Ask-An-Expert

ALL great answers. Best to see your surgeon to discuss your issues. (more)

ALL great answers. Best to see your surgeon to discuss your issues. (less)

All the surgeons have made valid and important points and I agree with just about all that has been previously written. The most important recurring statement is that perfect symmetry is (more)

All the surgeons have made valid and important points and I agree with just about all that has been previously written. The most important recurring statement is that perfect symmetry is impossible to achieve and that expectations should be reasonable. However, most who have laibiaplasty done have an image or look they are trying to achieve. If it is not achieved on the first try then revision can be considered. Some with be able to live comfortably with the results and some will want a revision. The patient is the final decision maker on the need for revision. Once that decision is made for revision then the options open up. Looking at your pictures shows me a fairly normal and typical looking labia minora that does not strictly need a revision. In other words, it is within the normal range of normal results. But not perfect.

For irregular and discolored edges, dog ears of the frenulum or clitoral hood, notches from sutures, size discrepancy, irritating flaps of introital skin, even just bumpiness of labia, revision can be done. In your case, smoothing of tissues and matching sizes is best done, in my opinion, using radiosurgical resurfacing. You can see some examples at http://urogyn.org/labiaplasty_revisions.html. The radiosurgical tool I use is an Ellman Pelleve or Surgitron. It is exceptionally precise in work near or around the clitoris. It is able to smoothen and shrink tissues to a very refined look if wanted. Recovery takes six weeks and is uncomfortable because you are basically healing from a second degree burn. However, the results are quite amazing and gratifying. No sutures are needed in most cases. Similar results can be obtained with a CO2 laser with even greater shrinkage of tissues but the precision is lacking for work around the clitoris. Can revision be achieved without the Ellman? Yes, of course. Knives and excisions can be done but sutures will be needed. Standard cautery can be used but the burn is even greater. 980 Diode lasers can also be used but the lateral burn spread and precision around the clitoris and frenulum are a distinct issue requiring great care. Go to someone who does a million revisions for this type of surgery requires the right tools, the right choice of surgery, and experience. In most cases, revision labiaplasty is more difficult than a primary labiaplasty and requires more advanced planning and forward thinking and an artistic eye. Lastly, question yourself well on the need and desire for revision surgery. Get input, get consults, and make a decision that is right for you.

Hope this helps.

Red Alinsod, MD
pelvicsurgeon.com (less)

The asymmetry that you see is completely normal, as total symmetry simply does not exist in nature.
Clitoral hood reduction can be achieved by a rather simple surgical procedure you can (more)

The asymmetry that you see is completely normal, as total symmetry simply does not exist in nature.
Clitoral hood reduction can be achieved by a rather simple surgical procedure you can discuss with your surgeon.
Good luck from NYC. (less)

The asymmetry that you see is completely normal, as total symmetry simply does not exist in nature.
Clitoral hood reduction can be achieved by a rather simple surgical procedure you can (more)

The asymmetry that you see is completely normal, as total symmetry simply does not exist in nature.
Clitoral hood reduction can be achieved by a rather simple surgical procedure you can discuss with your surgeon.
Good luck from NYC. (less)

With all due respect, you must have an appreciation for the human body as a biologic entity; although symmetry is desireable it is not realistic nor is it achievable unless you were made (more)

With all due respect, you must have an appreciation for the human body as a biologic entity; although symmetry is desireable it is not realistic nor is it achievable unless you were made out of clay and could be molded. The human body simply does not work that way. Less asymmetry or less uneveness is a better goal and way to approach this. Any further correction has the potential for over-correction with the left side becoming smaller or thinner than the right.

It sounds as if you are very clear in your desires but you may need to adjust your expectations. I am certain that the surgeon wants you to be satisfied as well and will seek to achieve your goals. Some surgeons will perform a variety of techniques including the use of radiofrequency resurfacing to contour the final edge of the labia or to refine the final result and improve the outcome. Occasionally using different suture methods may also be beneficial to minimizing scalloping.

When it comes to the clitoral hood, I do not believe there is anything non-surgical that will accomplishe a more neat appearance. Estrogen creams tend to be more active on the mucosal lining of the labia minora and vagina but will do little to improve the skin tone of the clitoral hood.

I hope this helps to explain the limitations that surgery can accomplish. (less)