Frequently Asked Questions

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.

Should I Choose to Have a Labiaplasty?

Posted on June 20, 2016 in Frequently Asked Questions

Cosmetic surgery is a personal choice, and patients often have a diverse array of reasons for why they select a certain operation. Vaginal rejuvenation is no different. Labiaplasty can be performed to address aesthetic concerns, functional concerns, or a combination of the two. Our board-certified plastic surgeon, Dr. Dimitri Koumanis, emphasizes that there may be more factors involved in this decision than many people at first realize. In response to the question “Should I choose to have a labiaplasty?”, Dr. Koumanis says:

“Some women just don’t like the appearance of their prominent labia. Others are bothered by chafing, traction, and irritation with intercourse, or when wearing tight clothing. Exercising can put pressure on the groin, particularly activities like bike riding or spinning. Still, others complain of hygiene problems such as a diverted spray when urinating or difficulty ‘keeping clean.’ Other women have combination issues and concerns.

“It’s important to know, help is available to provide you with reduced labia size, improved symmetry, and a relief of symptoms caused by prominent labia minora. Speak to a plastic surgeon who is an expert in labiaplasty for the best results! Be sure to see his patients’ before and after photos to be sure you like the results you see before committing!”

No woman should have to feel uncomfortable or self-conscious as a result of her intimate anatomy. If you would like to discuss your concerns, our skilled medical team can explain all your options and help you to make a well-informed decision. If you choose to have a labiaplasty, your procedure is done right at our Joint Commission accredited office surgery facility with our dedicated team for your convenience, comfort, privacy and cost savings over the hospital setting.

Is It Possible to Have Excessively Loose Vaginal Skin?

Posted on May 15, 2016 in Frequently Asked Questions

A common concern among many women, what constitutes “normal” in regard to vaginal appearance and labial tissue length is an open-ended question with many answers. Aesthetic preferences can vary dramatically from person to person. However, if you experience physical or emotional discomfort as a result of the way your feminine anatomy is shaped, our board-certified plastic surgeon may be able to help. Dr. Dimitri Koumanis has several years of experience performing labiaplasty, and he will thoughtfully and honestly address your questions and concerns during your initial consultation.

A patient recently posed a question to Dr. Koumanis, asking whether it was possible to have excessively loose skin in this area. She indicated that she felt her vagina didn’t look normal. In his response, he explained that most every woman’s labia minora are “normal” and there are seemingly limitless anatomical variations in shape, size, and symmetry—just like with noses. He adds that most variations in labial shape and size are normal, and they function normally. However, Dr. Koumanis notes that women often desire labiaplasty to reduce their labia minora to modify the appearance to suit their needs. Functional issues can be a concern that many women have—but it’s not the only one. Just like nose reshaping, Dr. Koumanis says labiaplasty is most often requested for cosmetic reasons.

Your beauty preferences are likely different from someone else’s. This is why Dr. Koumanis will take the time to listen attentively to what your cosmetic goals are. With this information, he will then develop a customized treatment plan that can optimize your result and help you feel more confident about your body.

Should I Remove My Labiaplasty Sutures?

Posted on April 21, 2016 in Frequently Asked Questions

Recovery following a procedure like labiaplasty can lead to a variety of questions. Many patients wonder what is considered normal in regards to healing. To help prepare you for the recovery process, Dr. Dimitri Koumanis provides post-operative care instructions to ensure you heal properly. He also encourages you to ask any questions you may have so he can help you understand what to expect. Among the many concerns with which he has helped patients, Dr. Koumanis recently responded to a woman who was asking a question in the online medical forum RealSelf. The individual posted, “I see a suture two weeks after labiaplasty. Should I remove it myself?”

In his response, Dr. Koumanis revealed that despite the kind of labiaplasty performed, the sutures are usually absorbable (dissolve on their own) and must remain for the first month or two to provide support. He explained that the patient’s surgeon should provide her with follow-up care and can assist her with suture removal when it is appropriate.

He went on to say that wedge resection labiaplasty sutures dissolve slowly and are mostly internal. Dr. Koumanis warned the woman that she is stronger than the healing wound at two weeks postop – if she were to remove the sutures, she could accidentally tear the wound open. That is why Dr. Koumanis insisted the woman see her plastic surgeon for advice and treatment, and  added “please don’t remove your own sutures, especially after only two weeks!”

