CHARLES GRUENWALD JR MD FACS4309 Bluebonnet Blvd.
Baton Rouge, Louisiana 70809
Labiaplasty (also spelled "labioplasty") is a plastic surgery procedure of the female external genital folds, the labia minora (inner lips) and/or the labia majora (outer lips). Labiaplasty usually reduces the size and reshapes these inner lips or outer lips.
This cosmetic procedure has been used by plastic surgeons for well over a decade but, in recent years, it has also experienced increased popularity. Reasons for this growing interest include such factors as more readily available information about this procedure (via the media and internet) and the abundance of graphic adult material causing a realization that the appearance of feminine genitals can vary considerably (depending on the size and shape of the labia).
Add to this, the desire of many women, after adopting a more cleanly shaven pubic style (e.g., a Brazilian wax), to be able to wear sheer panties or similar apparel without the fear of a noticeable "bulge" showing through, or even protruding dark labia minora "slipping out", being the source of a tremendous sense of insecurity.
There are, in addition, some women who, because of enlarged labia, are hampered by pain or irritation arising from trying to wear certain articles of clothing, participating in some athletic pursuits and even during intimate sexual activity. In these instances, the reason for surgery may be viewed more as a medical necessity than as strictly an aesthetic choice.
To decide if you are a good candidate for cosmetic labia surgery, you must first decide if you fit into one of the above mentioned situations pertaining to your labia minora (inner lips), your labia majora (outer lips), or even both. If you do, then the next step is to be examined by a labiaplasty surgeon, who is capable of safely and effectively performing the operation, and who can tell you the likelihood of a labiaplasty correcting your problem.
Once it can be confirmed that you'll benefit from labia surgery, you will want to learn the exact technique that will best fulfill your needs. As this implies, there's more than one way to do a labiaplasty, and a detailed discussion of the various methods for labia rejuventaion is available to those who have an interest.
The question occasionally arises regarding the advisability of labiaplasty for African American, Asian or Hispanic women who may also experience identical symptoms of discomfort or diminished self-esteem (and confidence) due to enlarged labia minora or an undesirable appearance of their labia majora. The obvious answer is that race or ethnicity is totally irrelevant to the decision for or against labia surgery to correct those problems. These women are just as likely to benefit from labiaplasty surgery, and it's been my experience they are not exposed to any additional surgical risk. The only possible exception is the rare chance of forming thick or "keloid" type scars, occasionally associated with the dark skin pigmentation of African American patients. Although this is occasionally mentioned as a possible complication, I personally have never encountered it.
The true difference I see with respect to African American, Asian or Hispanic patients, who are interested in undergoing labiaplasty, relates to the greater likelihood of dark labia minora margins, which may influence the type of labiaplasty to be selected (labiaplasty to correct dark labia minora margins is fully discussed elsewhere).
Cosmetic labia surgery really has no age boundaries. As with most plastic surgery procedures, the decision hinges on whether a patient's health is satisfactory to tolerate the surgery and whether there are possible unwanted effects on subsequent development if this surgery is performed before full physical maturity has been reached.
With labiaplasty, though, there may be strong reasons to actually consider performing this surgery at an early age (during puberty). This should be considered, for example, when a young lady becomes inhibited from participation, with girls her age, in activities for which it is necessary to share locker room space, showers or bathrooms. The greater the availability of activities that require those facilities, the greater the challenge for the self-conscious teen to keep that part of her anatomy "private".
There are also those girls and young ladies, who, because of labial irritation and discomfort, choose to avoid certain physical activities or sports that they find associated this annoyance.
Since surgical correction is entirely possible and safe, it's very appropriate to offer labiaplasty as an option, provided the teen and her parents are in complete agreement. So, yes, there is a place for "Teen Labiaplasty", although it should be thoughtfully applied.
Although labiaplasty is a minor surgical procedure, the location for this surgery may vary from a full service hospital (along with an overnight hospital stay) to the office of a labiaplasty surgeon where it may be carried out as a simple outpatient procedure.
I prefer to perform labiaplasties as outpatient procedures, and the surgical time is approximately one hour. Most often, this is carried out in a fully accredited outpatient surgery facility. Frequently I combine labia surgery with other cosmetic surgery, at the request of the patient.
Labiaplasties can be performed using just a topical anesthetic cream (Emla Cream), in addition to administration of a local anesthetic, without the requirement for any sedation. In this case, the patient is perfectly capable of driving herself to and from the surgery center, without the need to share the purpose of her visit with anyone (i.e. she can keep it a secret).
