Why do almost all of my patients prefer to have their labiaplasty in the office rather than at a surgicenter? This is due to convenience and to save money. I always give my patients oral sedation and locally numb the labia. It is easy to completely numb the labia so that you will not experience any discomfort during the procedure. There is nothing wrong with having it done at a surgicenter but it does add expense since you are having to pay both for the surgicenter and for the anesthesiologist or nurse anesthesiologist. Sometimes for convenience, when a patient is already having another procedure, such as a breast augmentation or a tummy tuck, they will opt to have the labiaplasty done at the same time.
There are two major surgical techniques for reducing the prominence of the labia minora. Whenever there is more than one technique for doing something, there will inevitably be surgeons saying, “only one technique is the correct!” I feel both techniques work well and each one has its advantages.
One technique is the “trim” and it basically means that the “extra” labia minora tissue that extends beyond the labia majora is trimmed back. This also has the advantage of removing the most distal labial skin which is usually darker and more wrinkled. Some women, especially in my experience, Asian women, prefer this technique since it removes this darker more wrinkled skin and gives the labial area a more youthful appearance.
The other technique is the “wedge” technique. Here, a triangle of labial tissue is excised (removed) so that the scar runs internally. Think of it as similar to a fan. This has the advantage (or disadvantage) of leaving the distal labial skin largely unchanged.
Both techniques can be done in the office. All sutures are dissolving and there are no drains. Most women return to work in 3-5 days (most of my patients are returning to work in 3 days, but not all). Afterwards, a lot of ice will help control the swelling. No exercising for a week. No sex for at least 3 weeks (though I know some of my patients have resumed relations at 2 weeks).
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David Berman MD, FRCSC