Labiaplasty

This procedure focuses on reducing the size or shape of the inner lips (labia minora), as well as the removal of dark skin tone tissues. These are the cause of discomfort for many women for reasons related to physical sensation in the area, psychological reasons such as lack of self-confidence, or sexual performance if a woman dislikes the appearance her vaginal lips.

This procedure aims to reduce the size and look of the exterior vaginal lips by removing the excess fat and tightening or lifting relaxed skin there.

Dr Novikova performs labiaplasty procedures under local anaesthesia in the procedure room in Cape Town or Johannesburg. You will be instructed to apply a special anaesthetic cream to numb the skin over the area and take a tablet that will allow you to relax before the procedure. She will inject a local anaesthetic into the area to remove any discomfort during the procedure.

Labiaplasty can be done in many different ways. Common types of procedure are trim or curvilinear technique (or trim technique or “barbie” labiaplasty), V- labiaplasty or central wedge resection and de-epithelization techniques.

Trim or curvilinear labiaplasty is when the edges of the labia minora are removed. This technique reduces the size of the labia minora. Because the end of the labia minora is excised, the area loses its natural look. Women who choose the trim technique usually desire to have the darkened skin of labia minora to be removed. The lips will look pink with this technique.

V-wedge labiaplasty is done when the V-shape area is cut off in the middle of the lips, and they are re-shaped with sutures. Although the edges have a natural look, as they are not cut off, there will be a tiny scar in the middle of the area which is not visible once you heal.
It’s common for the clitoris to look bigger once the lips are reduced in size because of its proportional size. In such cases (which is 90% of labiaplasties in this practice) Dr Novikova will perform the clitoral hood reduction at the time of labiaplasty.

At times, women choose to remove excess skin of the labia major  (or outer lips) or have fat-filling or hyaluronic acid fillers injected into the outer lips to improve the look. All of these procedures can be performed at the time of the labiaplasty.

Dr Novikova uses a diathermy or laser beam to perform the labiaplasty. She will use dissolvable sutures during labiaplasty that are hidden under the skin and choose the technique of labiaplasty based on the patient’s preference and the final look they desire. Your anatomy and expectations are discussed in detail and you will study before and after photos of Dr Novikova’s cases to decide on your preferred technique of labiaplasty.

Dr Novikova will send you a prescription to collect from your usual pharmacy. Bring all the medications to the hospital with you.
Check-in with the receptionist and she will show you to your bed. You can have a friend or relative accompany you. You will meet one of the nurses who will show you around the ward. You may not see Dr Novikova immediately as she will be operating. Directions will be communicated to the nursing staff as to when you need to take your oral pre-med and apply the anaesthetic cream.

Your operation will take place in an operating theatre. You will lie on an operating bed with your knees in stirrups and will be made comfy and warm by the theatre nurses. Dr Novikova will inject a local anaesthetic so that you do not feel discomfort whilst she performs the surgery. You may experience a burning sensation during the injection. At the end of the surgery an ice pack will be applied to the area of surgery to help minimise swelling, and you will be taken back to the ward in your bed. You will be required to leave the ice pack in place whilst in hospital – it will be beneficial to your recovery and healing process if you apply an ice pack overnight whilst at home for the first night.

You will have a short stay in the clinic until you feel up to going home, you can expect to feel sleepy and you will rest in bed until the pre-med has worn off. You are unlikely to feel any pain at this stage as local anaesthetic injected into the area of surgery only wears off in about 8 hours or longer. It’s normal to have a small amount of bleeding for a few days.

Use your ice pack to help with swelling. We advise you to use a thin pad on your underwear. Apply an ice pack and another underwear so the ice pack sits in between. Ice pack is very helpful in the first 48 hours after the surgery. We advise it to use it at all times. It decreases / prevents swelling / bruising / bleeding and helps with pain.

Please note the area of the procedure will look swollen and bruised, you may see some fluid in the wound area. It is normal and part of healing. Your final cosmetic result is in 3 months following surgery. Wear loose-fitting clothes and cotton underwear.

You will need to keep the area clean. If passing urine stings, you can pour clean water over your vagina whilst urinating. Do not rub the delicate healing tissue, do not stretch it. It is important to keep the area clean and dry.

Do not apply any creams, soaps or detergents. In the first week after surgery, you may use salt water (put a spoon of salt into a sports bottle) or Normal Saline solution to wash the genital area after you pass urine or have bowel motion. It is important that you don’t become constipated especially as you won’t be as active as usual and take pain medications. You can take recommended over-the-counter medication if required.

It is normal to have bruising, swelling and minor oozing from the wounds in the first week or two. If you have any concerns or questions, please contact Dr Novikova.

The sutures used are dissolvable and should take 6 weeks to dissolve. You should avoid strenuous exercise for 4 weeks and sexual intercourse for 6 weeks. Dr Novikova usually sees her patients postoperatively two weeks and six weeks after your operation for a check-up.

The procedure takes one to two hours and once the anaesthetic wears off, usually one hour after the operation, you can go home.

Dr Novikova has performed many labiaplasties and is skilled in various techniques of the labiaplasty procedure. She has participated in workshops and meetings on aesthetic gynaecology and is certified by the European Society of Aesthetic Gynaecology. She is a pelvic surgeon and endoscopic (minimally invasive) surgeon with many years of experience in the field. Each labiaplasty is different, as no one has the same anatomy and she adjusts her technique based on the patient’s desires, concerns and anatomy. She will share before and after photographs during the consultation. Dr Novikova’s team, which includes a practice nurse, scrub nurse and herself, are always available to answer your questions and provide pre-procedure and post-procedure support to make the recovery as easy as possible.

Please read here for more information on labiaplasty.