Dr Luísa Magalhães Ramos on TV
About Hypertrophy
Vaginal lips
Hypertrophy of the vaginal lips is the abnormal growth of the labia minora. Although it is not considered a health problem, is a condition that can limit quality of life, interfere with self-esteem and affect a couple's intimate life. Women who suffer from this condition usually feel uncomfortable and embarrassed, as the volume in this area can be visible when wearing tighter, uncovered clothes.
Although most changes in the female genital area are related to the natural ageing process, they can also be associated with genetic issues, hormonal changes, pregnancy, medication, obesity and some diseases such as diabetes.
Hypertrophy of the labia minora can be unilateral or bilateral and gives rise to complaints such as local irritation due to friction, repeated vulvovaginal infections, uncomfortable and pain during sport and sexual activity or when wearing tight clothing.
What is Labioplasty/ Nymphoplasty?
Labioplasty is a surgical procedure that reduces and remodels the vaginal lips when they are too large, flaccid, irregular or asymmetrical. In other words, this surgery, also known as nymphoplasty or labia reduction surgery, removes excess skin from the labia and clitoral hood, whenever necessary.
It's a simple surgery that lasts approximately one hour and is performed under light sedation and local anaesthesia. The stitches are spontaneously absorbed by the body and the outer stitches fall out spontaneously. As the area is hidden by the labia majora, there are no apparent scars. Some discomfort and oedema are to be expected in the post-operative period, so it is recommended that you rest in the immediate post-operative period and follow all the recommendations given to you by your plastic surgeon.
Diagnosis
The diagnosis of vaginal labia hypertrophy is usually made by observation and symptoms. Vaginal lips come in different sizes and shapes and there is no defined size that establishes an indication for surgery. Labioplasty is indicated as soon as the size of the labia causes discomfort and interferes with the woman's quality of life and self-esteem.
Characteristics of the candidates
ideal for labioplasty
Ideal candidates for labia minora reduction surgery usually have the following characteristics:
- Excessively large labia minora;
- Asymmetry and/or irregularity of the labia minora;
- Excess skin on the clitoral hood;
- Patients without possible adjacent (uncontrolled) causes of labia minora growth (e.g. hormonal problems, medication, and some health problems);
- Discomfort during sexual intercourse and physical activity;
- Low self-esteem;
- Healthy;
- Non-smokers;
- Emotionally mature;
- Realistic expectations.
What results can I expect
after labioplasty?
The results of vaginal labia reduction surgery are satisfactory and long-lasting. Improving the appearance of the genital region contributes to an increase in confidence and self-esteem. Some of the benefits of labioplasty include:
- Improving the appearance of the genital area;
- More confidence and self-esteem;
- Improving the couple's intimate life;
- Greater comfort on a daily basis and during physical activity;
- Greater freedom to wear tighter, uncovered clothes.
Click here to download the Before and After Labioplasty Cases
Surgery Procedure
Intimate Surgery
Diagnosis
The first step of your labioplasty consultation, é a medical assessment of the genital area, physical complaints, general state of health and lifestyle;
Surgical plan
According to the medical diagnosis, a surgical treatment plan is drawn up which aims to improve the appearance of the sexual organ and eliminate the associated discomfort;
Detailed explanation
During your labioplasty consultation, a personalised treatment plan will be presented and the risks of surgery, pre- and post-operative care and the results you can expect will be explained;
Budget
After the medical consultation, you will be given an exact quote for labioplasty. The cost of the surgery depends on the diagnosis and complexity of the procedure.
Type of Anaesthesia
Vaginal labia reduction is a relatively simple procedure, usually carried out under light sedation and local anaesthetic. However, the type of anaesthetic can vary according to the complexity of the procedure. The anaesthetist will be present throughout the procedure for the patient's comfort and safety. The patient can usually return home the same day after a few hours.
Type of Incision - Scar
One of the issues that most concerns patients is the appearance of the scar. Labioplasty scars are practically unnoticeable because they are “hidden” inside the vaginal lips. The protruding labia is excised in a “V” shape and the upper and lower edges are sutured together, creating a small, transverse suture line. The sutures are made using absorbable thread, which falls out spontaneously a few days after surgery. After around 30 days, the area will have healed.
