Life After Labiaplasty: What to Expect

Monique Ramsey (00:04):
What is life really like after a labiaplasty? How do women feel about their results and what's the emotional journey during recovery? Those are things that we're going to talk to Dr. Diana Breister today about. She's a board certified plastic surgeon and she's here with me to get into all the questions that you might've read about or heard, or you see things online, but maybe you don't really know what is that road to recovery and healing and kind of the mental, physical, emotional balance of all that. So we're welcoming you back, Dr. Briester.

Dr. Breister (00:41):
Good morning. Glad to be back.

Monique Ramsey (00:43):
Okay, so what are some things that patients have said to you about their results and how a labiaplasty has changed their life?

Dr. Breister (00:52):
I think the greatest thing that I see is just this overall sense of well-being and confidence amongst other things, just wearing clothes, having intimacy. It's like a relief. It's like there is this burden that has been kind of almost lifted off their shoulders. They come into the office lighter. They just feel like, wow, I can just feel it, I can sense it from them. So I don't know if that's really answering your question, but I think life after labiaplasty, at least what I see is kind of a renewed sense of confidence and something that they're just pleased that they did it and they can go on with their life and that's not something that has to be worried about anymore.

Monique Ramsey (01:39):
Now is the recovery for women who are having labiaplasty, is it something for them that is a lot to take on psychologically or mentally, or do they need to prepare at all for something afterwards?

Dr. Breister (01:51):
I think the process goes like this. I think a woman may dislike her labia, and so they live like that for a couple of years. Then something happens where they figure out that hey wait, there's a procedure that could help this. And a lot of people don't know about it. They don't even know what it is. It's getting more and more popular. So then it becomes like, oh wow, there's something that maybe I could do about it. So I think there's a phase of that, of thinking about that mentally. Is that something I'd want to do? So then maybe there's a little bit of a research stage or whatnot of thinking about, so phases can last years. Then they start the process of maybe looking for a doctor, and I think that process in and of itself takes a little bit of time. They naturally seek out a doctor that they're going to feel comfortable with.

(02:42):
Obviously it's very sensitive area. It's not something that they're excited to come be examined for. So I think then once the doctor is found, the appointment is booked. All of these are huge steps, huge steps, and so they are of emotionally preparing themselves through this whole transitionary stage. So yes, there is a lot of psychological preparation that is kind of ongoing for that whole process. And like I said, I think it starts years prior to them getting to the office. Most of the time, by the time they've come to the office, they're like, oh yeah, I've been thinking about this for years. They've gone through and it's taken them a lot of time to get to that point. But once they get there, I think they've done a lot of the thinking and then it's exciting for them to meet a doctor that they feel safe with, they feel reassured with and they feel confident with. And so that's ultimately the greatest step is that, okay, feeling good. This doctor knows what she's doing. She's going to take good care of me. I feel safe. So it's a long process, but well worth it.

Monique Ramsey (03:49):
And I would think that it's almost like a weight being lifted off your shoulders after the surgery. It's like you had all that mental preparation that it's just like, ugh, I can breathe.

Dr. Breister (04:00):
That's exactly, and trust me, it's a palpable feeling. Maybe not on the first post-op visit, they have a little bit of pain, but after that you can just feel they have a bounce in their step that wasn't there before and you can just tell that they are just transformed, honestly, really, really transformed.

Monique Ramsey (04:21):
Now, I know in some surgeries there's sort of that emotional up and down rollercoaster day one, why did I do this? Day three, whatever, your body's going through healing and then your brain is doing stuff too. Is that the same with labiaplasty?

