PROCEDURE

Early on these surgeries were few and not talked about much. In less than a decade the general public has been introduced to aesthetic vaginal surgery by terms such as labiaplasty and vaginoplasty. Shows such as “Dr. 90210” have brought previously private topics of discussion out into the open. As the popularity of labiaplasty increases so does the number of cases done by untrained or minimally trained surgeons. Even well established gynecologists, urogynecologists, plastic surgeons, and a few urologists have had cases where healing did not occur as desired. The numbers of those patients requiring labiaplasty revisions have dramatically increased over the past several years. It is not a common procedure but one that is steadily on the rise as more surgeons attempt to perform labiaplasty surgery without knowledge of the basic tenets of aesthetic vaginal surgery. In my practice, the volume of revision surgeries sent to me has doubled in the past three years. The most common revision labiaplasty surgery I deal with is correcting wedge labiaplasties. Wedge-type labiaplasties have an inherent tendency to pull apart and open up leaving two wings per side of labia minora tissue. The relatively poor circulation in healing labia minora tissue predisposes the edges to pull apart. Popularized by the TV show “Dr. 90210,” this technique, in my humble opinion, is inferior in most hands. There are renowned surgeons who are able to perform this technique quite successfully but they are in the minority. Most labial surgeons doing wedge labiaplasty surgery would be better served by a change in technique. Cost of revision: Labiaplasty of the minora or the majora typically costs $5-6,000. A labiaplasty revision typically costs $7,000 on up. A revision following a primary labial surgery costs more since the anatomy is altered and proper healing is sometimes compromised. It is almost impossible to re-approximate the wedged labial edges together or to add labia minora in a labiaplasty that removed most or all of the labia.