Dr Novikova performing a labiaplasty surgery.

Labiaplasty & Vaginoplasty. Interview with Patricia Ntuli on SAFM Radio.

Labiaplasty

Labiaplasty is the surgical correction of labia minora (small lips on the side of the genital area) or labia majora (large lips that usually cover small lips). Labiaplasty is only relatively recently available in Cape Town and Johannesburg.

What are the reasons for labiaplasty?

Some women simply do not like the look of their labia minora because they are too long or asymmetrical (one longer or bigger than the other one). In other cases, the lips can be uncomfortable during exercise or sexual intercourse. Occasionally, they may (rarely) be a cause of frequent infections, itchiness, and discharge.

Girls who are younger than 18 will be requested to see a psychologist before they can undergo the procedure. In some cases, Dr Novikova may request a psychological evaluation for women who are older than 18. This is to ensure that the procedure is performed for the right reasons, that expectations are met and that sound psychological support is provided.

FAQs

All labia minora are normal. You can check labialibrary.org.au to see all the different shapes and types. They are all normal. However, if you are unhappy, bothered and distressed with the shape of your genitals it is advisable to see a specialist and get advice.

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.

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.

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