Current Trends in Vaginal Labioplasty A Survey of Plastic Surgeons

Background: Labioplasty serves to resolve an anatomic variation that results in aesthetic and functional difficulties for many women. To date, little effort has been made to compare the efficacy or prevalence of various techniques, and furthermore, evidence-based practice guidelines have not yet been established for this procedure. The purpose of this study is to elucidate the current armamentarium and practice guidelines for labia minora reduction, as well as to examine self-reported outcomes for this procedure. Methods: A 2009 web-based survey was sent to members of the American Society of Plastic Surgeons via electronic mail. The survey was used to assess surgeon demographics, practice guidelines for labioplasty, and self-reported outcomes measures. Results: A total of 750 surgeons responded to the survey (19.7% response rate), and 51.0% of surgeons currently offered labioplasty. The total number of procedures over the past 24 months for all respondents was 2255. Per surgeon over 24 months, the mean number of procedures was 7.37 (range, 0-300). Surgeons that directly advertised that they performed labioplasty performed a mean of 14.2 procedures over 24 months versus a mean of 5.01 for those who did not (P = 0.001). The mean time suggested to refrain from intercourse was 31.3 days. Redundancy or inadequate resection and wound dehiscence were the 2 most common reasons that caused surgeons to reoperate. Surgeons using plain gut suture material had the highest reported rates of reoperation. The prevalence of each technique was as follows: simple amputation (52.7%), w-shaped resection (9.5%), S-shaped resection (8.8%), central v-wedge (36.1%), central wedge with z-plasty (13.9%), and deepithelialization (1.2%). The mean perceived patient satisfaction rate reported by surgeons was greater than 95% for all techniques, and there was no statistically significant difference when comparing perceived patient satisfaction among the techniques (P = 0.337). Conclusions: This study provides data suggesting that labioplasty has been safely and effectively used by many plastic surgeons. However, there is great variation with regard to both techniques and practice guidelines. In establishing these discrepancies among surgeons, we hope to provide the impetus for further academic dialogue and prospective trials.