Women complain of larger, asymmetric, uneven or protruding labia. This may be exacerbated after childbirth. There is a large range of normal variance. Symptoms include discomfort, irritation and rashes from clothing, sporting activities (like cycling), prolonged sitting, gym and intercourse.
The labia may be visible through some swimming costumes. Labia may even protrude from clothing, underwear and swimmers. Women of all ages are affected. With time, the labia may become more prominent.
As it involves a very sensitive area, surgery is performed with a combination of local anaesthetic and sedation or very light general anaesthetic. Adrenaline in the local anaesthetic helps reduce bruising and bleeding, reduces the requirement for sedation or general anaesthetic and ensures a pain-free number of hours after the surgery. Surgery is usually performed as day surgery and takes between 60 and 90 minutes. It can be combined with other procedures. Labioplasty, where medically indicated, has a Medicare rebate.
After the procedure pain tablets and antibiotics are prescribed. Pain requiring regular medication may persist for a few days. An antibiotic ointment is also used. All sutures used are dissolving so there is no discomfort of removal. Personal hygiene is important and showers can resume the next day. Gently pat the area dry with a soft towel. Some people dry the area with a hair dryer on low heat. No dressings or dressing changes are needed and supportive padding worn inside a pair (or sometimes two pairs) of underpants relieves discomfort. Cool packs can also be used.
Recovery is similar to most surgery. Sedentary work can be resumed at about a week. Gradual increase in exercise from two weeks, with a return to sport in about four to six weeks is the norm. Sexual activity can be restarted from about six weeks. These are a guide only and faster recoveries are common. Follow-up is scheduled at regular intervals.
All surgery has risks. Bruising resolves by two weeks but swelling may take up to four weeks. There is a risk of infection, between one to three per cent. Haematomas or bleeding may occur. Scars anywhere on the body may be raised, thickened, visible or tender, and wounds may be delayed in healing. Residual asymmetry may persist. Despite this long list the procedure is usually well tolerated with many favourable outcomes.
The clitoris and surrounding area is avoided to reduce the risk of any sensation changes, especially numbness. There are specific procedures to reduce the clitoral hood.
As everyone is different, a thorough medical history and examination is required. This enables optimal planning and outcome. A full understanding of the procedure, likely outcome and potential risks need to be fully understood.
Dr Kippen is a practicing plastic, cosmetic and reconstructive surgeon and a member of the Australian Society of Plastic Surgeons. Dr Kippen consults from rooms in Mona Vale, Brookvale and Wahroonga. Phone 1300 547 736 or email firstname.lastname@example.org
Please check the website www.johnkippen.com.au articles section for more information.
Plastic surgeon Dr Sawjin Tew has worked on the Northern Beaches since 2001 and has privileges at Manly District Hospital, Mona Vale Hospital, Warringah Day Surgery, Castlecrag Private Hospital and North Shore Private Hospital. Phone 94112266 or visit drtew.com.au