Dr. Breister (04:36):
I think with that surgery, there are those.The good thing about the labiaplasty is that it heals very relatively quickly. So once they've gone through it, I do a very good job of prepping them for what to expect in those first 48 to 72 hours. I'm very strict about them not doing much for three days in a row and icing it literally as much as they humanly can, because it's so critical in helping those tissues heal and prevent swelling. So I warn them and prep them, things are going to be swollen, they're going to be bruised. Just try not to look. When I think they're prepped for that, they know what to expect. And after about three days, four days, things are settling down and I think they can see the potential of what the result's going to be, immediately they're thrilled because they're like, oh my gosh, swelling. But I'm still so happy because it's such a change already. So the emotional highs and lows do exist, but not to the extent of other procedures that take longer times to see results.

Monique Ramsey (05:43):
Now, how do you advise them to communicate with their partner about activity restrictions or recovery needs?

Dr. Breister (05:51):
You really just should be lying on a couch for three days and putting ice on the area. That's really all you should be doing. You can get up, go to the bathroom, you can get up, make yourself some food, check some mail. Then you need to be back down. So you don't really need the help of a partner, just they need to be obviously supported, have ice packs ready for you, that sort of thing. They just need to know that it's going to be about four weeks before intimacy can occur again. Usually by the partners, they understand. Once that time comes, there's a few little things that you just want to be aware of that the first couple of times of being intimate might be a little uncomfortable. So I'm always saying recommend they use some lubrication because that's extremely helpful. And the partners that my patients have told me about are very, very sympathetic and it doesn't seem to be an issue at all.

Monique Ramsey (06:40):
Thinking about the day of surgery, how long are they under anesthesia and what kind of pain, do they have a lot of pain when they wake up? Is it a little, what do they say, spicy?

Dr. Breister (06:53):
So number one, before we do any kind of cutting, we inject the areas with a local anesthetic that lasts about 12 hours, so that's very good. The surgery itself usually takes anywhere from an hour to an hour and a half, so it's a very quick procedure. Once you wake up from surgery, the area is pretty numb from that local anesthetic. Once you start icing, as we all know, ice is a fabulous numbing device. It's really not too bad. I would say it's one of the best tolerated procedures. Many women don't even end up taking a narcotic pain pill. They'll take some Tylenol. It's not as painful as one might envision or think. Obviously it's a little uncomfortable and that sort of thing, it's a little swollen, a little uncomfortable, but the excruciating pain that can come with other procedures, none of that.

Monique Ramsey (07:49):
Since they'll have had anesthesia, they need a ride home, right? And somebody to be with.

Dr. Breister (07:54):
Yes, they do need a ride home for sure.

Monique Ramsey (07:57):
You're not jumping me in the Uber and going home. You have to have a real driver.

Dr. Breister (08:01):
No, we don't like to do that. Yeah, it's really important that yes, you get a ride home, you take those three days very seriously, because that's when if something could happen, that's when it's going to happen is in those first couple days. that little something is usually bleeding because our body bleeds to heal. And if a woman is doing too much, if standing up, gravity is not our friend in healing, okay, swelling goes to the area, more blood goes to the area. So if they're walking around too much trying to make food, take care of kids in that first day, no, that can lead to a disaster and that disaster can be bleeding and then that's scary and then it's not good. So that is really the main thing that I can't stress enough is those first couple days are critical.

Monique Ramsey (08:50):
When do you have them come back for their first post-op visit? Is it the next day or do you give them those three days to stay home?

Dr. Breister (08:58):
We usually give it three or four days before we need to see them because we want them staying home, relaxing, putting the ice on it. We are always available via phone. They can call us anytime. If there's a question, we can always help them, but usually it's about three or four days that we see them the first visit. Then the stitches that I use are all dissolvable, so we don't have to take out any stitches. They pretty much fall out on their own. So after we see 'em the first visit, we'll have 'em come back probably in about 10 days. By that time, usually the stitches are all gone. They've dissolved and they're well on their way to healing.

Monique Ramsey (09:37):
I know when you do your facial surgery, you do body surgery, we have a wonderful group of Alastin products. Is there something that you have them use afterwards to maintain softness?

