Maximizing Safety and Optimizing Outcomes of Labiaplasty: A Systematic Review and Meta-Analysis

Abstract

Background: The considerable increase in labiaplasty requires plastic surgeons to be acquainted with the surgical techniques, their respective complications, and satisfaction rates. The authors conducted a systematic review of the available evidence on labia minoraplasty, looking at surgical techniques, clinical outcomes, and patient satisfaction. Methods: A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane CENTRAL was performed through October of 2020. A random-effects model meta-analysis was performed to assess satisfaction and complication rates. Results: Forty-six studies including 3804 patients fulfilled the inclusion criteria. The pooled satisfaction rate after labia minoraplasty was 99 percent (95 percent CI, 97 to 99 percent). Substantial heterogeneity was present across studies (I2 = 63.09 percent; p < 0.001). The highest pooled incidence of dehiscence was reported for laser-assisted labiaplasty (5 percent; 95 percent CI, 2 to 8 percent) and wedge resection (3 percent; 95 percent CI, 1 to 5 perecent). The highest pooled incidence of hematoma formation (8 percent; 95 percent CI, <1 to 23 percent) and postoperative bleeding (2 percent; 95 percent CI, <1 to 15 percent) was reported for W-shape resection. The highest pooled incidence of transient pain or discomfort was reported for de-epithelialization (2 percent; 95 percent CI, <1 to 23 percent) and W-shape resection (2 percent; 95 percent CI, <1 to 15 percent). Three cases of flap necrosis were reported; two occurred using wedge resection labia minoraplasty and one was not specified. The most common causes for revision surgery (n = 169) were dehiscence and aesthetic concerns. Conclusions: Labia minoraplasty is a safe procedure, but serious complications requiring surgical management have been reported. Surgical experience, knowledge of female genital anatomy, and thorough technique selection in accordance with the patient characteristics are mandatory.

Labial Length and Patient Symptomatology: Is There a Correlation?

“… 8 , 9 Labiaplasty's numbers have grown dramatically amid evidence that it is a safe procedure with low complication rates and high patient satisfaction rates, reflecting resolution of symptoms, improved genital perception, sexual function, and quality of life. 1 , 10-14 …”

Patient Perspectives on Intimate Relationship Outcomes After Labiaplasty: A Preliminary Qualitative Analysis

“…The number of labia minora reduction or labiaplasty procedures performed across the world has risen in the last decade with consistent reports of high patient satisfaction and minimal complications. 1-3 Motivations to pursue labiaplasty commonly include dissatisfaction with genital appearance, and discomfort while wearing tight clothing and during physical or sexual activity. 2 , 4 Previously identified outcomes of labiaplasty include improving women's perceptions towards their genital appearance.…”