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Painful Scars After Labiaplasty—What Should I Do?

Posted on December 20, 2016 in Frequently Asked Questions

Some women who I’ve seen in referral after having labiaplasty by another physician using an edge-trim technique have complained of painful scars which have deterred them from resuming comfortable relations.

The edge-trim technique places a scar along the entire leading edge of the labia minora which can be tender as nerves regenerate. That is why I most commonly recommend a wedge type labia minora reduction which only rarely causes long-term pain. Painful scars after labiaplasty are most commonly managed with time, and it is likely that the pain will resolve over 3-6 months. I recommend that my patients avoid stressing the repair by waiting 8-10 weeks after surgery for sex and use of tampons or anything else that might be inserted into the vagina. With that said, if a painful scar remains after 5-6 months, touch-up surgery may be needed to improve the result of an edge-trim type of labiaplasty. This may include converting an edge-trim to a wedge type labiaplasty or creating skin flaps from the skin of the lateral clitoral hood to recreate a more natural appearing border of the labia minora. Scar revision or corrective surgery is rarely needed after a wedge type labiaplasty, however. It is best to allow scars to mature for at least 6 months after the wound completely closes before rushing into more surgery. Sometimes gentle massage or “desensitization exercises” can eliminate scar-related pain. Since it is not “normal” to have pain 6-8 weeks after a labiaplasty (and most patients state that pain or discomfort resolves within a few weeks of surgery), be sure to speak with your plastic surgeon if pain persists.

When Can I Have Labiaplasty Revision Surgery?

Posted on November 7, 2016 in Frequently Asked Questions

Female intimate surgery can be a complex surgery, and in order to reach your ideal outcome, it is crucial you seek a qualified plastic surgeon who is experienced at performing the procedure. With extensive experience performing labiaplasty, Dr. Dimitri Kumanis is considered a leading plastic surgeon in the specialty. In addition to performing different variations of female intimate surgery, Dr. Koumanis also performs revision surgery to help women who underwent labiaplasty from another surgeon and are unhappy with their results. To provide a better understanding of what a revision labiaplasty may entail, our board-certified plastic surgeon answered one woman’s questions on the online medical forum RealSelf.

This individual was five months into her recovery. She had expressed concerns to her surgeon about her results, which included excess skin and an uneven shape, but he disregarded her comments. This left the patient unhappy, saying she had a “‘mini lip’ on top of [her] labia minora,” which she described as looking worse than before the surgery. After seeing her doctor again for a follow-up, he told her not to worry and that he could make minor alterations to improve her results. This response left the concerned patient with more questions, which is when she decided to go online to ask for advice from other plastic surgeons.

After learning about her case, Dr. Koumanis provided his professional opinion for how the patient should move forward, based on the information she provided. He said it appeared she had an edge trim type labiaplasty that left excess labia minora and clitoral hood skin. To improve her outcome and provide the natural-looking appearance she desired, Dr. Koumanis recommended a revision with a double wedge type skin and clitoral hoods resection. By doing so, he explained this would help minimize the anterior prominence of the clitoris, which could also help eliminate associated irritation and sensitivity.

Since the patient was still recovering from her original labiaplasty, Dr. Koumanis recommended that she should let several months pass before undergoing reconstruction. This would allow enough time for the swelling to resolve and incisions to heal. During this waiting period, he advised the woman to seek a board-certified plastic surgeon who is a member of the American Society for Aesthetic Plastic Surgery (ASPS). To get the best outcome from her revision, he further encouraged her to find a surgeon who specializes in wedge type labiaplasties and reconstruction after labiaplasty. When consulting with the surgeon, he stressed the importance of asking questions and viewing before and after pictures to make sure they can provide the results she is seeking.

Learn More About ThermiVa

Posted on September 30, 2016 in News

Interested in ThermiVa but looking to learn more about the treatment? Dr. Yarinsky is hosting an education event on Tuesday, October 18th and a private consultation day Tuesday, October 25th to help educate those interested. Attendees will receive special pricing when purchasing a three package treatment. Contact us today to RSVP as space is limited.

Can My Period Affect the Healing Process?

Posted on September 27, 2016 in Frequently Asked Questions

Considering the intimate nature of labiaplasty, many patients have unique concerns related to healing after the surgery. From suture removal to scar visibility, Dr. Dimitri Koumanis has heard a wide variety of questions from his patients. In addition to addressing every concern they have, our board-certified plastic surgeon also offers his expertise by answering questions in the online medical forum Real Self.

One woman, in particular, had undergone labiaplasty and was inquiring whether her period would affect the healing process. She explained, “The labiaplasty wound is almost closed, but I am afraid that this could infect the tender area.” The woman also mentioned the burning sensation was minimal and questioned whether she should stop using her antibiotic cream.

