November 22, 2011

Labioplasty for Pain or Pleasure?

This week, the CBS show The Doctors featured a segment on Labial Redundancy. There are many reasons that women seek to reduce the size of the labial lips, or make other adjustments or enhancements to their vaginal area. Here is one story (click on photo below to launch video).

It has been my experience with the past 300 labia minora reductions or labioplasties I have done over the past 6 years that patients seek the type of surgery most commonly NOT for pain but for appearance. My typical patient is in her mid 20's to 40's, has very little pubic hair by choice (Brazilian waxing or landing strip) and dislikes the protrusion of the labia minora past the labia majora. It is surprising to me that patients in Southern California would seek out a plastic surgeon for a labioplasty for pain...Perhaps Boston girls are truly more concerned with appearance...Should Bravo create the Housewives of Beacon Hill instead of the Housewives of Beverly Hills? Hopefully the lips below the belt won't look like their facial lips....

Currently I am doing two studies for labia majora rejuvenation. One involves Thermage or radiofrequency skin tightening of the labia majora which may become loose and wrinkly due to aging and or hormone deficiencies and the other involves hyaluronic acid fillers (Restylane or Juvederm) used in an off-label manner to puff up the labia majora: with the help of Dr. Jennifer Berman, a urologist with vast experience in women's sexual health, I have coined these procedures Labial Puffs. I agree with Dr. Stevens that aging of the vaginal area is similar to the face and should be treated in a similar fashion by tightening the skin envelope (facelift or Thermage) and volumizing the area (fat grafting or filler injections). Fat injections to the Mons pubis (bump over pubic bone) and the labia majora are effective in restoring the volume (rejuvenating the vulva) in patients interested in a more permanent result.

All in all the aesthetics of the vaginal area still needs exploration as well as the motivating factors that influence women to seek alteration of the natural appearance of their genitalia. I guess women have been increasing the size of their breasts for many years so what's the problem with making the vaginal area more youthful and sexy? Does the increasing interest in vaginal rejuvenation procedures represent a paradigm shift as women continue to express their sexuality in a more open manner? The pharmaceutical industry invests millions of dollars into the marketing and production of Viagra, Levitra and Cialis. What about the women?

I have anonymously surveyed over 200 men, lawyers, bankers, lawyers, business men, plastic surgeons, firemen... and have found that the appearance of the vaginal area is NOT particularly important. Men do prefer a groomed vaginal area and interestingly find a bit of labial show (protrusion of the labia minora beyond the labia majora) to be sexy! The appearance of the area is much more concerning to women but why? Perhaps since there is no pubic hair, and they now notice dangling of the labia minora beyond the majora (natural state in most women past puberty) when they stand nude in front of the mirror. Studies by sexual psychologist, Dr. Laura Berman, have shown that when women feel confident about the appearance of their genitalia they are more confident in the bedroom.

I am happy to see The Doctors continue to be on the cutting edge of plastic surgery and show such great surgeons as Dr. Grants and Dr. Berman helping a young women traumatized by the appearance and pain she experienced due to the elongated labia minora and scarred clitoral hood. Vaginal rejuvenation is just in its infancy and I feel will continue to grow as a field in plastic surgery. It is important to seek out a BOARD CERTIFIED plastic surgeon for safe optimal results in this delicate area. Please refer to Plastic Surgery Channel for more information.