Labiaplasty Under Local Anesthesia

During a labiaplasty, your surgeon will re-shape the labia minora, or inner lips of the vagina.  There are many different reasons that you may be considering a labiaplasty.  For instance, some women have asymmetries that they’d like corrected.  Other women have naturally large labia that they’d like to reduce for aesthetic or other reasons.  For instance, having large labia can cause irritation during some activities (such as riding a bicycle) and can even cause painful intercourse due to chafing or twisting of the labia. Even wearing certain clothing, such as tight jeans or yoga pants, can be off limits for women with larger labia due to discomfort caused by rubbing or pressure of the fabric. And, if you have large or uneven labia, you may feel self-conscious about how you look, and this can take its toll on your sex life.

Fortunately, if you experience any of these problems, there is a surgical solution to having large or uneven labia that allows your highly skilled surgeon to remove excess tissue and reshape the labia to your liking.  This outpatient surgery, called a labiaplasty, can be done relatively quickly and with low risk of complications. This surgery is becoming quite popular, as it is fast, effective, and gives excellent results. And, as more women are shaving or removing hair from their vagina, uneven and misshapen labia are more noticeable and many women are choosing labiaplasty to address their concerns.

While some patients have labiaplasty under general anesthesia, it is possible to have this highly-effective and quick procedure performed under local anesthesia in our state-of-the-art facility at The Plastic Surgery Center of Nashville. Having this procedure performed under local anesthesia has several benefits over using general anesthesia. This blog discusses the procedure, why you might prefer to have it performed without general anesthesia, and what to expect throughout the process.

What happens during a labiaplasty?

During your labiaplasty procedure, one or both of your labia will be trimmed to enhance both their appearance and comfort.  In cases where asymmetry is present, but you are happy with the smaller of the two labia, only one may be trimmed to match the other and restore symmetry to your vagina.  In other cases, women prefer to have both labia reshaped to create smaller, smoother vaginal lips. We understand that this surgery can be a bit uncomfortable due to the area of your body that is treated, but you will find that we will constantly strive to make you feel comfortable and secure throughout the process. Our female plastic surgeons can relate to your concerns and will put you at ease when you come in for your initial consultation.

There are two main approaches to labiaplasty, the trim method and the wedge method, that remove tissue from different parts of the labia.  Using the trim method, your surgeon will remove tissue from the outer edge of the labia to create a smaller size and re-contour the outer edge. Once the desired shape and size are achieved, sutures are placed along this outer edge.  This approach to labiaplasty is popular because it allows your surgeon to create a feminine, smooth edge to the newly-sized labia.

In contrast, the wedge method removes a pie-shaped wedge of tissue from the labia that is somewhat inwards from the outer edge. This allows the natural outer edge of the labia to be preserved, and the sutures are placed inwards from the outer edge. The wedge approach is generally less common than the trim method, as most women prefer to have the outer edge of the labia reshaped and thus opt for the trim method.

Your labiaplasty can be performed under general or local anesthesia, both of which prevent pain during the surgery. Whether you are “put under” or giving a local numbing agent, the labiaplasty itself will be relatively fast. After cleaning, measuring, and marking the area of the labia for trimming, your surgeon will use a blade to skillfully remove excess tissue. Sutures will then be placed and the surgical area will be dressed with a bandage.

What are the benefits to having labiaplasty under local anesthesia?

There are several reasons that you might prefer to have labiaplasty under local anesthesia.  The surgery itself is relatively minor in that it can happen quickly (usually less than half an hour from start to finish), requires small incisions, and the treatment area is localized to one spot. General anesthesia would “put you under” for the duration of the surgery so that you would have no awareness of the procedure. You would awake with the procedure complete and stitches in place, and you would need some time to recover from the anesthesia itself before you could go home.

While you may feel that general anesthesia could save you from some nervousness and pain from your labiaplasty, you may not know that most women can have a comfortable, safe labiaplasty with only local anesthesia. This approach is actually preferable for many reasons.

