Labiaplasty in Turkey

Quite different labiaplasty techniques have been described in the medical literature. These are:

• Curvilinear Excision (Labial Shaving, Partial Resection),
• Wedge Resection (Wedge Removal, V plasty),
• Extended Central Wedge Resection (Wedge Removal),
• Bilateral Deepitelization (Delamination),
• Zig Zag Technique,
• Modified Double Wedge Resection (Star Labiaplasty),
• Laser Labiaplasty.
• Curvilinear Excision (Partial removal, Trimming)

Curvilinear Excision

Curvilinear excision technique is also known as partial removal of inner lip tissue or trimming. It is the removal of the inner lip edges in the form of a slight ellipse. It is one of the most preferred techniques today. It is also known by names such as 'curvilinear amputation', 'Labial trimming', 'Edge trim' and 'Partial resection'. In the curvilinear shaving technique, the structure and color of the original edges are not preserved. Regardless of the localization of vessels and nerves, cutting is performed. Theoretically, there are concerns that the sensitivity due to scar formation after the incision along the longitudinal line may be negatively affected, but such problems are not encountered in practice. This technique is used quite frequently, especially in cases of "advanced hypertrophy" where the skin tissue of the inner genital lips is quite high, as it allows excess tissue to be removed.

Wedge Resection (Wedge Removal, V plasty)

Wedge resection is a method also known as “Wedge removal” or “V plasty”. It is the removal of the tissue in the form of a “V letter”. The inner lips are reduced by removing the tissue in the form of a wedge, that is, almost a "V letter", from that area. Wedge extraction can be made from the upper, middle, or lower parts of the inner genital lips.

Extended Central Wedge Resection

In this technique, after the excess tissue is removed with the classical wedge technique, the incision is extended forward and to the side like a "hockey stick" and the removal of the skin folds above the clitoris is included in the operation.
if the wedge resections are done well, healing is observed quickly and postoperative comfort in terms of pain is also quite high. However, if the correct technique is not applied, complications such as opening of the sutures, scar formation due to tissue necrosis and windowing can be seen. These conditions are generally related to the surgical technique. Care must be taken in order not to disturb the blood circulation of the tissue and to prevent the opening of the stitches.

Bilateral Deepitalization

It is a kind of epithelial peeling (deepitalization) process by making incisions in the areas with the most tissue excess in both the inner and outer parts of the labia. Also called 'delamination'.
In this technique, unlike the others, all the original labial edges are preserved. Since no incision is made, all vessels and nerves are also preserved. The disadvantage is the risk of scar formation. In addition, the inner lips are shortened only vertically. Therefore, it is not a suitable method for large inner lips. On the other hand, swelling may occur on the sole, and the appearance of excess tissue edges may cause psychological problems in the patient.
Deepitelization is an alternative labiaplasty technique for patients whose inner lip is not too wide, whose thickness is thin, and who are satisfied with their original edges and want to be preserved.

Zig Zag Technique

The edges are completely removed with an ongoing zig zag incision applied to the inner lip edges. The aim is to form the lip edges in a rounded shape. However, there may be loss of pigmentation along the lip edges.

Modified Double Wedge Resection (Star labiaplasty)

Star labiaplasty is a technique also known as the "double wedge technique". In this modified wedge technique, a star-shaped incision is made into the inner lip and excess tissues are removed.

Laser Labiaplasty

In laser labiaplasty, the cutting of the inner genital lip is made with high-energy laser light. The most commonly used lasers in genital aesthetic surgeries;

• Fractionated CO2 (Carbon Dioxide) lasers,
• Potassium Titanyl Phosphate (KTP) lasers,
• Erbium Yag lasers,
• Nd Yag lasers.
• Cutting process in labiaplasty with CO2 laser is done with 15–20-Watt energy.

Barbie Vagina Method

'Barbie doll vagina', which was first used for labiaplasty surgeries by Los Angeles society in the USA, is the name of the appearance obtained by shortening the inner lips as much as possible.
In the Barbie Vagina concept, maximum tissue is removed from the inner lips, and the skin on the clitoris is reduced as much as possible with reverse Y plasty. If necessary, a sexier look is obtained by injecting oil into the large lips. Thus, the large lips will completely cover the inner lips, and a cleft will appear as a 'Venus cleft' in between.