Dr. Koumanis was happy to clarify that a woman’s menstrual period should have no effect on healing from labiaplasty and, therefore, should be no cause for concern. “Blood from your menses, or period, is not infected, and the vagina has a normal cleaning mechanism which requires little maintenance,” he said. Beyond using soap and water during a routine shower, Dr. Koumanis explained that there is typically no need for douches or irrigation of the area.

While the blood from a woman’s period should not cause any issues to the incision site, Dr. Koumanis emphasized that tub baths, swimming, and hot tub use should be avoided for three or more months following labiaplasty to prevent complications like infection and skin irritation or wound edge separation (showering is fine). In regards to applying prescription antibiotic ointment, Dr. Koumanis explained that this is usually recommended until the incision location heals and the sutures dissolve—about one to two months. In his conclusion, Dr. Koumanis suggested the woman check with her plastic surgeon to learn if she should continue use of her antibiotic cream or if she is safe to stop.

Dr. Yarinsky featured in Radiant You Magazine

Posted on September 23, 2016 in In the Media

Online magazine Radiant You recently spoke with Dr. Yarinsky about ThermiVa, a non-surgical treatment for vaginal rejuvenation. Click the image below to read the full article.

Can I Get a “Perfect Vagina”?

Posted on August 23, 2016 in Frequently Asked Questions

As with any cosmetic procedure, Dr. Steven Yarinsky stresses the importance of having realistic expectations with the outcome of labiaplasty. While patients can often achieve their desired results, he notes that women should maintain a practical outlook on what is attainable with their procedure. At Saratoga Springs Plastic Surgery, Dr. Yarinsky helps patients understand what they can expect based on their physical examination during the consultation process. He also strives to help others by answering questions about labiaplasty through the online medical forum RealSelf.

One woman, in particular, was a 16-year-old who was seeking the “perfect vagina.” She had undergone a labiaplasty with clitoral hood reduction two months prior and was now considering a second procedure once she turned 18 to reduce the size of her vulva to be “as tiny as possible.” Based on the before-and-after pictures she had seen, she wasn’t sure if her idea of “the perfect vagina” was attainable. She posed the question, “Is there a doctor out there who can make a drastic change so I would get the result I dream of?” As part of his mission to educate women on female intimate surgery, Dr. Yarinsky provided a detailed answer to help clarify the young woman’s confusion.

Dr. Yarinsky responded that there are many variations of the appearance of the vulva, so there is no single “perfect vagina.” After all, beauty is in the eye of the beholder. Without examining the young woman, or seeing her current photos, Dr. Yarinsky could not accurately determine whether further surgery, another labiaplasty, would be of any benefit to her. Any ethical plastic surgeon screens his patients for dysmorphic behavior before operating. Body dysmorphism involves undue concern with an appearance of a body part that to most would be within the realm of “normal”. Patients who have dysmorphism should not be offered cosmetic surgery, since there really is nothing “correctable” and they will no doubt be very disappointed with the results. Two other factors that needed to be considered were the issues of her age and expectations. A few questions he recommended she consider included:

• Why are you so bothered by the appearance of your labia?
• What changes in appearance are you trying to obtain?
• Do you have realistic expectations of what can be achieved?

He explained that these are all questions to address during her consultation with a board-certified plastic surgeon who specializes in labiaplasty. Above all, Dr. Yarinsky highlighted that no matter what cosmetic surgery she chooses, her expectation of the results must be realistic or she will be dissatisfied. This is why he encouraged her to seek a caring expert plastic surgeon who would let her know whether or not he can help to reach her goal.

How Can I Avoid Having Too Much Skin Removed?

Posted on July 21, 2016 in Frequently Asked Questions

A common reason why many women seek female intimate surgery is to decrease the size of their labia minora(the inner lips) for functional and/or aesthetic reasons. While the details of each labiaplasty will vary based on the woman’s unique needs, a major concern that Dr. Dimitri Koumanis addresses in the consultation is how the patient can avoid too much skin removal, which could produce dryness, pain and an abnormal appearance with more visible scars. This is a problem that can be avoided when the best surgical technique is used.

Dr. Koumanis reveals that edge-trim type labiaplasty – which removes extra skin with a straight line resection – is prone to removing too much skin and providing more visible scars and possible complication of excessive vaginal dryness and scar pain or hypersensitivity. He prefers using the wedge-type labiaplasty as originally described by Beverly Hills plastic surgeon Gary Alter, MD. The wedge procedure does not completely trim off the labia and leaves patients with a more naturally appearing delicate labial edge. The smaller labia minora after the wedge procedure still provides the necessary function of covering the vaginal opening to maintain the appropriate degree of moisture to avoid dryness.

For women who have had complications from an edge-trim labiaplasty, Dr. Koumanis says they will generally need to wait at least six to eights months before corrective touch-up or reconstructive surgery can be done.