On other occasions, it may be performed using local anesthesia but under light oral sedation or, even, heavy intravenous sedation (twilight sleep). In these cases, the use of sedation raises the necessity for someone, other than the patient, to be the driver (unlikely to maintain secrecy).
Finally, if the patient prefers and is willing to pay the additinal cost, labiaplasty may be done under general anesthesia (totally asleep). Discharge from the outpatient surgery facility is then about one hour after the operation ends, and, with the patient still slightly sedated, someone else (family or friend) must drive her home.
Naturally, there's the onset of some discomfort as local anesthetic wears off, several hours following the procedure. I prescribe adequate oral medication to help patients tolerate this without difficulty. After a few days, pain medication is no longer necessary, and patients can plan to be back at work or school. Though all patients are different, this typically occurs between the 3rd and 5th day following surgery.
To many readers, this fast recovery may sound like an exaggeration, particularly if they happen to have read some of the blogs or forums, relating experiences of pain and suffering associated with labia surgery. No doubt the truth is being expressed by those bloggers, but I must attribute such unfortunate experiences to poor surgeon selection and, consequently, undergoing this surgery at the hands of an inexperienced or careless surgeon. Such should never be the case!
I advise all of my patients to avoid any activity that might be particularly traumatic to the genital area for a period of 6 weeks. This obviously includes horseback riding, bicycling and sexual intercourse, to name a few examples.
Although labiaplasty is considered by most surgeons to be a form of "minor surgery", there are still surgical risks that prospective patients should consider before finalizing a decision in favor of any surgery. Providing risk information for labia surgery is not an attempt to frighten patients, but it should encourage them to carefully select a qualified and skilled labiaplasty surgeon. Few will argue against the fact that skilled and caring surgeons experience fewer surgical complications, and when faced with an unexpected outcome, a highly skilled surgeon is in a far better position to satisfactorily correct the problem.
Aside from a small risk normally associated with the use of anesthetic agents, the following is a brief list of complications occasionally seen following labiaplasty:
Revision labiaplasty (known also as "secondary labiaplasty") becomes required when the original labia surgery has either failed to completely improve a labia problem or has resulted in a deformed appearance of the labia. Such a deformity can even occur when an unexpected postoperative complication causes distorion of a labiaplasty which had been well performed originally. Most often, it's not a difficult matter for a well trained labiaplasty surgeon to correct these deformities.
Unfortunately, however, deformity may also result when an unsuspecting patient has her labiaplasty performed by a surgeon who is inept with regard to good plastic surgical technique or is lacking in the understanding of sound labiaplasty concepts.
Women seeking revision labiaplasty often find themselves to be humiliated and of very low self-esteem because of their deformed appearing genitalia (often a sexually inhibiting circumstance). It isn't uncommon for these women to realize the error they made in the selection of their original surgeon and, understandably, to be loathe to return to that same doctor for a revision. These women are strongly encouraged to seek the services of a well regarded plastic surgeon for their secondary surgery (preferably one who also has an active labiaplasty practice).
Since the variety of possible labial deformities is immense, it's impossible to describe a single approach for the surgical repair. As a general rule, the less labial tissue that was removed by the initial surgery, the greater flexibility the next surgeon has with which to accomplish a successful surgical revision.
As the number of labiaplasties has dramatically risen in recent years, so too has the number of women who suffer from unsatisfactory labiaplasty results. Learning whether a revision is advisable or even possible is a often a problem, particularly when reliable and experienced advice isn't readily available. This website has positioned me to receive email requests for a professional opinion about labiaplasty outcome and to offer suggestions when I believe revision seems advisable. I'm always anxious to help, and I do welcome all such email, which should be directed to:
By their very nature, the labia are extremely pliable and stretchable. A labiaplasty reduces the length of the labia, but it does not eliminate the ability of the labia to stretch. As a consequence, having a previous labiaplasty does not, in any way, hinder natural childbirth and, in fact, may make it easier.
The current cost for my labia minora labiaplasty, with or without clitoral hood reduction, is approximately $2600, when performed under heavy sedation (twilight sleep).
If no sedation is used and the procedure performed under local anesthesia, the fee is less. If general anesthesia is chosen, the fee rises accordingly.
These costs compare extremely well with almost all other advertised prices which tend to range from $3,500 to $10,000, depending upon locality.