For patients at Saratoga Springs Plastic Surgery, Dr. Koumanis personally removes labiaplasty sutures if they have not dissolved by four to six weeks postop.

Will My Partner Be Able to See My Scar?

Posted on March 14, 2016 in Frequently Asked Questions

Every patient’s recovery from labiaplasty will vary to some degree. When you seek a board-certified plastic surgeon like Dr. Dimitri Koumanis, who has extensive experience performing labiaplasty, you can be confident you are receiving the highest quality of care, setting you up for the smoothest recovery possible. He utilizes a calculated approach to the procedure, helping patients avoid scars that are noticeable to their partner.

Dr. Koumanis prefers the wedge-type labiaplasty, as this makes resulting scars virtually undetectable. Wedge labiaplasty involves more work and meticulous technique, using magnification to close the wounds. After about six months, you should be approximately 90% healed. Swelling and bruising resolve over the first month or two. By six to eight weeks after, you and your partner should not be able to notice the scars, as long as they are appropriately and properly placed and positioned in hidden areas by a plastic surgeon trained and experienced in wedge resection type labiaplasty.

If you undergo the “edge-trim” labiaplasty technique (which Dr. Koumanis usually discourages), however, it is much more likely that your scars will be visible. The edge trim type of labiaplasty is easier to do since it simply involves amputation of the prominent labia minora (inner lips). The edge-trim labiaplasty can also lead to a painful scar located along the labial edge with excessive vaginal dryness and, and it is easy to remove too much skin creating an “operated-upon” look. Therefore, edge-trim labiaplasty is to be avoided in most cases. When you attend your labiaplasty consultation, be sure to discuss both the wedge and edge-trim labiaplasty techniques with your plastic surgeon. For most of his patients, Dr. Koumanis recommends wedge-type labiaplasty to avoid prominent scars and the most natural appearance. Plus, clitoral hood skin reduction can be done at the same time with a second “V” or wedge skin resection to give you a natural balance. Asymmetry can also be corrected, if one side has more skin than the other. All labiaplasty options will be discussed and all of your questions will be answered as he educates you at your personalized consultation visit. Dr. Koumanis believes strongly that your initial operation is your one best chance to get the best labiaplasty result. So we encourage you to call us and see him in consultation before you have labiaplasty elsewhere!

When Can I Return to My Daily Routine After Labiaplasty?

Posted on February 15, 2016 in Frequently Asked Questions

As with any surgery, patients are often concerned with how long the recovery will be following labiaplasty. This, among many other frequently asked questions, is thoroughly answered during the consultation with Dr. Dimitri Koumanis. Aside from helping his patients at Saratoga Springs Plastic Surgery, Dr. Koumanis also answers women’s questions about labiaplasty on the online medical education forum RealSelf.

One patient asked: “What is the healing process after labiaplasty? When can I resume my normal activities such as sports and having sex?” Dr. Koumanis was pleased to clear up any confusion from mixed information received from other plastic surgeons she had seen by replying with this explanation.

Dr. Koumanis stated that since the skin in the labia region is very delicate, it takes 2 to 3 months (typically 8 to 10 weeks) before he allows his patients to resume any activity that puts pressure, or causes friction or traction, on the skin of the perineal region or vulva. It takes this long for collagen to mature in the labiaplasty wound to be strong enough to not tear from resuming regular activities.

For safety, Dr. Koumanis clarified that the woman should avoid wearing thongs, having intercourse, using tampons, or placing anything else inside the vagina for the first 2 to 3 months after labiaplasty. He also strongly recommended avoiding strenuous sports – especially those that place pressure on the groin region such as bike riding or spin classes – during that time to allow for proper healing.

If other surgeons allow their patients to resume those activities earlier, they have ignored the fact that it take several months for healing wounds to become strong enough to resist tearing. “When it comes to wound healing, you can’t speed up mother nature!”

For a detailed consultation including an individualized description of what you can expect during labiaplasty recovery, please contact us to set up a consultation with Dr. Koumanis.