical central hypertrophy labiaplasty result

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Diffuse Labia hypertrophy is the most difficult to correct


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Anterior Labia hypertrophy-before and  3 months after labiaplasty

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Labiaplasty central hypertrophy result- shown at 6 weeks after surgery

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Dr. Daniel A. Medalie
Expert Labiaplasty Surgeon

(216)778-4450

Labiaplasty in Cleveland, Ohio

What is Labiaplasty?


Labiaplasty (Labioplasty) or Labia Minora Reduction is a surgical procedure that reduces and/or reshapes the labia minora - the skin surrounding the vaginal opening. In most women, the labia minora are seen only when the legs are separated. However in some women, large labia minora are visible when the legs are not apart, or are barely separated, causing embarrassment, self-consciousness, and distancing in relationships. Enlarged labia may also be noticeable in tight fitting pants, and can cause discomfort during intercourse, with clothes, or with exercise. Enlarged labia are usually congenital but may be increased from hormonal changes or childbirth. 

How Does the Surgery Work?


Labia Minora reduction (Labiaplasty) is a procedure to correct enlarged Labia Minora. Various techniques are available for treating prominent labia minora. One approach utilized by many gynecologists and plastic surgeons is a simple removal of leading edge of the labia (the excess tissue that projects beyond the level of the labia majora), thereby shortening and reducing it. The edge is then repaired. This is the least complicated technique but also the least aesthetically pleasing. It does not tighten the remaining labia and leaves a long, flat scar along the top of the labia. This scar can remain irritated and sensitive for a long time. 
Some practitioners advertise for "laser labiaplasty". This use of a laser adds no benefit to the procedure and is essentially a marketing tool.


What is the "V" Wedge Technique?


There is a more sophisticated technique of labia minora reduction (labioplasty) which preserves the contour, color, and anatomy of the labia minora edge. The excess labia is excised in a "V" manner and the upper and lower edges are sutured together. Therefore, the only suture line visible on the edge is a small transverse line instead of a long longitudinal vertical suture line. This significantly decreases the discomfort and visibility of the procedure. 

Please note that all of the labia reduction procedures displayed in this web site were performed using the "V" wedge resection technique. 

The pictures to the right demonstrates the Wedge technique of Labiaplasty





 

LABIAPLASTY FAQ


DO I NEED GENERAL ANESTHESIA?
No-Labioplasty can be performed with mild oral sedation and local anesthesia.

HOW LONG DOES IT TAKE?
Typical surgery time is around 1-1.5 hours.

WHAT IS THE CHANCE OF INFECTION?
I typically give my patients antibiotics for three days around the surgery. I have NEVER had a post-operative infection. Sometimes patients who take antibiotics get yeast infections and this has happened to several of my patients. The treatment consists of stopping the antibiotics and applying a topical anti-yeast agent.

ARE THERE BLEEDING RISKS?
The labia are very vascular and bleed easily. During the surgery local anesthetic is injected into the tissue-this blocks the sensation and also constricts blood vessels. As a result, there is very little bleeding during the surgery. I have NEVER had a patient have a bleeding complication post-op.

WHAT IS THE RECOVERY LIKE?
While it may seem that this is a very bad area to have surgery on, in fact, the labia are very resilient and heal speedily. Pain that may require narcotic pain medicine typically lasts only a few days. After that ibuprofen ( Motrin and Advil) is sufficient. I recommend that patients take a week off from work, but if you have a desk job, you can go back sooner. The post-op care is fairly easy and involves cleansing several times per day and the application of antibiotic ointment for a week. Most of the swelling and all of the external stitches have disappeared by two weeks.

WHEN CAN I RESUME MY SEX LIFE?
I recommend that patients refrain from intercourse for at least 4 weeks after surgery. This does not mean that other types of sexual activity cannot take place. Even after 4 weeks the labia incisions may be sensitive and patients need to use caution and plenty of lubrication.

WHEN WILL I BE COMPLETELY HEALED?
Some of the deep sutures under the skin can take up to three months to completely dissolve. For this reason, some patients may report sensitivity issue such as itching for up to three months post-op. After that, sensation issues are very uncommon. Damage to the clitoris with resulting changes in the ability to have orgasm has never happened in my patient population.

CAN OTHER PROCEDURES BE PERFORMED WITH LABIAPLASTY?
Yes- I frequently perform multiple procedures on labaiplasty patients. Sometimes I perform clitoral unhooding. This procedure removes some of the skin overlying the clitoris to allow for greater stimulation during intercourse. The labia majora can also be reduced (this is more typically asked for by my older patients or patients who have lost significant amounts of weight).Vaginoplasty or vaginal rejuvenation is a procedure to tighten the vaginal introitus after child bearing. This is easily performed in conjunction with labiaplasty. Finally, all the other cosmetic procedures that I perform (e.g. breast augmentation, tummy tuck etc.) can be performed at the same time as labioplasty. These would require a trip to the operating room and general anesthesia.

WHAT DOES IT COST?
Simple labiaplasty under local anesthesia and mild sedation costs around $3700 at Dr. Medalie's outpatient procedure clinic. Clitoral unhooding adds another $500. Combination labiaplasty and vaginoplasty needs to be done in an OR and takes around 2 hours. The cost is around $8000.

WHAT IF I AM FROM OUT OF TOWN?
I frequently perform Labia reduction operations on patients who live out of town and are unable to easily to see me in consultation prior to the procedure. I have several requirements for these patients: I must see pictures of them prior to scheduling surgery. They need to contact my office and have my secretary fax or e-mail them a history and physical form to be filled out and sent back). Typically the patient will come in to town 1-2 days prior to the procedure, and I will see them in my clinic (alternatively I will perform a phone consultation). I will then perform the operation and see them back in my clinic in several days  to check the surgical site and answer any questions. This means that the patient will spend around 4-7 days in the Cleveland, Ohio area. Occasionally patients have stayed only for 24 hours and had family doctors check on them. Patients who live far away, but can drive to Cleveland (2-6 hrs.), can go home the next day and drive back to see me for their first post-operative appointment. I will then follow the progress of the patient via e-mailed pictures on a weekly basis. My secretary, Valerie has information about hotels in the area as well as financing. You may contact her at  vrowan@metrohealth.org


WHERE CAN I GET MORE INFORMATION?

Please visit Dr. Daniel Medalie's main Cleveland,Ohio web site

at
 www.ClevelandPlasticSurgery.com 

or call him at

216-778-4450

You can also e-mail his secretary at vrowan@metrohealth.org





 

Video of Dr. Medalie performing Live Labiaplasty  Surgery
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