What is a labiaplasty?
Labiaplasty is a surgical procedure to reduce the labia minora (inner labia) or labia majora (outer labia). Following pregnancy, many mothers find their labia has become enlarged due to hormones and physical strain placed on their vagina. When this occurs, women may become self-conscious due to the appearance of their enlarged labia. In addition, this can become physically uncomfortable due to chafing. With labiaplasty, patients get relief from these symptoms, restoring their labia to their original size and appearance. Dr. Rady Rahban is happy to present this as an option as a part of a patient's custom Beverly Hills Mommy Makeover.
Am I a candidate?
Most women who are unhappy or uncomfortable due to the large size of their labia are candidates for labiaplasty. Specifically, this includes:
- Irritation and chafing while performing routine activities
- Painful sexual intercourse
- Trouble with undergarments
- Embarrassment due to the cosmetic appearance of the labia
The labiaplasty consultation
Note: while each surgeon approaches the consultation process differently, Dr. Rahban feels they should all have the same basic elements, ensuring patients leave very well informed regarding surgery. If you think you are ready to take the next step towards one of the best Mommy Makeovers Beverly Hills can lay claim to, the next step is to set up a consultation. Below is how Dr. Rahban conducts a consultation.
Your consultation should be done by your Mommy Makeover surgeon and not by his staff, such as his coordinator. In many cases, patients are offered free consultations, but you must understand that often means you’ll get a hurried consult. As a point of reference, Dr. Rahban on average spends up to an hour with each patient, reviewing not only what the patient came in for, but also explaining all the nuances such as the risks and alternatives to what that patient has requested.
There is no way to accelerate the dissemination of knowledge when it is so complicated and crucial.
During a Mommy Makeover labiaplasty consultation, Dr. Rahban covers several crucial points. Firstly, he gathers data regarding your specific cosmetic objectives. After all, the goal is your satisfaction and confidence. Plastic surgery is all about what you are trying to accomplish. Just because a surgeon likes a result, it does not mean you will like it. In all plastic surgery, you are the unique element in the equation.
Second, after an examination, Dr. Rahban defines the exact problem, allowing you to better understand what your body has been through. Next, he lays out your options, including incisions, amount of tissue to be excised, and other factors involved in a labiaplasty.
As an extension of this, Dr. Rahban also reviews what patients should not expect from surgery. He is well known for telling his patients the truth and establishing a healthy level of expectation. Most patient dissatisfaction is related to inaccurate understanding and expectation of their surgery. Dr. Rahban deals in full disclosure to prevent this from occurring.
In the interest of helping his patients fully understand the procedure, Dr. Rahban will take this opportunity to review all potential risks. While some risks are quite unlikely, he still wants his patients to be aware of the potential downsides of a labiaplasty. All surgeries come with risks. Therefore, he believes the only time to engage in surgery is if the benefits far outweigh the risks. If you will only have a mild improvement, Dr. Rahban will most definitely recommend you do not undergo the procedure.
During a consultation, Dr. Rahban has one primary purpose—total patient education. He wants each patient to fully understand the nuances of the labiaplasty procedure, as well as every risk and exactly how the procedure applies to them, allowing them to make the best decision for themselves. With his honest, candid approach, Dr. Rahban brings a new level of care to ensuring his patients know exactly how a labiaplasty works.
Note: while no two surgeons perform this procedure identically, most techniques have a similar series of steps. Below is a brief overview of Dr. Rahban’s technique, allowing you to gain a more detailed understanding regarding how your surgery will be performed. The more you know, the more control you have.
While this procedure can be done under local anesthesia, Dr. Rahban prefers general as he feels the patient is more comfortable and he has better control of the operating room environment. The labia will be marked prior to any infiltration of local anesthetic. The markings are the most crucial element. Since the labial tissue is stretchable, the biggest error with labiaplasty is over-resection. Surgeons may pull too hard on the labia when marking, therefore thinking there is more tissue than there actually is. They later realize that the labia has been shortened too much.
