Frequently Asked Questions

What Should I Do if a Hematoma Develops After Labiaplasty?

Posted on June 12, 2018 in Frequently Asked Questions

Before you undergo your labiaplasty procedure, Dr. Dimitri Koumanis will thoroughly explain what you can expect in your recovery. This will include going over your post-operative instructions and making you aware of complications that could potentially occur. Although rare, one problem that can develop after surgery is a hematoma. This is caused by excessive bleeding and the collection of blood and fluid underneath the skin. When a hematoma is present, this requires close monitoring and may need to be drained by your surgeon.

Some patients may mistake post-operative swelling for a hematoma, which is why Dr. Koumanis recommends patients continue practicing careful wound observation and call their doctor to be evaluated if they notice excessive swelling, bruising or bleeding. As a precaution, it can be helpful to avoid OTC drugs such as fish oil supplements, Motrin, aspirin and vitamin E, which thin the blood and can lead to more bleeding. Dr. Koumanis provides you with a list of medications to avoid at your consultation visit. In addition to swelling, if you experience severe pain, redness, or fever, it is important that you contact your doctor ASAP, as these signs may indicate infection.

Although hematomas can be worrisome and sometimes prolong the healing process after labiaplasty, seeking prompt care from your surgeon should prevent the complication from interfering with your final results. If at any point during your recovery you are concerned about your progress with healing, please do not hesitate to reach out to your surgeon.

Laser vs. Radiofrequency Vaginal Rejuvenation: Which Is Better?

Posted on May 23, 2018 in Frequently Asked Questions

Non-surgical vaginal rejuvenation has come a long way in recent years, and Dr. Dimitri Koumanis is committed to staying at the forefront of these latest advancements. Although surgical vaginal rejuvenation procedures may be ideal for those in need of more extensive repair, minimally invasive techniques can provide significant tightening results for the right candidates. Two of the most popular non-surgical options includes laser and radiofrequency technologies. Both can be effective for tightening of the vaginal tissues; however, each technique works in a unique way and, as a result, produces slightly different outcomes.

Laser vaginal tightening generally employs CO2 fractional or erbium laser technology. This method works by sending pulses of laser energy into the vaginal tissue, which damages the surface of the skin and perforates the skin signaling the body to repair itself. This healing process stimulates collagen production, which has shown to help tighten the vagina, increase lubrication, and improve urinary incontinence. Laser vaginal rejuvenation is typically a quick treatment process but requires a few days of recovery and down time, including avoiding intercourse for several days after each of the three recommended initial monthly treatments. Generally speaking, the outside of the vagina, the labia minora and majora, cannot be treated with laser vaginal rejuvenation. The laser treatment also is typically more painful than radiofrequency vaginal rejuvenation, and the laser treatment head which must be placed inside your vagina during treatment may be as large as a toilet paper roll. This combined with the laser burning the surface of the skin and lining of the vagina can be quite uncomfortable and require days to recuperate and the use of topical creams to heal, such as aloe vera.

Radiofrequency (RF)-based vaginal rejuvenation, such as ThermiVa^®, uses a small probe the diameter of your little finger that comfortably delivers thermal (electrical) energy to warm the lining and outside of the vagina. This includes the labia majora and minora to lift, tone and tighten the outside skin like “shrink-wrap.” Treatments feel like having a “hot stone massage” so they are not only bearable but comfortable for patients. Similar to laser treatments, this technique damages the tissue (but only beneath the surface of the skin) in order to increase cell growth as the body heals. Since the surface of the skin is not destroyed with RF energy, there is usually absolutely no downtime with ThermiVa^® and, therefore, no need to abstain from having sex or resuming all activities the same day as the treatment. Through this RF energy, patients have reported a tighter labia majora and labia minora, improved lubrication and sensitivity, as well as correction of mild urinary incontinence with improved muscle tone. Postmenopausal women (who typically complain of dryness during penetration) find intercourse with the increased lubrication is much more comfortable and pain free. After their RF treatment, women who complain of vaginal looseness (often a result of vaginal delivery) achieve muscle tightening, a tighter vaginal opening, and more pleasant stimulation with intercourse. A unique benefit of ThermiVa^® in contrast to laser vaginal rejuvenation, is its ability to treat both the inner and outer areas of the vagina. Just like the laser treatments, three monthly ThermiVa^® treatments are needed to reach the maximum result. Touch-up single treatments are given every 8-12 months to maintain the results.

With several years of experience performing vaginal rejuvenation with labiaplasty, Dr. Koumanis has found ThermiVa^® to offer exceptional results for his patients. In fact, nearly every patient who has been treated with ThermiVa^® at Saratoga Springs Plastic Surgery has reported a positive outcome and is happy with the results from their procedure. This has been possible due to Dr. Koumanis’ expertise in performing the technique as well as only recommending it for ideal candidates.

