Current Trends in Vaginal Labioplasty: A Survey of Plastic Surgeons
Michael N. Mirzabeigi, BS1, John H. Moore, Jr., MD1, Alexander F. Mericli, MD1, Peter Bucciarelli, BS1, Ian L. Valerio, MD2, Guy M. Stofman, MD2.
1Thomas Jefferson University Hospital, Philadelphia, PA, USA, 2University of Pittsburgh, Pittsburgh, PA, USA.
BACKGROUND: Reduction of the labia minora, or labioplasty, has emerged as an increasingly more ubiquitous procedure within the plastic surgery community. Likely due to a recent media-based establishment of aesthetic vulvar ideals and an increasing awareness of surgical solutions, this procedure has grown in popularity among women at a seemingly exponential rate. Labioplasty serves as a course of action for resolving an anatomical variation that causes aesthetic, functional, and/or psychosocial difficulties for countless women. The purpose of this study is to elucidate the current armamentarium for labia minora reduction, as well as demonstrate the safety and efficacy of this procedure.
METHODS: A 2009 web based survey was sent to members of the American Society of Plastic Surgeons via electronic mail. All members receiving the survey were asked to participate regardless of whether or not they were presently offering vaginal labioplasty. The blinded survey was employed to assess the profile and practice guidelines of the individual surgeon, as well as their practice demographics.
A total of 758 surgeons responded to the survey (19.9% response rate). 51.0% of surgeons currently offered labioplasty, 49.0% did not. The total number of procedures for all respondents was 2255. 13 infections were collectively cited over 24 months (infection rate of 0.58%). 9.83% of surgeons reoperated for wound dehiscence and 17.3% for redundancy. Per surgeon over 24 months: mean was 7.37 procedures, median was 3 (Range 0-300). 13.1% of surgeons identified patients having this done for work-related purposes. 68.5% of respondents were never formally taught how to perform this procedure. Of those offering labioplasty 69.2% were formally taught. However, of those currently offering labioplasty, formal training had no statistical significance on the number of procedures done over 24 months, perceived patient satisfaction, or rate of reoperation. 18.9% advertised that they performed labioplasty (internet most common means). There was no significant difference in volume for those that used purely general advertising. However, those that mention labioplasty specifically in their advertising performed almost three times the mean number of procedures (p=0.001) and charged $600 more than those not advertising labioplasty (p=0.002). The youngest patients surgeons operated on were 8 weeks and 2 years old, and 78 surgeons cited teenagers as their youngest patients. 5 surgeons recall operating on women in their 70’s with 75 being the oldest patient. The mean time suggested to refrain from intercourse was 31.3 days (range 7-365 days). The mean cost was $2266.51 (range $500-10000). Also see Table 1
CONCLUSIONS: Labioplasty is a safe and effective technique employed by plastic surgeons. However, through highlighting the expansive armamentarium and incongruities of practice for this elegant procedure, we believe our study is a first, vital and necessary, step in establishing optimal practice guidelines for the plastic surgery community. Additionally, in establishing these discrepancies among surgeons, we hope to provide the impetus for further academic dialogue and prospective trials.
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