Labiaplasty: Difference between revisions

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Latest revision as of 18:26, 25 March 2015

Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [1]; Michel C. Samson, M.D., FRCSC, FACS [2]

Overview

Labiaplasty (sometimes spelled labioplasty and sometimes referred to as labia minor reduction or labial reduction)^[1] is plastic surgery of the labia majora and/or the labia minora, which are the external folds of skin surrounding the vaginal opening. The procedure involves reducing elongated labium. When labia are created where there were none, it is usually part of a vaginoplasty.

Surgical procedures

Labiaplasty reduces the size of one or both sets of labia. It may also be employed to repair the labia following disease or injury, or especially after childbirth. In addition, a hoodectomy may be performed at the same time, which exposes the clitoris in an attempt to increase sexual stimulation. Hoodectomy is sometimes used to treat sexual dysfunction such as anorgasmia.

As recently as 1999, surgeons usually performed labium reduction by straight amputation of the protuberant sections and then by suturing the edges together.^[2] However, this procedure sometimes created a fragile and stiff suture line as well as eliminating the natural contour and pigmentation of the labia minora. Moreover, other procedural and clinical problems existed with amputation that did not ensure a favorable outcome.

Several years later, more surgeons introduced lasers into their armamentarium and began using more refined surgical procedures like one known as inferior wedge resection and superior pedicle flap reconstruction. In one outcome study, surgeons studied the results of 20 patients undergoing labiaplasty via the procedure. 95.2 percent of patients at 46 months reported being very satisfied. While five complications cropped up, all but one were handled immediately postoperatively and did not require additional hospital stays or interfere with healing.^[3]

Labiaplasty is almost always an outpatient procedure performed under local anesthesia. After surgery, patients may experience some mild discomfort and swelling, which usually disappear completely after one to two weeks. Recovery times ranging from three days to one or two weeks are often listed on surgeons’ websites.

Risks

While statistics on any botched plastic surgery procedures are rare, the comparable rate of satisfaction for other commonly performed cosmetic plastic surgery procedures in the United States is about the same or slightly less than labiaplasty. According to Jeffrey Rawnsley, an assistant professor and director the UCLA Facial Aesthetic Center at the University of California, Los Angeles, about 90 percent of patients report a positive outcome for breast augmentation.^[4] Experts report about an 85 percent positive outcome for rhinoplasty (the “nose job”), while liposuction patients in the late 1990s suffered a mortality rate of about 20 per 100,000, according to author Christine Rosen.^[5] While liposuction outcome rates have improved, many breast augmentation and rhinoplasty revisions are performed worldwide, because the procedure was not done correctly the first time.

Labiaplasty—in comparison to other popular rejuvenation surgeries—requires additional treatment in five to seven percent of cases. While the American Society of Plastic Surgeons (ASPS) listed only about 1000 “vaginal rejuvenations” during 2006, the most current year for which U.S. statistics have been compiled, surgeons in both the U.S. and the U.K.—as well as in other developed nations—report that the procedure seems to be growing exponentially. The professional plastic surgery organizations like ASPS, the American Society for Aesthetic Plastic Surgery, the British Association of Aesthetic Plastic Surgeons (BAAPS) and the International Society of Aesthetic Plastic Surgeons do not count labiaplasties among the other yearly statistics of plastic cosmetic procedures.

References

↑ Demand for 'Designer Vagina' Surgery Rising in U.K.", ABC News, 2007-05-25. Retrieved on 2007-05-29
↑ Maas, Sylvester M. M.D.; Hage J. Joris M.D., Ph.D Functional and Aesthetic Labia Minora Reduction. Plastic & Reconstructive Surgery 105(4)”1453-1456, April 2000
↑ Munhoz, Alexandre Mendonca M.D.; Filassi, Jose Roberto M.D., Ph.D.; Ricci, Marcos Desideno M.D.; Aldrighi, Claudio M.D.; Correia, Lelia Domingues M.D.; Aldrilghi, Jose Mendes M.D., Ph.D.; Ferreira, Marcus Castro M.D., Ph.D Aesthetic Labia Minora Reduction with Inferior Wedge Resection and Superior Pedicle Flap Reconstruction. Plastic & Reconstrucive Surgery, 118(5):1237-1247, October 2006
↑ http://www.cosmeticsurgery.com/articles/archive/an~119
↑ The Democratization of Beauty,” The New Atlantis, Number 5, Spring 2004