Overall, while laser and radiofrequency treatments can each offer positive vaginal rejuvenation outcomes, the best option will ultimately depend upon your specific concerns and goals. It is important that you schedule a consultation with a board-certified plastic surgeon who is experienced in performing both surgical and non-surgical vaginal rejuvenation treatments to determine which option is most appropriate for your needs.

Is Labiaplasty Safe?

Posted on December 28, 2017 in Frequently Asked Questions

Choosing to undergo surgery can be intimidating for many people, and labiaplasty, in particular, can be a very personal and challenging decision. As such a private matter, women are often concerned about the safety of their vaginal rejuvenation, wondering if the procedure is worth the investment or carries more risk than reward. With extensive experience doing labiaplasties, our plastic surgeon, Dr. Dimitri Koumanis, strives to educate patients so they are well-informed, learning about the many pros and understanding the potential cons of labiaplasty. Your most important decision is who you choose for your labiaplasty surgeon.

When performed with proper care provided by an expert and qualified surgeon such as Dr. Koumanis, labiaplasty is considered a safe and very effective procedure. However, like any surgery, labiaplasty comes with risks. This includes the possibility of infection, bleeding, and issues with poor wound healing. Most importantly for women, a poorly done labiaplasty by an inexperienced surgeon can leave them with visible and permanent scars and an abnormal appearance. Patients may be at a higher risk of healing complications if they smoke, take blood thinners, or have a medical condition that interferes with the natural healing process.

Dr. Koumanis takes every precaution to minimize these risks. During the consultation process, he works closely with you to identify the areas of anatomy that are of most concern and determine the most effective and safest technique for your needs. Dr. Koumanis will discuss in detail what to expect throughout the process, including providing detailed written and verbal post-operative instructions patients should follow to ensure they heal properly.

All surgical procedures offered at Saratoga Springs Plastic Surgery, PC are performed at our in-office surgical facility that is accredited by the Joint Commission, which offers the “Gold Standard” for safety and exceptional care in medicine. This is the same accreditation required by local hospitals, which indicates our commitment to providing you with a safe environment of care at our practice.

When carefully planned and executed by an experienced plastic surgeon, labiaplasty has an extremely high patient satisfaction rate and low risk of complications. Dr. Koumanis will go over all benefits and possible complications of labiaplasty with you in person, allowing you to ultimately decide if the procedure is right for you.

To discover important qualities to look for in a surgeon, read our blog about how to choose a surgeon for labiaplasty.

How to Choose a Surgeon for Your Labiaplasty

Posted on November 2, 2017 in Frequently Asked Questions

Finding a qualified and experienced plastic surgeon to perform your labiaplasty procedure is important for many reasons. The quality of your results, your recovery, and your overall experience depend on having a surgeon whose skills and credentials you can trust. Our plastic surgeon, Dimitri Koumanis, MD, FACS, devotes a large part of his practice to female intimate surgery and has developed a special interest in labiaplasty. As a respected and well-known board certified plastic surgeon experienced in labiaplasty, Dr. Koumanis often provides guidance to women in other areas of the country who inquire about how to find the right surgeon for labiaplasty.

First and foremost, Dr. Koumanis emphasizes the importance of taking your time when researching surgeons and not ruling out highly-recommended surgeons you may have to travel to see. You will find that the extra time and distance are worth it if it leads to a satisfying end result. Next, he suggests only considering board certified plastic surgeons who are members of the American Society for Aesthetic Plastic Surgery (ASAPS) and specialize in labiaplasty. Plastic surgeons of this caliber uphold some of the highest standards in patient care and have undergone extensive surgical training and evaluation. Finding out more about each surgeon’s training in labiaplasty and the labiaplasty techniques he or she uses is also helpful. Dr. Koumanis believes that the “wedge resection technique” is the most universally reliable, effective, and comfortable approach for achieving successful labiaplasty results, with virtually invisible scars. He recommends finding a surgeon who is experienced in the wedge method, which can also reduce excessive skin or fullness in the clitoral hood area. While other types of surgeons and physicians, like gynecologists, may offer labiaplasty, plastic surgeons are uniquely qualified to perform the wedge approach and are most likely to consistently achieve high-quality results and minimize or eliminate complications such as prolonged pain, physical deformity, and difficulty with sexual relations (if your labiaplasty surgery is “botched”). As a general rule, he advises avoiding surgeons who suggest the “edge trim” method, as this technique can result in a more painful recovery and visible scarring. Also, avoid choosing on price alone, since a low labiaplasty cost is often provided by a poorly trained doctor who is trying to grow his practice by using you as a guinea pig!