Once accurate markings have been made, the area is injected with local anesthesia so post-operatively the patient is comfortable. The excess skin is carefully excised, and the area is closed.
Labiaplasty with Dr. Rahban takes 1.5-2hrs.
Preparing for a labiaplasty
For patients receiving a labiaplasty, preparation begins about two weeks before the procedure. Every patient goes through a thorough pre-operative process. This begins with a pre-op visit two weeks prior to surgery. This is similar to a second consult. During this time, you will go over the details of your surgery with Dr. Rahban, and you will get a second opportunity to ask questions and go over your procedure, thus ensuring a complete understanding.
In the world of plastic surgery, this second visit is unusual. However, because the first visit can sometimes be overwhelming, patients often come up with new questions latently. Dr. Rahban provides this second visit so his patients can be completely at ease with every question answered.
Dr. Rahban and his staff will provide all the dos and don’ts prior to your surgery. They’ll include a laboratory evaluation and any other workup to ensure your complete safety. If Dr. Rahban feels you are not ready to undergo your procedure for health reasons, he will assuredly cancel your procedure. His only interest is that you are safe to undergo surgery.
Dr. Rahban and his office will additionally give you step-by-step instructions for the days and weeks leading up to surgery. These instructions will include all actions necessary to prepare for your day of surgery, such as what medications to stop taking, and plenty of other guidelines to ensure you are physically fit to undergo surgery.
If you have any questions prior to your surgery, our office is available to you. Call or email us any time, and we will help with anything you need. Our goal is total peace of mind for our patients, as well as a safe, successful procedure.
Healing and recovery
Note: the recovery listed below is according to Dr. Rahban’s routine. Other surgeons may have a different approach to the recovery process.
Directly after a Mommy Makeover labiaplasty, you will remain in our recovery suite for several hours until you are ready to go home. Because the effects of anesthesia do not fully wear off for 24 hours, you will need assistance during this initial period, including a ride home. At home, it is wise to set a centralized location to relax, with medications and ice packs within easy reach.
When receiving a labiaplasty, the healing process is crucial to a beautiful result. For this reason, our office will ask that you strictly adhere to our list of post-operative guidelines. We will give you a full list in our office, but below are several examples so you know what to expect.
Wound and incision care
During the first week, you’ll be doing sitz baths with Epsom salt or a similar product. There are no sutures to remove, as the sutures used in this procedure are removable.
During the first week, Dr. Rahban recommends that you get up and move around the house in order to prevent blood clots. At the same time, limit your activities to mild movement. There should be no lifting greater than 5 pounds and no cardio for 6 weeks. This prevents pulling on the scar, which is the number one cause for a poorly healed scar.
Surgeons and nurses are extremely diligent when it comes to keeping infection out of the operating room. This diligence must be maintained after the procedure is over. Antibiotics are one of the primary methods of infection prevention.
A surgical garment is not necessary following a labiaplasty.
Surgical drains are not necessary following a labiaplasty.
After a labiaplasty, Dr. Rahban schedules a total of five follow-up appointments. Most plastic surgeons schedule two follow-ups, during which time you may not even see the doctor. During every follow-up appointment, Dr. Rabhan sees his patients personally. He believes it is the patient’s responsibility to follow up with him. This is because patients may not know something is wrong until they see a professional. From Dr. Rahban’s viewpoint, plastic surgery is a team approach, and you must do your part by showing up to your follow-up appointments.
In addition to the pre-scheduled follow-up appointments, Dr. Rahban is available to his patients at any time after surgery. If there are any questions or concerns that arise, he and his office are available to help. Just give us a call and we will provide every bit of assistance.
Labiaplasty risks and complications
Labiaplasty risks include but are not limited to:
This is a very rare complication. Dr. Rahban takes action to minimize the risk as much as possible. This primarily includes having the patient stop all medications that promote bleeding at least two weeks in advance, such as anti-inflammatories, aspirin and supplements.
Also quite rare, infection is thoroughly combatted before, during and after surgery. The night before surgery, we have patients wash themselves with an antiseptic soap. We give patients antibiotics directly prior to surgery, as well as after surgery. Additionally, Dr. Rahban has very strict post-operative instructions regarding wound management that he believes reduces the risk of infection.