Labioplasty surgery
step-by-step
Sedation
Light sedation is administered intravenously by the anaesthetist who will be present throughout the surgery;
Local anaesthesia
The local anaesthetic is injected into the area to be treated;
Bookings
Markings are made on the skin to be removed;
Disinfection
The area to be treated is cleaned and disinfected to prevent infection. Operating drapes are placed to isolate the genital area from the external environment;
Intervention
Excess skin is removed from the labia minora and the clitoral hood, if necessary. Before the stitches are made, the symmetry of the labia is checked;
Closing the incisions
The incisions are closed with small stitches that are absorbed by the body / others fall out spontaneously over the course of a few days. There is no need to remove them;
Recovery
The patient is sent to recovery where she remains under observation. The patient is expected to be discharged a few hours after surgery.
Preparation for Labioplasty
Before the surgery:
- Do not take anti-inflammatories or aspirin in the 10 days before surgery;
- Do not take slimming medication for one month before surgery;
- From midnight on the day before the operation, you must be absolutely fasting (no water);
- Shave the entire genital area;
- Do not smoke in the month before surgery or after surgery, while healing is taking place. Smokers have a higher risk of complications, particularly difficulties with healing and tissue oxygenation;
- Read the documentation provided before the surgery carefully, as doubts may arise;
- If you fall ill or feel unwell in the days leading up to the surgery, you should inform the medical team immediately;
- All social and professional activities should be scheduled to ensure complete rest in the two days following surgery;
- Do you have any questions about labioplasty, pre- or post-surgery? Don't wait until the last day and ask all your questions in advance.
On the day of surgery:
- Be absolutely fasting (from midnight the day before surgery);
- Shower with disinfectant gel the day before and the day of surgery to avoid infection;
- One hour before surgery, apply a thick layer of prescribed anaesthetic cream to the labia minora;
- Be clean shaven in the genital area, preferably a few days before the surgery to avoid sensitivity in the area to be treated;
- Take loose, comfortable clothes to wear when you are discharged;
- She should not go home alone or drive. She should be accompanied for the first 24/48 hours in case she needs assistance;
- You should plan your social and professional life in such a way as to guarantee rest in the two to three days following surgery.
Recovery and post-operative care:
- There may be pain and discomfort in the first few days;
- The recovery period depends on the individual, but on average it takes 2-3 days to return to work (non-strenuous activities);
- Take all medication as advised by the medical team;
- Wash the area with Betadine Gynaecological Foam;
- Avoid any kind of exertion for the first 8 days;
- Rest for the first few days and gradually return to your routine;
- Do not expose yourself to the sun;
- No smoking;
- Apply ice, with constant renewal in the first 72 hours after the operation, which is very important to avoid excessive oedema;
Benefits Labioplasty
The results of vaginal labia reduction surgery are satisfactory and long-lasting. Improving the appearance of the genital region contributes to an increase in confidence and self-esteem. Some of the benefits of labioplasty include:
- Improving the appearance of the genital area;
- More confidence and self-esteem;
- Improving the couple's intimate life;
- Greater comfort on a daily basis and during physical activity;
- Greater freedom to wear tighter, uncovered clothes.
Medical Specialists
About
Dr Luísa Magalhães Ramos / Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 42810, specialising in Reconstructive and Aesthetic Plastic Surgery.
Graduated from the Faculty of Medicine of the University of Porto, specialising in Plastic, Reconstructive and Aesthetic Surgery, He specialised in University Hospital Centre Lisboa Central - St Joseph's Hospital.
Throughout his training, he sub-specialised in the area of Aesthetic Plastic Surgery, He has worked in world-renowned centres. At the same time, he also worked on breast reconstruction and the reconstruction of facial malformations.
He is currently working mainly on Aesthetic Plastic Surgery of the Face (eyelids, nose and cervical-facial lift), Breast Surgery and Female Genital Surgery.
About
Dr Alice Varanda Pereira / Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 47051, specialist in Reconstructive and Aesthetic Plastic Surgery and Subspecialist in Aesthetic and Cosmetic Medicine.
Licensed by Lisbon Medical School, It was at this institution that she took her Master's degree in Human Sexuality and is currently working on her PhD.
She has been a member of the faculty's teaching staff since 2008, as Assistant Professor at the Institute of Anatomy. It is in this unit that she produces most of her research projects, essentially in the area of surgical anatomy, and she is also the supervisor of master's theses.
