Labiaplasty Recovery: What You Need To Know.

On its surface, a labiaplasty seems like one of the most uncomfortable plastic surgery procedures to recover from. Located in such a sensitive area of the body, one would naturally assume recovery from this plastic surgery procedure would  be challenging, painful, and lengthy. Paradoxically, however, I have found in my Seattle Plastic Surgery practice that a labiaplasty is one of the quicker recoveries that patients experience. Time off work, time away from exercise and duration of stronger pain medication usage all seem to be quite short. Patient satisfaction is also huge with this procedure, making it one of my favorite and most rewarding procedures to perform in my cosmetic practice. Despite the above truths, a labiaplasty remains a relatively obscure and overlooked procedure for women. In this blog post, I’ll review the procedure, spell out what a typical recovery looks like for patients, and discuss some helpful tips and tricks that patients use in order to recover quickly and uneventfully.  

What Is A Labiaplasty? 

Let’s start at the beginning. Anatomy of the groin/vaginal area/genitalia can be divided into both internal and external features. External female anatomy consists of the labia majora folds, labia minora tissue, and extra tissue covering the clitoris and urethra called the “clitoral hood”. Internally, you have the vaginal canal itself with many terms to describe its opening (vestibule, introitus, etc.). While many procedures typically get bundled into the umbrella term ‘labiaplasty’, this plastic surgery procedure typically addresses only the external female genitalia and, more specifically, often refers to the removal of excess labia minora tissue. What defines “excessive”? Most would agree that the ideal labia minora tissue will fit nicely tucked beneath the labia majora folds when someone is in a standing position. When the tissue is long enough to hang past the folds, we typically view this as extra. Why care? Truth be told, many women don’t. But for some, excessive tissue can make women self-conscious, can be visible in a bathing suit or tighter fitting clothing, can cause pain and discomfort during exercise or sexual intercourse, and even lead to chronic yeast infections. 

Correction of excessive tissue requires surgical removal. This is done in one of two ways– a trim labiaplasty or a wedge labiaplasty. Each is a useful tool depending on surgeon skill and patient anatomy. Both will leave an incision within the labia minora that may extend onto the clitoral hood if additional tissue excision in this location is also required. In my hands, a trim labiaplasty tends to be my technique of choice, placing absorbable sutures along the edge of the labia minora underneath the skin surface. 

What Should I Expect In Recovery? 

I find it helpful to define recovery after a labiaplasty in three phases– the first week, the first month, and after 6 weeks. 

Phase One: 

The first phase is the initial week after surgery. The defining features of this week are fresh surgical incisions and the potential risk of bleeding. A fresh surgical incision can lead to spotting in underwear or when going to the bathroom. Feminine pads can be helpful not only to avoid messes but also to help add extra protection to the area from inevitable pressure from clothing and sitting. Ice packs can be helpful for pain and discomfort, with some brands even offering pad-shaped ice packs made to fit in your underwear. Much like lemon juice in a fresh cut, the acidity of urine on a fresh labial incision can sting.  A postpartum peri-bottle can be used during urination to dilute urine and ease discomfort during those first few days after surgery. 

During this first week, the risk of bleeding is highest. The labial tissue has a robust blood supply, which makes it susceptible to bleeding after surgery. To help mitigate this risk, patients should avoid activity that will elevate the heart rate or blood pressure, and avoid any heavy lifting. Light movement such as walking is encouraged after surgery, however patients should wear looser fitting clothing to avoid pulling and sheering. Sitting upright may cause direct pressure to the surgical area so patients will often find sitting in a reclined position or even laying down to be most comfortable in the first few days after surgery. 

Depending on the nature of work, many patients will take a long weekend to one week off work for recovery. Stronger pain medications are usually needed only for the first few days after surgery, and at no point in recovery are patients encouraged to avoid movements like walking. 

Phase Two: 

The second phase of labiaplasty recovery happens after the first week but still during the first month. After the first few days, the incision has become water resistant so it is less susceptible to pain and stinging, especially during urination. Pads and ice packs are still useful during this phase as needed to ease discomfort, though spotting is unlikely to occur this far out from surgery. The biggest risk factor during this time period is healing issues along the incision site, as the sutures placed at the time of surgery are now beginning to dissolve. 

Typically at this stage, patients are returning back to work and a more normal routine. Comfortable and looser fitting clothing that avoids constricting and shearing the surgical area is a must. Patients who sit for long periods of time find it helpful to invest in shaped pillows that help to offload pressure directly on the surgical incisions. These are typically listed as a ‘donut’ shape or those pillows made for postpartum or hemorrhoids. 

Phase Three: 

The final stage involves returning back to normal. Restrictions for many types of exercise as well as the use of tampons and sexual intercourse are typically in place until six weeks postoperatively. Though six weeks might seem like a lifetime after surgery, six weeks is actually right out of the gate from a tissue healing perspective. In fact, scar tissue (including internal scar tissue beneath the incision as well as what is visible on the outside) takes a full year to complete its remodelling.  In addition, a return to normal sensation can take months to even a year after any surgical procedure.  So, how do you know when and how to get back to normal? Well, the best piece of advice I have for patients is to listen to your body— it has a pretty good metric (i.e. pain) for what you should and shouldn’t be doing. 

In Conclusion:

Despite taking place in such a sensitive area of the body, a labiaplasty is actually a relatively easy procedure to recover from. Thanks to postpartum hacks such as ice maxi pads and donut pillows, women have even more tools to help them comfortably return to a normal routine. If you are considering a labiaplasty and want to know more, the first step in your journey is to schedule a consultation today.

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Dr. Megan Dreveskracht is a Female Plastic Surgeon in Seattle, Washington who specializes in Aesthetic Surgeries of the Breast, Body & Face. To schedule your consultation, call 206.860.5582 or fill out a contact form here.