Dr. Breister (09:49):
There's no topical treatments necessary other than maybe a little bit of antibiotic ointment. Okay. The area can be a little scabby, a little crusty, and then having a little bit of antibiotic ointment can be very helpful. But other than a really good supply of ice packs that they can keep refreezing, that's going to be the most important thing. A comfortable place to be, whether it's a couch or a bed where you could be comfortable, have everything around you. Most of the preparation just comes preoperatively, just being healthy, being hydrated, avoiding alcohol, avoid stressing your body out, taking multivitamins just so you have all those wound factors ready for healing. The main thing is ice and time.

Monique Ramsey (10:32):
Ice and time. And then when would you say that the patient would be able to know, here's my final result? How long does that take?

Dr. Breister (10:41):
I would say by four to six weeks, they're looking quite good, probably to 75 to 80% of the final result. By three to four months is 100%. All the swelling's gone, any scar tissue has softened, and that's usually when it's 100% on target.

Monique Ramsey (11:03):
Now, do you have any advice or requirements on how they sleep or

Dr. Breister (11:09):
No.

Monique Ramsey (11:09):
It doesn't matter? Okay, so if they're a tummy sleeper or a back sleeper, it doesn't matter.

Dr. Breister (11:14):
Doesn't matter. Just get sleep. That's the most important thing.

Monique Ramsey (11:16):
This is true.

Dr. Breister (11:16):
That's important for healing. That's important for healing.

Monique Ramsey (11:19):
And then the incisions, how visible are they and where do you put them?

Dr. Breister (11:26):
The incisions are located on the labia kind of at the rim, but honestly, the incisions quite literally disappear. It's one of the best healing areas on our body. I would be hard pressed if at three, four months you can even find the incisions. So the area heals so well, that scarring, knock on wood, unusual scarring, I've never seen that as a problem, thank goodness. Other surgical areas, obviously people can have hypertrophic scars or thickening. I've never seen that in this area. There's something about the quality of the tissue that heals very fast and without too much scar tissue. So I would say any woman who's worried about scarring, don't worry about that. It literally disappears.

Monique Ramsey (12:17):
Okay, so if you're a woman who is not happy with her labia and she gets this done, and let's say she's out there in the dating world, would anybody ever know?

Dr. Breister (12:31):
Never. No, not in a million years.

Monique Ramsey (12:33):
That's kind of fun.

Dr. Breister (12:34):
I mean, you could take a magnifying glass and that you could not know. There's no way anyone would know. Absolutely not.

Monique Ramsey (12:43):
Yeah, I know scarring, all of us are thinking, okay, there's always a trade off, but in this case, maybe there really isn't. You just get the benefit of no scar.

Dr. Breister (12:51):
And everybody has different anatomy, so there would be no reason to even suspect anything.

Monique Ramsey (12:57):
True.

Dr. Breister (12:57):
Let alone suspect it and then analyze it.

Monique Ramsey (13:03):
Right. And then call you out.

Dr. Breister (13:05):
No one's doing. Yeah, no one is doing that. I trust you, trust me. I don't think anyone has a microscope to the area, however, it's not obvious at all.

Monique Ramsey (13:16):
That's a plus of how well it heals. I'm assuming you have certain steps you want them to do to keep the area clean and when can they shower and stuff like that.

Dr. Breister (13:25):
After about 24 hours, they can shower. Things can kind of get wet. We don't want any scrubbing or washing or anything like that. Just wash your body, just pat the area dry. So just be kind of gingerly with it. And then after about a week, there can be a little more washing with a washcloth, but really you would think that it would be hard to care for, you need squirt bottles to clean it. You really don't. You really don't. It's one of the easiest areas, going to the bathroom is not problematic for it. A little bit of urine may or can touch it. I've never seen it cause a problem. If a woman's more comfortable rinsing it off, but I don't recommend it really, just less is more in this situation. Let things heal, pad it dry, ice it. That's really what you need to do.