About
Dr Mariana da Rocha Martins/ Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 55124, specialising in Reconstructive and Aesthetic Plastic Surgery.
He graduated from Abel Salazar Institute of Biomedical Sciences at the University of Porto and completed his speciality in Plastic, Reconstructive and Aesthetic Surgery at the University Hospital Centre Lisboa Central - St Joseph's Hospital.
During his specific training in Plastic Surgery, he worked at internationally renowned institutions such as the Kaplan Institute (Barcelona), in La Clinic (Montreux) and Great Ormond Street Hospital (London).
Frequently Asked Questions about
Intimate Surgery - Labioplasty / Nymphoplasty
Is labioplasty a safe surgery?
Yes, labioplasty is a relatively low-complexity operation and is also very safe, provided it is carried out in an accredited clinic and by a reconstructive and aesthetic plastic surgeon who is registered with the Portuguese Medical Association and has many years' experience in performing female intimate surgery.
What is the price of labioplasty at your clinic (in Lisbon or Porto)?
The price of vaginal labia reduction surgery, whether carried out in Lisbon or Porto, depends on the degree of complexity and the combination of procedures. Often, labia reduction is combined with other intimate surgeries such as reduction of the clitoral hood, liposuction of the mount of Venus, augmentation of the labia majora with fat grafting or hyaluronic acid to improve sagging and colporraphy (“tightening” of the vagina). The exact price of labioplasty is confirmed after a medical consultation to diagnose and identify the problem to be treated.
At what age does hypertrophy of the vaginal lips usually appear?
Although most changes in the female genital region are related to advancing age, there are other factors that can contribute to the enlargement of the vaginal lips at any age: hormonal changes, pregnancy, diabetes, obesity, some medications and the use of anabolic steroids.
From what age can a labioplasty be performed?
Labioplasty can be performed whenever there is an indication for surgery, regardless of the patient's age. The surgery is often carried out on more mature women for aesthetic reasons and also to correct the changes that have occurred during pregnancy. It is also performed on very young patients because hypertrophy of the vaginal lips can prove to be a very embarrassing condition and even affect the quality of life.
Will the scars disappear?
Every surgical procedure leaves scars and labioplasty is no exception. However, because the labia minora are not exposed, the scars are hidden and unnoticeable.
How painful is the recovery?
Recovery from a labioplasty takes around 2 to 3 days to return to effortless activities. There may be discomfort and moderate pain in the first few days, but recovery is usually not very painful. Taking the prescribed painkillers will ease the associated discomfort and make the recovery more comfortable.
When can I resume physical activity and sexual activity?
Initial recovery is relatively quick, but in order to achieve good healing there should be no sexual activity or physical exercise for around four weeks. Failure to comply with these indications could result in the surgical wounds opening up again, possibly requiring suturing and jeopardising the final result.
Can surgery cause loss of sensation?
Most changes in sensitivity after labioplasty are transient and are due to post-operative oedema. Reduction of the labia minora is a very superficial surgery in which only excess skin is removed, so it doesn't interfere with the nerve endings in the clitoral region.
Are there alternative, non-surgical procedures for reducing the size of the vaginal lips?
Labioplasty consists of reducing the size of the labia minora by cutting away excess skin. The only ways available to eliminate excess skin is through excision with a scalpel or laser.
Are the results visible immediately after surgery?
Immediately after labioplasty, some oedema can be expected, which can distort the result. As the oedema subsides, the result becomes visible. This usually happens after the first week. The final result is usually expected after 6 to 12 months.
Can the vaginal lips grow back after surgery?
The results of labioplasty are long-lasting and permanent if there are no adjacent untreated causes. On the other hand, if after surgery the patient has significant weight fluctuations, suffers from hormonal problems, certain illnesses, pregnancies or takes anabolic steroids, the results of the surgery may be compromised.
What are the risks and complications of surgery?
Any surgery can have risks that stem from the anaesthetic and the surgical technique. The most common risks of labia reduction surgery are: reaction to anaesthesia, infection, haematoma, prolonged oedema, changes in skin sensitivity, irregularities, asymmetry, delayed or unsightly healing. The possible risks and complications of labioplasty will be explained in detail during your medical consultation.