Clitoral Hoodoplasty

The term "clitoral hud" refers to the skin tissue that covers the clitoris. Clitoral hoodoplasty, removal of skin folds on the clitoris; Thus, it is an operation that aims to remove wrinkles in the upper clitoris area and to give this area a more aesthetic appearance. It is also known as 'clitoris aesthetics' among the people.
Clitoral hoodoplasty is usually performed during 'labiaplasty', that is, inner lip aesthetic surgeries. Sometimes, it can be requested as a second operation later on in patients who have only undergone inner lip surgery (labiaplasty) and do not experience sufficient aesthetic satisfaction.
The skin folds and wrinkles on the clitoris typically persist after the inner lips are decreased and given a pleasing appearance during labiaplasty, thus the puffiness in this region displays a "micropenis" appearance. For this reason, almost all patients with inner lip aesthetics, especially in the form of Barbie vagina, should also have clitoris region aesthetics and surgery. Otherwise, dissatisfaction may occur in patients who are dissatisfied with the appearance after the operation.
When done correctly, it never has a negative impact on sexual enjoyment. During the surgery, there is no harm done to the clitoris organ. Only the excess skin tissue on the clitoris is removed, so it does not have a negative effect on sexual pleasure and orgasm.
In fact, with the increased self-confidence in patients after genital aesthetic surgery, pleasure from sexuality increases and reaching orgasm may become easier. There is, however, something crucial to remember. Gynecologists and plastic surgeons can both do labiaplasty procedures today. . However, due to the anatomical features of the region, the number of surgeons who have experience in clitoris region aesthetics is much less. Due to the anatomical and functional location of the region, it is important to approach the tissue sensitively during surgery.

Before Labiaplasty Operation

Patients desire labiaplasty operation for different purposes. The reasons for labiaplasty vary from person to person. The most common causes of labiaplasty surgery are:

• Discomfort caused by apparent bulge when wearing bikini and tights. The outward appearance of this region can have a negative impact on social life.
• Due to maintaining the genital area's moisture, there are frequent yeast infections and vaginal infections.
• Being embarrassed or terrified of the other person while having sex, or not being able to focus.
• Hygienic issues such odor production and an accumulation of discharge in the vaginal region.
• Large and drooping inner lips are uncomfortable by rubbing while wearing underwear, jeans and tights.
• Feeling pain due to stretching during sexual intercourse when the penis is inserted into the vagina.
• Difficulty urinating, the need to strain.
• One of the most common reasons is that the urine goes in different directions in the toilet and wets the legs.

In summary, labiaplasty had physical, sexual, hygienic and medical benefits.

Before the surgery, the evaluation to be made is extremely important for the success of the surgery.

We divide our patients who are considering labiaplasty into three groups according to their personality and surgery expectations: The groups categorized according to ages. This approach, which is somewhat humorous, guides us in planning the operation to be performed and meeting the expectations fully.

Labiaplasty surgeries can be performed according to the preferences of the patients. When we need to classify patients in this regard, we can divide them into 3 different categories.

First group, who are generally over 40 years old, prefer to stay as minimal as possible in their operations. They refrain from taking too many risks with radical procedures, their aim is to feel comfortable in terms of functionality rather than aesthetics.

Simple reductions due to their 'naturalistic' nature will meet their expectations. It is okay for the inner lips to protrude beyond the outer lips after the surgery. Mostly, they do not need clitoral hoodoplasty or they are afraid of the operations of this region.The labiaplasty technique to be applied for them can be in the form of V plasty. Thus, both inner lip reduction will be achieved, and the natural edges of the lips will be preserved. A superficial trimming (edge trimming) can also be done.

The main aim of the second group, who are generally in the group of 30 and above, is to feel comfortable both aesthetically and functionally. For second group, it is sufficient for the inner genital lips to remain at the same level as the outer lips. A light shave will often meet their needs. Thus, the inner lips will be shortened, and the keratinized, dark and wrinkled edges will be removed.

The last one is the patients who are the ones looking for the "Barbie look" that is most often desired in Western societies. In particular, the pornography industry has idealized the rather short and pinkish appearance of the inner genital lips. Patients who desire a Barbie vagina look are generally younger, but they can be from all age groups.

After Labiaplasty Operation

Severe pain is usually not felt after this surgery, no special care is required for the operation, it is sufficient to keep the genitals clean and dry. Labiaplasty surgery is not a risky operation, the complication rate is extremely low. The satisfaction rate is quite high with a permanent and definitive solution. After the labiaplasty operation, the woman's self-confidence, sexual happiness, and quality of life increase. It is extremely important to follow the doctor's recommendations after labiaplasty.

• It is quite natural to have some bleeding in the form of leakage after the surgery.
• In the first days after surgery, the vulva may be edematous, swollen, red and tender. Applying ice at intervals of 1-2 days provides relief from edema.
• Since the inner lips are a muscle-rich region, the healing of the wound is fast.
• The stitches used are thin stitches and usually fall off on their own within 1-2 weeks.
• Although it changes from patient to patient, the patient can return to work within 3-4 days.
• Complete recovery takes 4-6 weeks when no complications develop.
• For 6 weeks after the procedure, activities that cause tension such as yoga and pilates, and sports that will create pressure such as horse riding and cycling should be avoided.
• Toilet cleaning should always be done from front to back.
• In order to prevent the risk of infection, you should not enter the pool, bath, sea, jacuzzi for 4-6 weeks, and instead of taking a bath by filling the tub, showering while standing should be preferred.
• Sexual intercourse should be avoided until full recovery (4-6 weeks).
• Again, epilation and waxing should be avoided until full recovery is achieved.