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Female genital plastic surgery

Correction of female external genitalia (labioplasty) and vaginoplasty have been a growing trend in the last 10 years. On the one hand, increasing awareness of women, possible comparison with others because of better availability of materials with sexual content and removal of hair from the genital area, and on the other hand, availability of safe surgical techniques are the reasons why women choose this surgery. The female external genitals are often asymmetrical and there is no one standard. The most frequent reason why women choose this procedure is enlarged inner labia (usually hereditary, but may also be related to post-pregnancy changes and using oestrogen containing medication). Women have also requested to improve the appearance of the outer labia or alter the folds of skin in the clitoris area. Although in most cases women choose this procedure because of aesthetic reasons, enlarged labia may cause friction during physical training or discomfort when wearing tighter clothing. Vagina tightening surgery i.e. vaginoplasty is mostly required by women that have given birth.

Pre-operative consultation

The expectations of the patient and options for meeting them are identified during a pre-operative consultation. The discussion will cover the health status of the patient and the medications used. Prior to the surgery, it is important to stabilise body weight because weight changes may also significantly change the appearance of the external genital organs.

During the examination of the patient, excess tissue is assessed when the patient is standing and the state and symmetry of the labia and the area of the clitoris are assessed. Photos are taken of the area to be operated on for the medical records. The surgical method and the location of the wounds (later scars) are planned.

Course of surgery and recovery

The operation is performed under local anaesthesia (vaginoplasty usually under general anaesthesia) and it lasts about 0.5–2 hours. During labioplasty, excess skin is removed from the labia and, if necessary, the clitoris area. When outer labia are operated on, excess fatty tissue is removed in addition to skin.

The patient is usually allowed home two hours after the surgery; in case of vaginoplasty, the next morning after the operation. Recovery is individual, depending on the patient. Post-operative pain treatment is usually necessary in the first days after the surgery; antibiotic ointment or solution must be applied to the wounds and a cold compress is used to reduce swelling. The patient is advised to limit physical exertion for 3 weeks and to avoid certain activities, such as yoga, riding a horse etc., that are not advisable for up to 8 weeks. Sexual intercourse is allowed 6 weeks after the surgery.

Results and risks

The final result may take months to develop. The result is long-term.

Long-term swelling may develop after the surgery (in 80% of cases the swelling goes down within 6 weeks). Less frequent side effects are longer-term discomfort or bruising in the operated area. Inflammation is rare. Slower healing of the wounds or discharge from the wounds for a longer period have occurred in less than 1% of cases.

The surgery is performed by Dr. Mart Eller, plastic and reconstructive surgeon.