While an inevitability of surgery, the issue is not whether you will have a scar, but rather the quality of your scar. The goal is for you to have a well-healed, faint or fair scar with time. In order to prevent the unsightly scar that so many people are worried about, Dr. Rahban takes steps to minimize it.
Dr. Rahban believes in a 50-50 rule. Fifty percent of scar healing has to do with the technique of your surgeon’s closure, or how well the incised tissues are brought back together. The other fifty percent is the patient’s biology. Because a patient has little control over her biology, there is a lot of emphasis placed on your surgeon and his closure technique. While many surgeons place their emphasis on post-operative scar management, there is very little science that any of these modalities actually work. Therefore, Dr. Rahban focuses on an unusually fastidious closure technique to ensure that all tissues heal with minimal scarring.
Please refer to his timeline on wound management for more information.
In delivering labiaplasty, the goal is to get the labia fairly similar in size and shape. While there is no such thing as perfect symmetry, Dr. Rahban’s goal is for it to be indistinguishable to the naked eye.
The labia are very malleable. When a surgeon marks the incisions, he can make the mistake of marking them too close to their base, causing over-resection.
Dr. Rahban’s approach
While marking is crucial to any plastic surgery procedure, none is more the case than labiaplasty. The labial tissue is very stretchable, making it easy to mark the incision points too close. In labiaplasty, the number one error is over-resection. I will take extra time while measuring the labia, ensuring you are not left with too little tissue. There is also the issue of symmetry. Extra time must be taken, because the labia are often asymmetrical to begin with.
There is no standard cost for a labiaplasty as there are many unique variables. Below is a list of the elements that will determine the cost of your procedure so you understand what exactly you are paying for.
- The skillset of your surgeon. Is he or she a plastic surgeon or a cosmetic surgeon? Is he or she board certified? A board certified plastic surgeon will often be more expensive.
- How long it takes to perform the procedure. Generally the faster your surgeon, the less facility and anesthesia fees and the greater the surgeon’s profit. Therefore, surgeons have an incentive to work more quickly. When it comes to surgery, faster is not better. Be sure to ask your surgeon how long the procedure will take and be wary if it seems too quick. The average time for a labiaplasty is: 1.5-2hrs.
- The anesthesia provider. There are many types of anesthesia providers. An anesthesiologist who is a medical doctor will be more expensive than a nurse anesthetist. Do your research and find out who provides anesthesia for your plastic surgeon. Dr Rahban is partial to using an anesthesiologist as opposed to a nurse anesthetist.
- The facility in which your operation is performed. Unfortunately, surgery centers and hospitals are not all created equal. The more sophisticated the facility, the more expensive its hourly fee. Facilities that are Medicare-certified tend to be more costly as well.
Questions to ask your surgeon
Below are specific questions to ask your surgeon during your consultation. Each of these will allow you to understand his or her approach and thus make an informed decision. To print these questions so you can ask your surgeon, see link below to download a copy take with you to your consultation.
I understand the labia are very malleable. Are you careful in marking them so they’re not over-resected?
The labia will be marked prior to any infiltration of local anesthetic. The markings are the most crucial element. Since the labial tissue is stretchable, the biggest error with labiaplasty is over-resection. Surgeons may pull too hard on the labia when marking, therefore thinking there is more tissue than there actually is.
Do you offer a second consultation prior to my procedure?
Every patient goes through a thorough pre-operative process. This begins with a pre-op visit two weeks prior to surgery. This is similar to a second consult. During this time, you will go over the details of your surgery with Dr. Rahban, and you will get a second opportunity to ask questions and go over your procedure, thus ensuring a complete understanding.
How many follow-up appointments do we have?
After a labiaplasty, Dr. Rahban schedules a total of five follow-up appointments. Most plastic surgeons schedule two follow-ups, during which time you may not even see the doctor. During every follow-up appointment, Dr. Rabhan sees his patients personally.