Posts Tagged labiaplasty
Labiaplasty is portrayed by some online as akin to heresy. Jezebel takes a stab at it in a post entitled: Unhappy With Your Gross Vagina? Why Not Try ‘The Barbie’?
It is probably true that some surgeons might have earned some of this sarcasm due to their “polyester clad used car salesman’s pitch” for the operation. I don’t easily fit into the caricature that the author portrays:
Dr. B, by the way, is less of a vulva-hater than some of his colleagues. Consider Dr. A who invented the “Barbie” surgery, which amputates the entire icky labia minora. Why the fuck do women want their vulvas to look like they’re made out of plastic? (A minority of women seek out labiaplasty for non-aesthetic reasons, but most do because they’re embarrassed or ashamed of their “abnormal” lower lips.)
“Vulva hater?” That’s a new one. We have actually discussed Barbie labiaplasty here before. I am not a fan. I don’t like the idea of removing any part of a woman’s anatomy completely without good reason. I do not call any part of a woman’s genitalia “abnormal” or “icky” by the way. And in my patients about half seek the surgery for non-aesthetic reasons. I don’t “sell” the operation and my patients seem pretty happy after having it. Specifically I do not use embarrassment to encourage my patients to have surgery.
One thing to which I have become accustomed since I started offering labiaplasty some ten plus years ago is mischaracterization. There are those who do not believe women should seek this surgery and that it is dangerous. They believe that women should be happy with what they have “down there” and any man who operates for this reason must certainly be a misogynist.
Then again they do not have issue with their privates and other women do. Some women have large enough Labiae to actually hurt in clothing even though by definition they are normal in size. Other women admittedly just don’t like the way they look and if I can figure a way to be of assistance, we have a place to start talking. Sometimes surgery comes out of that. Sometimes it doesn’t.
John Di Saia MD
Stacie Halas is a science teacher in an Oxnard middle school who was put on administrative leave while her bosses looked into the allegations that she was moonlighting as a porn star.
The question was probably put to me in jest, but I couldn’t tell you if I had operated upon her without her permission anyway. Have you ever heard of HIPAA? Patients have their privacy on health care information whether they are accused on moonlighting in the adult industry or not. It is not like most labiaplasty patients volunteer much private information about themselves. Their operations are pretty private in the vast majority of cases anyway.
Another equally important point is that I haven’t seen a single image identifying Ms Halas, so I wouldn’t know if I had operated upon her or not.
John Di Saia MD
Originally posted 2012-03-09 07:30:29.
Clients come to the office frequently anxious about considering surgery of their genitals. Many are understandably worried as the impressions online from those having elective genital surgery vary enormously. Some had had a great experience and others warn of the “dangers.” Not all surgery of the genitals is performed the same way and the results vary with the technique and experience. Then again you can’t expect all operations done “down there” to address the same issues.
As I have written here before, I limit the operations I do in the genitalia to labiaplasty, specifically modification of the outer structures. These are usually reductions. Some are designed to reduce the discomfort of patients with larger lips (usually the Labia minora) and others are for more cosmetic issues like “evenness.” Vaginoplasty refers to operations on the inside of the vagina. These are frequently designed to tighten things internally. Some labiaplasty patients report increased “tightness” after surgery, but this is not usually the case.
My personal opinion is that vaginoplasty operations are higher risk…risk to internal structures and often the nerves. Long standing pain after vaginoplasty is not as uncommon as it is in properly performed labiaplasty surgery. My patients tend to have a pretty good experience.
Be sure if you are to consider an operation of your genitalia, that you review the risk and benefit of your specific operation before you decide to proceed. Realize that not all operations “down there” are the same and each one comes with its own risk/benefit profile. What different surgeons call “Labiaplasty” and “Vaginoplasty” also varies between surgeons. You need to ask an adequate number of questions beforehand to figure if the operation a particular surgeon is offering you might be right for you.
John Di Saia MD
Originally posted 2011-06-28 07:30:56.
I am 16 in Orange County and want a labia reduction. Can I have it without telling my parents?
For those of you who may not know, labiaplasty (sometimes called labioplasty) is an operation to change the shape of the labiae, a woman’s outer genitals. It can be performed for cosmetic or functional concerns. Some women with large labiae experience pain with tighter garments and in rare circumstances they can get in the way of sexual relations. The operations are different things to different surgeons and have been controversial to say the least.
Quite a bit in the practice of surgery of the privates is a matter of the surgeon’s philosophy. This includes the design and scope of the operation as we’ve mentioned. Traditionally for any surgery on a patient under the age of legal consent, a legal guardian (usually a parent) must consent.
