F.A.Q. FOR WOMEN

Labiaplasty

Labiaplasty is a minor procedure to reduce enlarged labia or to correct asymmetry of both the labia minora and majora. It is usually done under local anesthesia as an outpatient.

Labiaplasties are done on both the labia minora and majora. For the labia minora, there are two main types of surgery to reduce the size or make the labia minora symmetrical. The first one is the linear resection, and the second one is wedge resection. With the wedge resection, the resulting edge of the labia minora is much smoother with very little scarring on the edge. It can also correct the vertical excess of labia minora. Sometimes, the linear resection is used because the patient wants more of the dark discoloration removed.

Labiaplasty corrects excess or asymmetry of the labia majora. This can be done with a simple removal of the excess skin. The labia majora can also be enlarged by fat grafting with fat obtained from your own body.

Any woman who has enlarged or asymmetrical labia can benefit from labiaplasty, especially, if they also have pain during intercourse. It is best if you set up an appointment with Dr. Liu, so he can advise what is best for you.

Labiaplasty is usually performed under local anesthesia as an outpatient. After surgery, there may be some discomfort and swelling, but it rarely requires pain medication. You can return to work after 3-5 days, unless you have other procedures done at the same time, in which case it will depend on what other surgeries you had. You should always ask Dr. Liu about the right time to return to work. Normal sexual activities can be resumed after six weeks unless Dr. Liu advises otherwise. When in doubt, always ask Dr. Liu.

As with any surgical procedures, there are risks in surgery. However, under normal circumstances, they are rare. Risks include, but not limited to, infection, bleeding, scarring, discomfort, prolonged swelling, loss of sensation, and other unforeseen complications. Most risks are self-limiting and correctable. You should discuss any associated risk with Dr. Liu before deciding on having the procedures done.

The best time to do it is when you need it. If it bothers you now, it will most likely bother you in the future.

If your “deformity” is great before surgery, more than likely your partner will notice the change after surgery, but if it was minor, your partner may not notice it. I normally advise my patients to discuss this with their sexual partner before the surgery to avoid “surprises.”

It depends. You can go to a gynecologist or plastic surgeon for the surgery if the doctors are well trained to do them. As a plastic surgeon, Dr. Liu is well trained to see the aesthetics and can accomplish them.

Too much skin around the clitoris can result in loss of sensitivity, and many women want to have this trimmed. The procedure is called hoodectomy, and it is commonly done together with labiaplasty at the same time.

Symmetry and size of a labia play a role in determining how labia should look, but the most important is how you feel about them. If you feel good about the labia and your clitoris, then they are normal, even though they may be enlarged or asymmetrical. If you are uncomfortable with how they look like, you can call for a free consultation with Dr. Liu to discuss the details of your issues with your labia.

Although surgery gives the best results, the labia can be improved by non-surgical means. Dr. Liu uses a radiofrequency apparatus called Thermi-Va to shrink the labia and to somewhat erase the “wrinkles” in the labia. There is no surgery involved and there is no downtime with this procedure.

Yes. It is preferable to do all the above together so there is only one recovery time needed. Patients tolerate this very well.

Vaginoplasty

Vaginal loosening and stress urinary incontinence (SUI) are common problems after natural childbirth. Typically, the vagina and its supporting muscles and tissues become stretched or even torn during childbirth. A new radiofrequency device, Viveve, is very effective in improving both conditions, especially, if the looseness is limited to the vaginal canal. However, if the looseness involves scarring and separation of the levator ani muscles, which is a major muscle responsible for supporting the pelvic floor, vaginoplasty surgery is required to remove the scars and to re-approximate the muscles.

Vaginoplasty can tighten the tissues of the vagina to provide greater friction during sexual intercourse. Tightening of the introitus also re-directs the penile penetration to the front of the vaginal canal, which is more sensitive and is where the G-spot is located.

Vaginoplasty can be done in the hospital or in a certified surgical center as an outpatient. Dr. Liu has his own certified surgical center where he does vaginoplasty. Since most of these procedures are not covered by insurance, doing it in his center is much more cost effective.

Most vaginoplasties are done under local anesthesia. Some patients prefer to have general anesthesia, which can be done in the surgical center as an outpatient.

When done under local anesthesia, the whole area is numbed by local anesthetics or regional blocks, and there is no pain during surgery. It can also be done under general anesthesia as well.

Typically, this procedure takes approximately 1-2 hours.

There will be mild discomfort for a few days after surgery, but the discomfort can be well controlled with medications when necessary. The sutures are usually self-dissolvable and do not need to be removed. A patient can return to regular office work after about seven days. There should be no sexual activities for 6-7 weeks.

A few months after the procedure should show the final result, but a person can have sexual activities after 6-7 weeks.

All surgery will result in some scarring. That is the way the body heals. However, the scars are well hidden and not noticeable. The scars mostly fade away with time.

Like any operative procedure there are certain risks although rare. These include infection, hemorrhage, scarring and others such as too tight or not tight enough which you should discuss with Dr. Liu about. These can be corrected if necessary.

Absolutely! Vaginoplasties are often done on patients with no children. Please see Dr. Liu for evaluation.

If the loosening is mainly the vaginal canal and part of the introitus there is an effective way to tighten the vagina. The new machine Viveve is made specifically for this purpose. The big advantage of this is that the tightening can be effective after only one treatment as opposed to three treatments spaced one month apart. It can also treatment stress urinary incontinence which so often occur after childbirth. However, if the patient has scarring and widening of the introitus, this will not be effective and will need vaginoplasty. Also the effect of non-surgical treatment lasts up to 2 years, whereas surgery will last for a very long time.

At childbirth very often, it is necessary to do episiotomies, which is to open up the opening of the lower part of the vagina so that there is enough space for the baby’s head to come through. Very often this is poorly repaired or not repaired at all, resulting in a large gaping space and therefore the vagina is very loose. Repair of this is called perineoplasty. This is usually done together with the vaginoplasty. Repair of this is important because it can direct the penis to the front part of the vagina which is where most of the sensory nerves and the G-spot are.

Yes. It is preferable to do all the above together so that only one recovery time is needed. Patients tolerate this very well.

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