Template:WikiDoc Sources

[1] Demand for 'Designer Vagina' Surgery Rising in U.K.", ABC News, 2007-05-25. Retrieved on 2007-05-29

[2] Maas, Sylvester M. M.D.; Hage J. Joris M.D., Ph.D Functional and Aesthetic Labia Minora Reduction. Plastic & Reconstructive Surgery 105(4)”1453-1456, April 2000

[3] Munhoz, Alexandre Mendonca M.D.; Filassi, Jose Roberto M.D., Ph.D.; Ricci, Marcos Desideno M.D.; Aldrighi, Claudio M.D.; Correia, Lelia Domingues M.D.; Aldrilghi, Jose Mendes M.D., Ph.D.; Ferreira, Marcus Castro M.D., Ph.D Aesthetic Labia Minora Reduction with Inferior Wedge Resection and Superior Pedicle Flap Reconstruction. Plastic & Reconstrucive Surgery, 118(5):1237-1247, October 2006

[4] ttp://www.cosmeticsurgery.com/articles/archive/an~119

[5] The Democratization of Beauty,” The New Atlantis, Number 5, Spring 2004

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+[[Image:LabiaWikiLAbeled.JPG|right|350px]]
 {{SI}}
-'''Editor-In-Chief:''' [[User:Mcs|Michel C. Samson, M.D., FRCSC, FACS]] [mailto:samsonm1@ccf.org]
+'''Editors-In-Chief:''' Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [mailto:Newmanm@ccf.org]; [[User:Mcs|Michel C. Samson, M.D., FRCSC, FACS]] [mailto:samsonm1@ccf.org]
-{{EJ}}
 ==Overview==
@@ Line 18: / Line 18: @@
 ==Risks==
-While [[statistics]] on any [[botched]] plastic surgery procedures are rare, the comparable rate of satisfaction for other commonly performed cosmetic plastic surgery procedures in the United States is about the same or slightly less than labiaplasty. According to Jeffrey Rawnsley, an assistant professor and director the UCLA Facial Aesthetic Center at the University of California, Los Angeles, about 90 percent of patients report a positive outcome for [[breast augmentation]].<ref>http://www.cosmeticsurgery.com/articles/archive/an~119</ref>  Experts report about an 85 percent positive outcome for [[rhinoplasty]] (the “nose job”), while [[liposuction]] patients in the late 1990s suffered a mortality rate of about 20 per 100,000, according to author Christine Rosen.<ref>The Democratization of Beauty,” The New Atlantis, Number 5, Spring 2004</ref>  While liposuction outcome rates have improved, many breast augmentation and rhinoplasty revisions are performed [[worldwide]], because the procedure was not done correctly the first time.
+While [[statistics]] on any botched plastic surgery procedures are rare, the comparable rate of satisfaction for other commonly performed cosmetic plastic surgery procedures in the United States is about the same or slightly less than labiaplasty. According to Jeffrey Rawnsley, an assistant professor and director the UCLA Facial Aesthetic Center at the University of California, Los Angeles, about 90 percent of patients report a positive outcome for [[breast augmentation]].<ref>http://www.cosmeticsurgery.com/articles/archive/an~119</ref>  Experts report about an 85 percent positive outcome for [[rhinoplasty]] (the “nose job”), while [[liposuction]] patients in the late 1990s suffered a mortality rate of about 20 per 100,000, according to author Christine Rosen.<ref>The Democratization of Beauty,” The New Atlantis, Number 5, Spring 2004</ref>  While liposuction outcome rates have improved, many breast augmentation and rhinoplasty revisions are performed worldwide, because the procedure was not done correctly the first time.
-Labiaplasty—in comparison to other popular rejuvenation surgeries—requires additional treatment in five to seven percent of cases. While the [[American Society of Plastic Surgeons]] (ASPS) listed only about 1000 “vaginal rejuvenations” during 2006, the most current year for which U.S. statistics have been compiled, surgeons in both the U.S. and the U.K.—as well as in other [[developed nations]]—report that the procedure seems to be growing exponentially. The professional plastic surgery organizations like [[ASPS]], the [[American Society for Aesthetic Plastic Surgery]], the [[British Association of Aesthetic Plastic Surgeons]] (BAAPS) and the [[International Society of Aesthetic Plastic Surgeons]] do not count labiaplasties among the other yearly statistics of plastic cosmetic procedures.