If you would like to learn more about labiaplasty or want to schedule a consultation with Dr. Koumanis, we encourage you to contact Saratoga Springs Plastic Surgery. We also offer virtual consultations to patients from outside the area!

Is It Normal to Experience Extreme Sensitivity After Labiaplasty?

Posted on September 6, 2017 in Frequently Asked Questions

Plastic surgeon Dimitri Koumanis, MD, FACS performs labiaplasty using the “wedge resection technique”—rather than an “edge trim” approach—to promote faster healing and minimize post-surgical discomfort for his patients during recovery. He explains that even with wedge-style labiaplasty, however, it is not uncommon for patients to experience swelling, hypersensitivity, and even itching during the early stages of recovery. The discomfort is usually minimal with the wedge type labiaplasty but can be severe with the edge trim technique.

For some patients, the sutures used to close the incisions are the main source of tissue irritation. These can often be removed after about three to four weeks if they are causing discomfort, though your surgeon should determine exactly when it is appropriate to remove your stitches. It is also important to pay attention to the clothing and underwear you wear after surgery, as contact or friction with certain fabrics can exacerbate the tenderness of your healing labia. Dr. Koumanis recommends avoiding thongs, rough fabrics, and tight-fitting clothing while you heal.

If you are concerned about your discomfort, you should always feel free to contact your plastic surgeon to discuss your problems. Depending on the nature of your issues, he or she may recommend coming in for an appointment to make sure your recovery is proceeding normally. It is always important to rule out the possibility of infection. There are also topical solutions such as numbing creams which may provide relief if your discomfort is characterized as “unbearable.”

If no infections or other problems develop during healing, discomfort tends to resolve completely within several weeks after surgery and normal skin sensitivity returns. Remember, though, that every person is different and your recovery may take a longer or shorter time than the average patient.

For more answers to questions about labiaplasty surgery and other female intimate procedures, we encourage you to contact our office to schedule a consultation with Dr. Koumanis.

Should I Shave Before My Labiaplasty?

Posted on August 2, 2017 in Frequently Asked Questions

A confused labiaplasty patient sought Dr. Dimitri Koumanis’ advice about whether or not she should shave before her procedure. The pre-operative instructions from her doctor were unclear and she found conflicting information on the internet, which left her in need of a knowledgeable opinion. As a plastic surgeon with extensive experience in labiaplasty, his simple answer to her question was: Yes, please shave.

Dr. Koumanis advises all of his labiaplasty patients to shave their pubic area, inner thighs, and labia majora prior to surgery. He finds that patients shaving a day or so before surgery provides better exposure of the area being operated on and also prevents hair from becoming tied up in the sutures. To remove hair, Dr. Koumanis recommends using an electric razor to avoid creating skin irritation or abrasions, which could potentially lead to infection. While it is always good to minimize risks, he also points out that he has never seen a labiaplasty infection that developed because of shaving.

If you have questions about labiaplasty or other female intimate procedures including new non-invasive ThermiVa vaginal rejuvenation, we encourage you to contact Saratoga Springs Plastic Surgery for a consultation appointment.

Can an OBGYN Perform Labiaplasty?

Posted on July 7, 2017 in Frequently Asked Questions

Recently, board certified plastic surgeon Dimitri Koumanis, MD was asked by a woman in a remote area if she could rely on the skills of any local OBGYN to perform labiaplasty to eliminate physical discomfort. He responded that while it may seem like all OBGYNs and plastic surgeons would be trained and capable of performing this type of surgery, the reality is, labiaplasty is an extremely delicate procedure that requires specialized surgical skill and experience few physicians have.

Dr. Koumanis urges any woman considering labiaplasty to take time researching surgeons, and travel if necessary, to find a doctor with the right qualifications, technical knowledge, and expertise to perform the surgery properly. To help ensure the best results, he suggests looking for a board certified plastic surgeon that specializes in labiaplasty and is a member of the American Society for Aesthetic Plastic Surgery (ASAPS). For labia reduction procedures, he believes the “wedge resection technique” to be the most effective, comfortable, and reliable approach, and he recommends finding a surgeon who is experienced in this labiaplasty method. In contrast to an “edge trim”, the “wedge” approach leaves nearly invisible scars. The wedge type procedure requires skin flap creation and repair which plastic surgeons are best qualified and trained in their residency to perform. Gynecologists typically are not trained to do labiaplasty using a wedge resection.

Dr. Koumanis devotes a large part of his practice to labiaplasty and other female intimate procedures, and he has considerable experience in advanced techniques that deliver consistent, high-quality results. If you have questions about labiaplasty or would like to schedule a consultation with Dr. Koumanis, please contact our practice.