Monique Ramsey (14:18):
You said about four weeks before they could resume intimate activities, and is that the same for getting back in the gym or let's say you're a swimmer.

Dr. Breister (14:26):
Four to six weeks, yeah, four to six weeks for everything. By four to six weeks they should be able to resume everything they want to do.

Monique Ramsey (14:35):
And are there any special clothing that you don't want them to wear?

Dr. Breister (14:40):
Obviously in those first couple weeks, a thong type underwear may not be good, so you may have to invest in a few pair of granny panties while you're healing because you just don't want a lot of pressure in the area, and you may want to put a little panty liner in the area too, so just to feel comforted. So it's definitely going to be looser garments in those first couple of weeks.

Monique Ramsey (15:05):
Will these results last forever, I would assume?

Dr. Breister (15:09):
Yeah. I think it's a big misconception that either childbirth or sexual activity has caused this problem that's completely wrong. The labia are genetic as my nose is different from yours. Everyone's labia is a little different, we're born with that. So by altering it and taking away some of the excess, that is never going to grow back. So it's permanent really. I mean, obviously as women, we all age and everywhere our faces, our labia might change a little with aging, so the volume might change a little bit, the texture of the skin. But the short answer to that is that it's never going to grow back or come back per se.

Monique Ramsey (15:52):
And are the biggest complications, what you mentioned with bleeding, is that kind of the biggest thing you're worried about?

Dr. Breister (15:58):
With all surgeries, bleeding or infection or scarring or the big three? Bleeding would be the one that I think would be the most common. It's not very common, thank goodness, if people do what they need to do. But that could be some bruising and bleeding, and so that would be something we'd be a little worried about. Infection is very rare. The area has a lot of blood supply, and blood is good because it's healing. Do put our patients on a little course of antibiotics, but I rarely see infection. It is a procedure that you want someone who does a lot of these to do because yes, if someone's not totally skilled in that area, could do some problematic things. So make sure you're with a surgeon who knows what they're doing, and that way the complications are extremely rare.

Monique Ramsey (16:51):
Having this as one of your specialties and you are so great about women's health and helping empower women through different procedures, helping them achieve sort of that confidence, whether it's their face, their body, their labia, and the area down there. And so I love that you're so approachable about it and you can help talk them through and not feel embarrassed. Your point about, let's say childbirth didn't necessarily cause this, it's more you're born with it. And so to that, let's say they're a swimmer and they have to wear tight swimsuits or something in a sport that they do, makes them feel really uncomfortable. What is the age where they might be able to talk to you about a labiaplasty?

Dr. Breister (17:37):
I'm willing to talk to women, I guess, in their late teens. I don't see that though. I don't see women at that age coming forward. Now. I will see early to late twenties very much, but I'm happy to have a consultation. If they're under 18, they do need to have a parent kind of involved. That's just legal. There's definitely, I would see them. Not to say I would operate for sure, it'd just be a case by case basis.

Monique Ramsey (18:06):
Yeah. Well, this was so informative and I think

Dr. Breister (18:10):
Oh good.

Monique Ramsey (18:11):
We really explored what life after labiaplasty is, and I thank everybody who's listening for tuning in. And every Tuesday, every Tuesday we've got another episode for you. And so make sure, subscribe or put on your little notifications. And thank you Dr. Breister.

Dr. Breister (18:28):
You're welcome. You're welcome. I will just urge anyone out there, if you're obviously listening to this, you're listening because you've thought about it or you've read about it or something's bothering you. So take the next step, come see me or your other board certified plastic surgeon that you're comfortable with because I think the next step in your empowerment is getting the concrete information.

Monique Ramsey (18:51):
Alright, well thanks everybody. And check the show notes for links for things we talked about, and we can even put in there a longer episode that we did about labiaplasty. So this is just life after, but we have more information on that. So thanks again Dr. Breister, and thanks everybody for tuning in.

Dr. Breister (19:06):
My pleasure. Have a great day.

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