-==Patient reports and reactions==
-According to plastic surgeons,{{Fact|date=June 2007}} patients often ask for labiaplasty for [[functional]] or [[aesthetic]] reasons, or a combination of the two. Many patients complain that elongated labia become painful during [[exercise]], or while sitting for long periods of time. A retrospective study conducted by Dr. John R. Miklos and Dr. Robert D. Moore found that close to two-thirds of women seeking labia reduction do so for reason such as pain or discomfort. <ref>Intimate Operations: OB-GYN Organization Issues Warning; ABC News, 08/31/2007 http://abcnews.go.com/Health/WomensHealth/Story?id=3547373&page=1</ref>
-Other patients explain to physicians that the elongated lips can be painfully drawn inside them during [[sexual penetration]].{{Fact|date=June 2007}} Some [[Model (person)|model]]s, [[dancer]]s and [[actor]]s feel [[embarrassment]] when wearing swimsuits and other revealing [[clothing]], because their labia are visible through form-fitting clothing, or because their labia slip out of skimpy [[garments]] altogether.{{Fact|date=June 2007}} Labiaplasty patients also report feeling embarrassment with their [[sex partner]]s.{{Fact|date=June 2007}}
-Physicians and [[mainstream]] [[mass media]] report that the widespread use of [[pornography]] has increased demand for labiaplasty.<ref>The Most Private of Makeovers; The New York Times, 12/28/04 http://www.stayfreemagazine.org/public/nyt_vaginal_surgery.html</ref>  Consequently, many more people have seen [[pornographic actress]]es with shortened labium, and come to regard that as an ideal.  Those who consider labiaplasty for this reason may not be aware that the actresses have had surgery, but may wish to get the surgery to appear what they believe to be "normal". [[Trends]] like [[thong underwear]], [[bikini]] waxes or shaved pubic hair add to the noticeability of protruding labia. The procedure is often the subject of articles in [[women's magazine]]s, complete with before-and-after [[picture]]s.{{Fact|date=June 2007}}
-Writing in the [[May]], [[2007]] [[British Medical Journal]], [[psychologist]] Lih Mei Liao and [[gynecologist]] Sara M. Creighton, noted that demand for cosmetic genitoplasty is increasing and that the National (U.K.) Health Service ([[NHS]]) has apparently doubled the number of labiaplasty procedures performed in the last five years.  Liao and Creighton interviewed healthy [[adults]] who had the procedure to learn their motivations for electing for labiaplasty. Many seemed to be moved by appearance.  Wrote the authors:
-<blockquote>
-“Patients consistently wanted their vulvas to be flat with no protrusion beyond the labia majora... some women brought along images to illustrate the desired appearance, usually from [[adverts]] or [[pornography]] that may have been digitally altered.”<ref>Lih Mei Liao, Sarah M. Creighton; Requests for cosmetic genitoplasty: how should healthcare providers respond? British Medical Journal 2007;334:1090-1092 (26 May)</ref>
-</blockquote>
-A study over nine years on 163 labiaplasty patients who underwent reduction of the labia minora showed a 93 percent rate of satisfaction.<ref>Rouzier, Roman MD; Louis-Sylvestre, Christine, MD; Paniel B.J., Haddad, B: Hypertropohy of labia minora: experience with 163 reductions. Am. J. Obst, Gyn 200 Jan;182 (1 Pt 1):35-40</ref>
+Labiaplasty—in comparison to other popular rejuvenation surgeries—requires additional treatment in five to seven percent of cases. While the American Society of Plastic Surgeons (ASPS) listed only about 1000 “vaginal rejuvenations” during 2006, the most current year for which U.S. statistics have been compiled, surgeons in both the U.S. and the U.K.—as well as in other developed nations—report that the procedure seems to be growing exponentially. The professional plastic surgery organizations like ASPS, the American Society for Aesthetic Plastic Surgery, the British Association of Aesthetic Plastic Surgeons (BAAPS) and the International Society of Aesthetic Plastic Surgeons do not count labiaplasties among the other yearly statistics of plastic cosmetic procedures.
