Labiaplasty.

I guess due to my specialisation in vaginal surgery and long standing obstetric service to the Hunter Valley I probably do the most Labiaplasty in the area.

It’s a sort of ‘don’t go there’ subject which of course means I feel we have to pull back the curtain a little on it.

The procedure itself can be painful afterwards and tricky to perform due to the amount of blood vessels in the area and the “art” required to pull it off.

However there is no doubting the satisfaction it brings to many women. - which surprised me. But can I get a google review about it? Nope.

It’s important to be reassuring to women about the wide array of normal anatomy and the authorities provide a book showing photos which I can offer to patients. I think the balance seems about right as in every case I have ever operated on I have agreed that there was either a very significant functional or cosmetic issue. These manifest in playing sport - especially cycling and running – confidence wearing swim wear and birth injuries which have not healed well.

Medicare used to provide support for the procedure but it was suddenly made ‘special request’ about 15 years ago. I made several of these requests which were ignored and then it went away completely. Politicians travel expenses you see? Priorities…..

I’m always surprised to see women go to plastic surgeons for these because they don’t go near any vaginas in their training. I did see an interesting talk once by a Californian “cosmetic” (means a GP) MD which was interesting. It started with a good crowd which soon whittled down as the demands of the procedure became apparent and it wasn’t the soft touch folks were hoping for. Due to the high costs of theatre time in the USA he would perform the surgery in his clinic after the patient had worn a tight pair of undies for 2 days prior filled with ELMA cream which is a local anaesthetic for skin. That and a green whistle puffer for breakthrough pain seemed to get folks through.

I’m pleased to say in Australia we prefer to do things in a sterile operating theatre under a proper anaesthetic with good lightening and a team of professionals ensuring excellent outcomes!