The actual charge can vary up or down, somewhat, depending upon various decisions to be made during your consultation. Your labiaplasty fee may also be reduced if other additional cosmetic surgery is performed. All of this is determined and presented as a quote during your first visit. My office will then continue to honor that quote for a period of one year. There are no additional costs for follow-up visits after surgery.
The very first cost to be encountered is, of course, that of the initial consultation. This is normally $80, and it is totally refunded if you follow through with the surgery.
There may even be additional "fee reduction" opportunities for some prospective labiaplasty patients. You may find it worthwhile to explore these various options. To learn more, please email me, and I will gladly share this information:
Generally, should not present a problem...
Labia surgery, being a minor surgical procedure, does not require an overnight stay in Baton Rouge, as is sometimes required with other cosmetic surgery. It's fairly simple to arrange this operation "long distance" and then to make a single trip to Baton Rouge to have the labiaplasty and then travel directly back to your home in New Orleans, Lafayette, Lake Charles or anywhere else, within a few hour drive of Baton Rouge.
Labia surgery can certainly be performed in any community hospital or in the clinic of many capable labiaplasty surgeons across the country. If such a surgeon is easily available to you and the cost is manageable, then, by all means, "stay at home". On the other hand, there are several reasons patients may decide to come to Baton Rouge, Louisiana, and to my practice for their plastic surgery needs:
Cost...
For many years, Baton Rouge has attracted cosmetic surgery patients from New Orleans, other surrounding cities and surrounding states. This partly occurs because of the favorable surgical prices here when compared to costs elsewhere. If the financial aspect of having labiaplasty surgery is of concern, it may be beneficial to take a good look at prices before deciding on a surgeon or a location.
Reputation...
I am fully board certified by the American Board of Plastic Surgery, and my plastic surgical reputation has been strongly established in Baton Rouge for 30 years. I perform all of my surgery with an experienced plastic surgical team and only at fully accredited surgical facilities. I also, maintain a strong working relationship with Woman's Hospital of Baton Rouge, where the majority of my "in hospital surgery" is performed.
Quality...
Although labiaplasty is performed by surgeons of several different specialties, not all have similar ability, training or plastic surgical experience. Nor do all have the willingness or knowledge to offer different labiaplasty methods to different patients, tailored to their individual needs. Even within the specialty of plastic surgery, many surgeons exhibit little interest in providing cosmetic labial surgery.
As a consequence, identifying a suitable surgeon for this purpose can be a daunting task. Women who want their labiaplasties to be performed with utmost skill and attention to detail are well advised to spend ample time locating the best qualified surgeon for that purpose.
Privacy...
Many patients hope to keep their cosmetic surgery experience as confidential as possible. This seems particularly true of women contemplating cosmetic labia surgery. What better way is there, to maintain privacy, than to undergo surgery away from home, in a privately run surgical setting? A visit to my practice in Baton Rouge may provide such an opportunity. Furthermore, my practice has consistently been vigilant about patient privacy, always enforcing strict rules in an effort to avoid any breach of patient confidentiality.
Convenience...
Certainly, traveling to Baton Rouge from "out of town" is not the most convenient arrangement. Knowing that, I make every effort to reduce the hassle for the individual who must make an effort to come to me as a patient. I am very willing to minimize the travel for labiaplasty to a single trip for those patients who are so inclined. This usually means, completion of "paperwork", sharing of photos, and arranging a date for surgery using a combination of phone, email and postal service. If a stay of one or more nights is planned (as it often is) and a local motel is required, we are happy to help patients find a suitable location. Following surgery, and after the patient has returned home, we resort, once again, to using phone and online communication to follow our patients' progress.
Labiaplasty is an operation that can (and should) be carried out safely and with good results. Patients deserve to have this procedure performed with extreme skill and with adherence to sound plastic surgery principals. For these reasons I, an experienced plastic surgeon, thoroughly enjoy this surgery and meeting some of the challenges it can, at times, present. Sensing a high degree of patient satisfaction associated with labiaplasty results is, to me, always a source of immense gratification.
My intent with this labiaplasty overview is to provide prospective labiaplasty patients a source of reference from which they can gain information, difficult to find elsewhere. I hope it serves to enlighten those who are seeking this surgery as to the importance of finding a well qualified surgeon, as well as the pitfalls of failing to do so. With a strong interest in this surgery, I invite any comments or questions that this discussion may generate...
CHARLES GRUENWALD JR MD FACS
4309 Bluebonnet Blvd.
Baton Rouge, Louisiana 70809
(225)925-3140
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