-==Controversy==
-Labiaplasty is controversial amongst some professionals and non-professionals who raise concerns that the desire for this procedure is driven by marketing, and an unhealthy self-image derived from media images of what the "ideal" female genitalia should look like.  The increasing attention this procedure is receiving in various media is believed to be generating a growing market for this surgery.  For most women, it is cosmetically unwarranted, and constitutes a needless exposure to the risks inherent in any surgery. Some have likened the procedure to other forms of [[genital modification and mutilation]]. {{Fact|date=June 2007}}
-Another concern about choosing this surgery for cosmetic reasons is that the ring of scar tissue created at the vaginal opening can later cause pain and complications during childbirth.  As this surgery is more and more frequently performed on younger women, a concern is that surgeons are not warning women of the long-term physical risks they may undertake by electing for labiaplasty. {{Fact|date=June 2007}}
-In [[May]] [[2007]] an article published in the British Medical Journal blasted the "designer vagina" craze, citing its popularity being rooted in commercial and media influences.<ref name="bb">{{cite news | title = Top medical journal blasts "designer vagina" craze| publisher = AFP via breitbart.com| date = 2007-05-24| url = http://www.breitbart.com/article.php?id=070524230339.aha5xr5x| accessdate = 2007-05-29}}</ref><ref name="bmj">{{cite journal | last = Liao | first = Lih Mei| coauthors = Sarah M Creighton| title = Requests for cosmetic genitoplasty: how should healthcare providers respond?| journal = BMJ| volume = 334| issue = 7603 | pages = 1090-1092| publisher = [[British Medical Journal]]| date = 2007-05-26| url = http://www.bmj.com/cgi/content/extract/334/7603/1090| doi = 10.1136/bmj.39206.422269.BE| accessdate = 2007-05-29}}</ref>
-Recently, the appropriateness of the procedure has come into question among [[academics]], [[feminists]] and health care providers, especially in the U.S. and the U.K.  Because some critics argue that [[women]] were reporting to plastic surgeons only to have more “acceptable” [[genitalia]] created, six [[scholars]], including the heads of two women’s centers and the chiefs of four departments of obstetrics and gynecology at major U.S. [[universities]] gathered for a list serve [[discussion]] sponsored by The International Society for the Study of Women’s Sexual Medicine. The participants took a serious look at elective vulvar plastic surgery, among other topics like female genital cutting in Third World nations, and assigned six [[experts]] with special or strong, evidence-based [[opinions]] about vulvar health.  Several noted that variations in the appearance of the vulvar region are normal but that labiaplasty, like any medical treatment, is a woman’s [[right]]. The group concluded that vulvar plastic surgery may be warranted only after counseling if it is still the patient’s preference, provided the procedure is conducted safely and not solely for the purpose of performing surgery.<ref>Goodman MP, Bachmann G, Johnson C, Fourcroyo JL, Goldstein A, Goldstein G, and Sklar S. Is elective vulvar plastic surgery ever warranted and what screening should be done preoperatively? J Sex Med 2007;4:269-276</ref>
-==Labiaplasty as part of sex reassignment==
-{{Main|Sex reassignment surgery male-to-female}}
-In the case of [[transwomen]], labiaplasty is frequently the second part of a two-stage [[vaginoplasty]], where labia and a [[clitoral hood]] are created. This is often performed a few months after the first part of the procedure. In some cases, labiaplasty is an elective procedure to improve appearance after a one-stage vaginoplasty.
 ==References==
 {{Reflist}}
-==See also==
-*[[Vaginoplasty]]
-*[[Genital modification and mutilation]]
-==External links==
 {{Plastic surgery}}
 {{Cleft lip and palate}}
-{{SIB}}
 [[Category:Plastic surgery]]
 [[Category:Genital modification]]
-[[de:Schamlippenplastik]]
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