Brief Overview of Labiaplasty

Labiaplasty is a minimally invasive surgical procedure for reshaping hypertrophied or enlarged labia minora, the inner folds of skin surrounding the vulva. The size of the inner labia is reduced so that they do not protrude beyond the labia majora, the outer labia. Any asymmetry in the shape is corrected and the thickened pigmented outer edges are removed.

This is one of the most common elective female genital cosmetic surgeries and women undergo it for a variety of reasons:

• The hypertrophied labia can cause painful sex and discomfort from chafing during exercise.
• Excess tissue protruding beyond the labia majora can harbor bacteria and make maintaining hygiene difficult.
• The hyperpigmented or asymmetrically enlarged labia minora cause cosmetic concerns and impact intimacy negatively.

Types of Labiaplasty Procedure

Trim labiaplasty

In this technique the surgeon makes a curvilinear cut along the outer margins of labia minora removing the excess tissue along their lengths to restore symmetry to both sides. The outer margins are then sutured individually along their lengths. This technique allows for better correction of asymmetry and tucks the inner labia neatly inside the outer labia.

Wedge labiaplasty

In this technique a pie or v-shaped area is removed from the inner labia and the remaining edges are sutured together. The normal contour of labia is retained while their size is reduced. With this labia reduction surgery, the scars are hidden but the asymmetry in both labia is not adequately corrected.

Importance of Understanding the Recovery Process

It is crucial to understand post-operative care before undergoing the procedure. Knowing what to expect after the labiaplasty procedure can help with the dreaded anxiety and helps you differentiate between the normal symptoms and potential complications. With an understanding of the labiaplasty healing process and the knowledge of symptom management, you can take steps for optimal recovery.

Day 1: Immediate Post-labiaplasty Care

What to Expect Immediately After Surgery

On the day of surgery, you will be monitored in the hospital for some time. It is a day procedure, which means that you can be discharged later the same day. The doctor may want to keep a check on your vitals, especially if the procedure is done under general anesthesia. 

The wound site is watched for excessive bleeding during this time. The urinary catheter is removed once the anesthesia wears off. However, your doctor may want you to stay till you pass urine without significant discomfort. Initial symptoms include:

• Pain
• Bleeding
• Discomfort while urinating
• Anesthesia recovery symptoms like nausea and vomiting

Managing Initial Discomfort and Swelling

Your doctor will prescribe you pain medications which will help subside the discomfort and swelling of the wound. 

Ice-cold packing of the area for the first few days is also helpful for pain management and reducing inflammation. Ice the area in a “20 minutes on and 20 minutes off” manner.

Rest and Activity Restrictions

Try to move as soon as the anesthesia wears off, as early mobilization is known to enhance recovery after surgery.

Avoid sitting for longer duration, especially on hard surfaces. When not moving around, lie on your back and keep the bottom elevated. This will reduce swelling and alleviate discomfort.

Week 1: The Initial Healing Stage

Daily Care Routine

Keep the surgical area clean and dry by washing with lukewarm water. Use a squirt bottle. Don’t use harsh soaps and avoid rubbing the area. Maintain good hygiene by washing from front to back and dabbing it dry.

Wear loose fitting clothing and change them often. This, in addition to regular use of prescribed antibiotics, will help in infection prevention.

The stitches are dissolvable and don’t need formal dressing. Apply an antibiotic ointment on them and wear a panty liner in your underwear.

Prioritize rest, limit your physical activities, and follow your post-operative instructions diligently. 

What to Expect in Terms of Symptoms

As the days pass by, the pain will become milder and the swelling will start subsiding. Don’t worry if your underclothes are stained with blood as a small amount of bleeding is normal. Urinating and moving the bowels may be painful in the initial few days. 

Symptoms that should raise an alarm are:

• Fever
• Pus or abnormal discharge
• Opening of the wound
• Heavy bleeding from the wound
• Excessive swelling
• Worsening pain

These symptoms may point to wound infection and breakdown. In such instances, visit your doctor to seek medical advice.

Tips for Managing Discomfort

Keep pain medications handy. Sleep with a pillow between your legs and continue applying ice-cool packs intermittently to minimize the discomfort.

Stay hydrated to avoid concentrated urine. Also, spray running warm water over the area while urinating to ease the burning sensation.

Eat nutritious meals to help in the healing process. Take a fiber-rich diet and laxatives prescribed by your doctor for a week to avoid straining in the loo.

First Follow-up Visit

A follow-up visit at the end of the first week is usually scheduled by your doctor to assess the healing process and customize your further care plan based on your progress. Usually, you will be given clearance to work after 5 to 7 days of surgery.

Weeks 2-4: Continued Recovery

Reduction in Symptoms

The pain, swelling, and bruising are markedly reduced in this period. You may no longer need painkillers. The suture material usually absorbs completely by the end of this period.

Sensory changes like reduced or heightened sensations and some degree of itching around the wound site are common and are a sign of tissue healing and remodeling. They should not cause a major concern and should improve with time.

Resuming Light Activities

Resume your routine day-to-day physical activities including light household chores. Avoid lifting heavy weights and strenuous exercises. 

Listen to your body and don’t push yourself beyond your comfort level. Start with daily walks and slowly build your way up the ladder.

Abstain from sex for the first 4 to 6 weeks to prevent wound breakdown, pain, bleeding, and infection.

Keep a check on your intimate hygiene and avoid using tampons during this time.

Beyond First Month: Final Stages of Healing

Returning to Normal Activities

You may now feel back to your usual self with a healed wound and only occasional discomfort. Most distorting swelling is gone but some degree of residual swelling may persist for up to 6 months. 

Resume your normal activities and engage in your workouts, gradually including strenuous exercises. This may increase the swelling transiently but is encouraged.

Sexual activity can be resumed after 4-6 weeks, once you feel ready. You may also use tampons after this time.

Long-Term Care and Maintenance

The scars from labiaplasty are usually inconspicuous but using recommended scar gels and ointments can help reduce their visibility even more.

Schedule a final follow-up visit with your doctor to ensure optimal outcomes.

Continue keeping an eye on the area and report any changes or concerns to your doctor. Some rare but potential long-term labiaplasty complications include asymmetry, altered sensations, vulvodynia, painful sex, an overdone or underdone procedure and unsightly scars.

Conclusion

Labiaplasty recovery timeline varies from patient to patient. The time to complete recovery depends upon the extent and technique of correction, the expertise of your provider, and any postoperative complications involved. 

For a smoother recovery, adhere to your surgeon’s instructions, attend follow-up appointments, and be patient with the healing process. Maintain a positive mindset and don’t hesitate to seek professional support and guidance whenever in doubt.

Dr. Jehan Ara is a highly qualified consultant obstetrician and gynaecologist with a passion for writing and health education. She has more than 10 years of practical patient care experience. She is currently working as an Assistant Professor of Obstetrics and Gynaecology in a medical school and a clinical supervisor for postgraduate residents of obstetrics and gynaecology in the affiliated teaching hospital. In addition to her clinical work, Dr. Jehan is also a passionate writer and educator. She regularly writes articles and blog posts on women’s health. She is committed to helping women understand their bodies and make informed decisions about their health