Labiaplasty surgery modifies a patient’s private anatomy permanently. Although I take the chance of being criticized here, I would say a parent’s consent for an underage patient strikes me the wrong way. Unless the circumstances are very unusual, I would rather wait for the patient to reach the age of legal consent before making such a decision about permanent modifications to her privates. A mother’s consent to reduce her daughter’s genitalia just doesn’t seem right.
As an aside, this situation has not materialized in my labiaplasty practice and I have been doing them for over 10 years.
John Di Saia MD
Originally posted 2011-04-14 07:30:03.
Women considering going under the knife for a “vagina lift” are being warned that the internet is rife with misinformation and inaccuracies in a new study released this week. In recent years, genital plastic surgery has become increasingly popular among women looking for “vaginal rejuvenation,” “G-spot amplification,” and other procedures that reshape the external lips or labia of the vagina.
But in a paper published online in Obstetrics & Gynaecology, researchers called for guidelines in genital cosmetic surgery to be drawn up after finding major gaps in the breadth, accuracy, and quality of the clinical information provided among the first five British and American websites which popped up on Google for the procedure. Among the most disturbing findings was the absence of setting age limits, authors note. Sixteen is the age of legal consent for surgery.
The labia police are back at it. As I have iterated here more times than perhaps than anyone else has one anywhere else is the fact that plastic surgery on the internet is a carnival of sorts. Surgery of the privates both in the way it is presented and at times performed certainly fits this description.
One of my reasons for writing my humble blog has been to set some of the misinformation plaguing my specialty straight. As a surgeon with significant experience performing labiaplasty surgery, I think I have earned the right to respond to this piece.
I have presented my philosophy of labiaplasty surgery here before many times. I have warned of the heterogeneity of those offering procedures in the privates of women. I have advised that women “stick to the outside” when having these operations (that means labiaplasty on external structures in my book.) I am not a fan of vaginoplasty or the term designer vagina.
Moreover I have encouraged those considering these operations to look carefully into the technique to be used and to choose proper surgical talent. I have also discussed dissenting opinions including a statement from the American College of Obstetricians and Gynecologists (ACOG) in 2007 warning of the dangers of the trending surgery and the relative lack of regulation or even categorization. I did point out that the specific type of the surgery that I perform was the only one that the ACOG committee considered potentially beneficial at the time.
I have poked fun at procedures in the area that I consider laughable…such as the G shot. In other areas of concern to the ACOG and their European equivalents, I am in total agreement:
Clinics offering the procedure also preyed on unnecessary and oftentimes unfounded fears about appearance of female genitals researchers said, reinforcing negative feelings towards the vagina also known as ‘pudendal disgust.’
This is a new term by me. I thought I had heard of everything. Those of you who know me know that I carefully screen my patients and do not talk anyone into anything. I do not deceive to operate. This may be amongst the reasons I am in solo practice but that is another story.
With all this being said, I still defend that surgery in the privates of women can be performed safely. I have done so for over ten years. Reduction labiaplasty utilizing the proper techniques is a safe and satisfying operation when offered to the proper patient. No operation is right for everyone after all.
John Di Saia MD
Female genital cosmetic surgery is a small segment of the U.S. plastic surgery market, but it is growing, with thousands of women estimated to undergo such procedures every year. That growth comes despite a warning from the American College of Obstetricians and Gynecologists (ACOG), in a 2007 notice to member physicians, that strongly questioned the medical validity and safety of female genital cosmetic surgery. Earlier this year the group debated the trend at its annual meeting in San Diego.
“None of these procedures have proven effectiveness, and there is potential for harm,” Dr. Cheryl Iglesia, a Washington, D.C., gynecologist and former ACOG committee member, wrote in an editorial published in the June issue of Obstetrics and Gynecology. “Women are being misled or are confused about what is normal,” she wrote — and about what constitutes a condition that can actually be helped through treatment.
Here we go again. The groin-e-cologists are coming out to bag genital surgery. They have done this before; last year actually.
Dr. Iglesia is not exactly correct however. When ACOG originally published their committee recommendations, they stated: “only labiaplasty, which involves trimming and reshaping part of the external genitalia, is well documented in the scientific literature.” While I agree with Dr. Iglesia about certain aspects of surgery in this very private area, not all female genital surgery is dangerous and/or ineffective. It is certainly the potential patient’s task to carefully select what they will allow in choosing surgery in this very specialized area.
That which I perform works very well and I do not mis-characterize it in any way. The keys are focus, selection and surgical technique.
John Di Saia MD
I want to get the [labiaplasty] surgery because I’m really embarrassed about the way I look… but I’ve read online that some experienced really bad results and ended up having pain for the rest of their lives… due to nerves getting trapped and stuff… how common is this? Do you make sure that no nerves get trapped? Because I believe that sensitivity is more important than the look… and how much do you usually remove? the bare minimum or…? I’m afraid of being embarrassed that I got this operation if I go through with it.
