Botched Labiaplasty and How to Avoid Them

Labiaplasty Revision Surgery due to Botched, or Labiaplasty Gone Wrong

Oops, Now What?
Revisionary Surgery, And What to Do Next…

Selecting a proverbial “All-Star” for your labiaplasty, vaginoplasty or hoodectomy can be very easy if you used one the trained, experienced surgeons on The vast majority of the time, our surgeons . . . well, they simply get it “right.” surgeons know labiaplasty, vaginoplasty and clitoral unhooding very well because of proper training or they’ve done so many cases, they generally get very good results without the need for any revision(s). However, if you got a bad surgical procedure, there is another alternative. It’s a word that most patients don’t want to hear . . . revisionary surgery. Now, if your former surgeon tells you that “everything’s fine,” but you aren’t so sure, it’s time for another opinion and contact us rather than go out on your own. Why? Because the vast majority of respected FCGS physician’s won’t work on another surgeon’s patient, because of the potential risk of not being able to “fix” the initial problem; and they don’t want to make it worse. So, you’ll probably get a lot of “no’s” if you go off on that trek alone. View photos of Labiaplasty Revision Surgery.

Labia Minora (inner lips) Reduction – Many women dislike the large protuberant appearance of their labia minora. This may cause severe embarrassment with a sexual partner. The overly large labia minora can also result in constant irritation in tight pants. Surgical labial reduction can greatly improve the aesthetic appearance of the abnormally enlarged labis. Some women are born with large labia, others may develop this condition with childbirth or age.

Labia Majora (outer lips) Reduction – This common anatomical variation may be worsened by childbirth or by weight gain or loss. They may sometimes be improved by liposuction. In more severe cases, surgical reduction is necessary.

Revision vs. Re-Operation/Reconstruction

Labiaplasty revisions are usually done in situations where a modest dissymmetry needs to be corrected, a “dog-ear” or prominent edge needs to be smoothed, a scar needs to be straightened, or a small “polyp” or irregularity needs to be removed. Labiaplasty re-operation or reconstruction, on the other hand, is the “redo” of an entirely unsatisfactory result.

Minor revisions can usually be performed without much ado by the original surgeon in their office under straight local anesthesia with a minimal recovery period. A re-operation/reconstruction is best performed by an experienced vulvovaginal aesthetic gynecologist or plastic surgeon well-versed in these often difficult and meticulous repairs. Minor revisions are usually performed free of charge by the original surgeon, but there is usually a fee for re-constructions, and it is often greater than the original surgery as these surgeries are frequently difficult and time-consuming.

Unfortunately, at least 50% of the time with “botched” labiaplasty, surgical reconstruction is impossible. This is especially the case in situations of over-removal—i.e. “cutting it all off” or “amputation,” which can occur when you select a general gynecologist not specifically trained in plastic technique and cosmetic gynecology. This does not mean there is no hope, as a good sexual medicine practitioner can work with these patients in other ways (sexual therapy, the use of compounded estrogen/testosterone gels to the denuded area, etc.) to aid in ongoing sexual and aesthetic satisfaction.

The Most Common Reasons for Reconstruction, and the Pitfalls Involved:

  1. “Cutting too much off” with “trim” or Linear Resection method
    Here, the surgeon pulls on the labum as he or she cuts, removing way too much as the springy labia retract. Unfortunately, there is nothing that can be done to re-grow or reconstruct what has been removed—but, if enough unresected tissue remains at the bottom, around the base of the vaginal opening or at the top in the area of the clitoral hood, repair may be performed by a “V-Y” reconstruction, a method perfected by Gary Alter, MD, a Plastic Surgeon from Los Angeles, CA. Quite often, novice surgeons do not have a clue how to deal with a redundant clitoral hood and leave this tissue, which may be “lifesaving” if re-anastamosis with the denuded area is to be attempted. The risk here is that, especially if performed too early (less than 3-4 months from original procedure), the “flap” might not take, leaving the patient no better off, but in fact significantly worse.
  2. Separation of the edges, or the entire reconstruction of a V-Wedge labiaplasty
    Here, as a result of either poor technique, hematoma (significant bleeding under the skin), injudicious activity on the part of the patient during recovery, smoking, diabetes or other factors, the anastomosis does not hold, bur rather widely separates. A simple trimming of the edges frequently suffices, but sometimes the V-wedge must be repeated—a daunting task, both from the perspective of symmetry and proper healing.
  3. Grossly inadequate removal of tissue the first time around
    This is usually the result of either a timid surgeon or miscommunication between surgeon and patient regarding the amount of tissue to be removed. In this situation (which better at least than taking too much off), the procedure is essentially undone by removing a modest amount of additional tissue, either by V-Wedge or linear trim technique.
    It takes a full 3-6 months before the final true outcome of a labiaplasty can be appreciated. For that reason, most minor revisions, and all re-dos, should not be done until 3-4 months have passed from the date of the original surgery. For difficult reconstructions, it is best to wait 6 months until the vasculature of the area has fully re-formed, significantly improving the odds of success.

A Word of Warning—It’s Always Best to Have It Done Right the First Time
Make no mistake: the first surgery is by far the time to “get it right,” because if the procedure is truly botched, there may not be a second chance. If results are unacceptable, you may have an opportunity for a single re-do, but rarely more than one.
This is why it is so important to choose well the first time around. A woman should never choose a surgeon based on a lower fee alone, especially one who says, “Oh, yes, I’ve done several of those; we can do it in the hospital/surgical center under general anesthesia…” but cannot show you at least 10-20 of their own case outcomes. Choosing such a surgeon means you have a 1 in 4 chance of a disastrous outcome, one which cannot be repaired 50% of the time and, if it can be repaired, the “re-do” is usually more expensive than if an experienced surgeon had performed the work the first time around.

So, Your Results Don’t Look So Good. What Do You Do Next?

First, don’t overreact. It’s not prudent to immediately threaten someone with a lawsuit because that will only create a bad environment for everyone, making a solution more difficult. Remember, the primary goal is to do a revision that will yield an acceptable result.

Step one—contact us.

Step two—when we receive your information, we’ll pass it on to the appropriate surgeon(s) in your general vicinity, or perhaps even to one of our specialists in another city. Many physicians can, and will do revisionary labiaplasty or vaginoplasty surgery if the former procedure can be revised or repaired and they can assure you of a good result. This isn’t a definite, but it’s still better than a blanket “no” from someone.

Step three—you will be contacted, either by telephone, or via a return email and you can discuss your issues with the physician in confidence. At this juncture, you may be asked to forward onto the surgeon’s office who responded to you a photograph of the problematic area, or they may ask you to come in for a consult and give you their professional opinion.

Botched Labiaplasty Revision Surgery Photos