Perhaps the most obvious benefit to having labiaplasty under local anesthesia is the avoidance of general anesthesia itself.  While general anesthesia is certainly safe and effective, there are some drawbacks associated with its use.  First, the procedure will take much longer under general anesthesia, as there are many additional steps that must be performed to put you under safely and monitor you during anesthesia.  Of course, this increases the cost of the procedure as well. Additional testing prior to your procedure may also be necessary, and not all patients are good candidates for general anesthesia.

You must recover for some time in the surgical center if you’ve had a procedure under general anesthesia, so a labiaplasty that would last less than 45 minutes under local anesthesia could take several hours if general anesthesia is used. Finally, general anesthesia also has some side effects during recovery.  Many patients may experience nausea or feelings of malaise as they recover from the anesthesia.  Also, the risk for complications increases with the use of general anesthesia. While it is certainly possible to perform labiaplasty under general anesthesia (and even preferable in some cases), most women can undergo this minor surgery quite comfortably using local anesthesia, which allows for a faster, easier recovery with fewer side effects and less risk of complications.

Prior to numbing the area with local anesthesia, you may be given a sedative medication that can enhance your ease and comfort during the procedure. The local anesthesia is given in the form of an injection to the treatment area; once the injections are given, sensation is reduced or eliminated in the area.

What if I feel too nervous about having only local anesthesia for my labiaplasty?

It is not uncommon to be nervous about your procedure, even if it is relatively quick and painless.  For some patients, sedation may help reduce your nervousness and put you more at ease for the procedure.  If you choose to have sedation for your labiaplasty, you will be given an IV or oral medication prior to your procedure. This will relax you and reduce your overall tension, as well as any pain that you might experience, but it will not put you to sleep and it does not carry the same side effects, recovery time, and risk of complication as general anesthesia. This is a great option for women who might otherwise prefer general anesthesia but would like to avoid the additional recovery and side effects.

Will labiaplasty under local anesthesia be painful?

Many women express nervousness about discomfort during their labiaplasty. After all, this is a highly sensitive area of the body! Combining local anesthesia with sedation will greatly reduce sensation during the surgery. Though some women describe the initial injections of the local anesthesia as slightly stinging and uncomfortable, most of our patients indicate that were pleasantly surprised to find that it was much less painful than they expected. And, once the local anesthesia has been applied, you will not feel the incisions or the sutures. Our patients are highly satisfied with their results, and they all say that the minor discomfort they experienced during the procedure is well worth it in the end!

Will should I expect during recovery from labiaplasty under local anesthesia?

If you’ve had oral or IV sedation with local anesthesia for your labiaplasty, you may feel groggy for just a bit after the surgery as the sedative wears off, but this will be much less than you would experience after general anesthesia. You will have stitches and a bandage in place, and you will be able to go home on the same day as your procedure. Before the surgery, we will give you specific instructions on how to care for your labia as they heal.  It is important to follow all post-surgical care recommendations in order to minimize post-surgical swelling and complications and maximize your healing and results. For instance, you may need to apply an ointment to the incision sites for the first few days.

In order to enhance your comfort during the first few days following surgery, we will give you prescription pain medication to take. Your stitches will come out on their own within 7 to 10 days after surgery, or they may be removed at your follow up appointment if they are not the absorbable type of sutures. Though you will be able to see changes immediately following the surgery, your final results will be visible in a few weeks, once the swelling subsides and the incisions have healed.

Most patients are able to return to work and gentle daily activities within a week of their surgery. We advise that our patients wait a few weeks before they engage in vigorous exercise or sexual activity to allow the labia adequate time to heal. You will be thrilled with your newly shaped and sized labia, and most of our patients indicate that the labiaplasty greatly enhances their confidence and their intimate activities. In fact, most express delight at what a difference the procedure makes for them!

If you are tired of living with large or uneven labia that make you feel uncomfortable or self-conscious, or even prevent you from comfortably engaging in sex, our female plastic surgeons can help by performing a labiaplasty. This relatively quick surgery can be performed under local anesthesia, allowing you to go home quickly with minimal side-effects.  Find out how we can help you feel happier with the look and function of your vagina. Call 615.467.6777 today to schedule your personalized consultation.