Labia Minora Enlargement can be Painful and Cause Hygiene Issues.

By: Dr. Sean Kelishadi, M.D. FACS

4/12/2015

Early in my path to becoming an Orange County Plastic Surgeon, a meaningful lesson I encountered was when I saw my first labiaplasty being performed during my first month of training at the University of Louisville. My mentor was quick to tell me that people have a variety of concerns, and our job as problem solvers is to help them by using our knowledge of anatomy to restore form and function. Not everyone is a candidate for labiaplasty.

As I learned more about this topic, I quickly realized that labia minora hypertrophy can cause physical pain or discomfort with activities such as sex or exercise; there are also women who have labia minora enlargement causing problems with hygiene or self-consciousness when they wear tight-fitting clothes or bathing suits. Seeking help regarding issues surrounding such a personal area can be intimidating, embarrassing, and frustrating. I wrote about this topic today to support patients and their friends and families; I invite them to come and talk to me about labiaplasty or other areas that I may help with during their Orange County Plastic Surgery pursuits.

The number of labiaplasties performed between 2012 and 2013 has grown by 44%, due in part to word-of-mouth advertising and increased public awareness of labia minora hypertrophy. My interest in helping women with symptomatic labia minora enlargement is demonstrated in an article I helped to write as a first author in the Aesthetic Surgery Journal in August 2013. By performing a “Posterior Wedge Resection,” we described a new procedure for labia minora reduction that preserves the natural aesthetic contours of the vaginal area and at the same time places scars in a location that is better concealed and less likely to cause irritation.

I take pride in being an advocate for my patients and their safety. Despite overwhelmingly positive reviews of labiaplasty procedures in the literature and no convincing reports of either lost sensation to the area or compromised blood supply (such as in flap or tissue loss), I chose to study this topic further. Using cadavers, I evaluated nerve density distributions to the labia minora through special stains designed to isolate nerve bundles. I was given the honor to speak on this study at the Residents and Fellows Forum at the annual Aesthetic Meeting for the American Society for Aesthetic Plastic Surgery in San Francisco on April 25, 2014, to reveal our preliminary data. Based on what I found, the good news is that the nerve density distribution to the labia minora is heterogeneous, meaning that there are nerves throughout and that it would be hard to make someone lose sensation with labiaplasty. Even-closer inspection indicates that the labiaplasty techniques I use, along with some others described, may be advantageous in preserving the parts of the labia minora that possess the greatest nerve densities.

Our patients have had a very high satisfaction rate noting improved self-esteem, improved hygiene, and decreased discomfort with physical activity in this sensitive area. This procedure can be performed under local anesthesia in our Orange County Plastic Surgery office, or it can be combined with other procedures such as breast augmentation, tummy tuck, or arm lift. In most cases, patients return to work in a few days and sexual intercourse can be resumed at 6 weeks.

Contact, call 949-625-2800, or visit us so that we can provide you further information or answer any questions that you may have.

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