Labiaplasty is a serious consideration. The online reflections of all patients who have had surgery however encompass a multitude of different operations.
It is my belief that the majority of the scary outcomes are the result of inexperience, surgery with too wide a scope or unfortunate situations.
When the surgery is performed with the simple goals of reduction of outer structures within conservative limits using the right techniques, sensory problems are extremely rare. If you are asking though how do you eliminate any risk, the only answer is not have surgery. To limit risk, you need the best hands you can afford and design your surgery conservatively. This has worked very well for my patients.
I put together a YouTube video outlining the key points for the woman considering reduction labiaplasty. Check it out if you wish.
Labiaplasty doesn’t have to be scary and doesn’t have to take sensation away from sensitive body parts. You have to be careful about what exactly you have done and what you expect it to accomplish if you want a successful outcome with surgery.
John Di Saia MD
Originally posted 2011-06-16 07:30:34.
A recent study…shows that male physicians and plastic surgeons are more inclined to recommend surgery to alter the physical appearance of an otherwise healthy vulva. Published in the Journal of Sexual Medicine, the study was conducted in the Netherlands with a set of 210 doctors who were shown photos four healthy vulvas, two pre-labiaplasty and two post, following about six months of healing. These vulvas belonged to two women, one age 35 and the other 40, who underwent cosmetic surgery to shrink the size of their labia minora (aka inner pussy lips) which they felt extended abnormally beyond their labia majora (aka outer pussy lips). 164 of these 210 doctors completed this survey, and most (90 percent) agreed that the smaller labia minora were closer to society’s ideal.
I have written a labiaplasty article for the Journal of Sexual Medicine. I have also served as an article reviewer for articles being considered for publication at the journal. I did not review this article. Even if I had I am not sure I would have recommended it for publication.
Needless to say there are quite a few misconceptions about labiaplasty surgery. Each labiaplasty surgeon has his (or her) own particular philosophy through which he offers the surgery. Mine has not been to judge women’s privates, but rather serve to make them more to the liking of their owners within reason. I am not running some kind of Playboy bikini contest. Local Orange County women do not drop their drawers to ask me whether they “need” their Labia reduced either. When the question is presented in this manner, very few do. Women have their reasons for considering labiaplasty surgery and some of these make pretty good sense.
This study seems to have looked at the impressions of a group of doctors regarding what was more acceptable by current societal standards in the way of the Labia. My contention is that these standards really do not matter. “Normal” labial lip size can still be large enough to cause pain in today’s small string underwear. So normalcy per se has little to do with the consideration of labiaplasty in many cases. In consultation, the patient and I try to figure out what bothers her and what I might do about it. I am not there to label. I am not there to judge. We are there to figure what (if anything) might be improved.
Studies like this one just muddy the waters and they are already pretty muddy. It is all a matter of philosophy anyway.
John Di Saia MD
I did labioplasty after I saw some ads that suggested that big labia were abnormal. Before that I had no physical discomfort or insecurities. But after I heard about labioplasty I got extremely ashamed of myself. Now that I have done it I look mutilated and after 7 months I still have agonizing pain and sex is impossible.
To what extent do we have to butcher our normal bodies to catch up with the media created “ideals”?
What can you say to a comment like this?
First of all, although I feel for your situation, patients really need to educate themselves before having this type of surgery and choose good surgical talent. I am not sure you did this. This surgery has many variants so what exactly you had done is unknown to me as you are not my patient. Some operations are obviously better than others.
I do not recommend people have surgery based upon advertisements alone and my practice does not advertise for this type of work. I never suggest that a woman’s Labiae are “abnormal” or “need surgery.” This is a matter of philosophy.
My labiaplasty patients do not have the experience (or the complications) you describe. They are examined periodically until they are healed and back to sexual activity. They report they look and feel better. Not one of them to date has desired to go back (even if she could) to her pre-operated condition. Long term pain is extremely unusual when the operation is properly performed by modern techniques.
It seems very likely that you had the wrong operation by the wrong surgeon. Better research by others will help them avoid your unfortunate mistake. I do hope you are able to have your result improved to your satisfaction.
John Di Saia MD
Originally posted 2010-02-22 17:00:19.
As my Labiaplasty YouTube video in which I describe Wedge versus Trim method surgery (Pros and Cons) was getting hits and likes lately, I decided to update it. The initial intro segment of yours truly was originally shot with an older video camera so I fixed it up.
The narration while I give the Powerpoint portion of the video is sadly not fixed up much. I might get to it later depending upon time.
John Di Saia MD