Gary Alter, MD is the innovator & acknowledged leader in botched labiaplasty reconstruction surgery. He wrote the FIRST medical paper on botched labiaplasties – published in the most prestigious plastic surgical journal in the world called “Plastic & Reconstructive Surgery”.
Background: Labia minora reduction (labioplasty, labiaplasty) is the most common female genital aesthetic procedure. The majority of labia reductions are performed by trimming the labial edges. Many of these women present with (1) asymmetry; (2) scalloping of the labial edges with wide, occasionally painful scars; and (3) abrupt termination and distortion of the clitoral hood at its normal junctions with the clitoral frenula and the upper labium. Reconstruction can usually be performed with wedge excisions, labial YV advancement, and touch-up trimming. Reconstruction of a labial amputation, however, required the development of a new clitoral hood flap. Methods: Twenty-four clitoral hood flaps were performed on 17 patients from June of 2006 through May of 2010. An island clitoral hood flap randomly based on the dartos fascia of the lower clitoral hood and medial labium majus is transposed to the ipsilateral labial defect to reconstruct a labium. Of the 10 patients with unilateral flaps, nine of the patients had previous bilateral labial reductions. Reconstruction of the opposite side in these nine women was performed using one or a combination of the following: wedge excisions, YV advancement flaps, or controlled touch-up trimming. Results: All 24 flaps survived, with four minor complications. Five patients underwent revision of a total of seven flaps, but only two were for complications. As experience increased, revisions for aesthetic improvement became less common. Conclusion: Reconstruction of labia minora defects secondary to trimming labia reductions is very successful using a combination of clitoral hood flaps, wedge excisions, and YV advancements. ©2011 American Society of Plastic Surgeons
OVERVIEW OF LABIA REDUCTION (LABIAPLASTY / LABIOPLASTY) TECHNIQUES
It is important to know the most common labia minora techniques to understand the best way to revise the “botched” labia reduction. With this corrective cosmetic vaginal surgery, the major types are the trimming techniques and the central wedge or “V” technique (which Dr. Alter invented in 1995 as the “Alter” labiaplasty).
The central wedge or “V” excision (“Alter” technique) to reduce the labia minora maintains the normal appearance and anatomy of the labia and labial edge, prevents over-removal, and has less post-operative discomfort than other techniques IF expertly performed. The disadvantage of this labia minora reduction technique is that it requires more surgical skill and time to perform.
The trimming method is the most common labiaplasty surgery used by gynecologists and most plastic surgeons to reduce the labia minora (labioplasty). The labial edges are trimmed with a scalpel, scissors, knife, clamp, or laser. However, this can lead to partial or complete over-removal of one or both labia with asymmetry or absence of labia. In addition, the labial edges often have a bumpy, scarred, unnatural appearance, since the suture line is along the entire labial edge. The scarred labia can be painful to any contact. In addition, the anatomy to the clitoris, clitoral hood, and labium can become distorted with this cosmetic vaginal surgery technique, because the labium and hood can end abruptly and stick out. This advantage of this labiaplasty (labioplsty) technique is that it is quick, but many surgeons do not take the time or have the skill to do it well.
Another deformity seen after botched labia reduction surgery is the large clitoral hood, which is not in synchrony with the smaller labia. The clitoral hood and labia do not match. Thus, many surgeons try to reduce the clitoral hood, but this is often done poorly, which causes more scarring and distortion. In addition, this elimination of much clitoral hood often removes the very tissue that is needed by Dr. Alter to reconstruct the botched labiaplasty surgery.
BOTCHED LABIAPLASTY REPAIR, REVISION & RECONSTRUCTION TECHNIQUES
The deformities from the various labia reductions (botched labiaplasties) can usually be reconstructed (“vaginal reconstruction”) to give a normal or near normal appearance using a wide assortment of plastic surgical techniques. Dr. Alter published the only extensive medical paper detailing the various reconstructive techniques in the world’s most prestigious plastic surgical journal “Plastic & Reconstructive Surgery” in 2011 and is considered one of the best botched labiaplasty repair surgeons and is the clear leader in cosmetic vaginal surgery. These labiaplasty reconstruction and labiaplasty revision techniques were created and refined by Dr. Alter after over a decade of reconstructing multiple labia minora and clitoral hood deformities from a wide variety of techniques.
Many doctors claim to be able to reconstruct the botched labia minora and clitoral hood. However, they do not use these sophisticated cosmetic vaginal surgery techniques, because the techniques are new, require tremendous skill, and take plastic surgical expertise. Their attempts at correction can eliminate any chance for Dr. Alter to reconstruct the botched labiaplasty.
Dr. Alter often uses remaining clitoral hood or labial tissue to reconstruct the deformed or absent labium caused by a botched labiaplasty. These are very complex plastic surgical techniques of moving tissues around without injuring the blood supply. Sometimes, he can correct the gap in an overly removed labium by cutting the gap out and bringing the normal-sized edges together. If one or both labia are totally absent, he can often make new labia out of the clitoral hood. Dr. Alter invented this complicated technique, which is often the only good way to create a normal labium. He can often fix the scarred or scalloped labium by partially removing it or accurately suturing it. A minor deformity can sometimes be improved by injecting fat into the smaller labium. The hanging clitoral hood can often be reattached to a normal position. Dr. Alter can also reduce a large clitoral hood by re-positioning the clitoris (clitoropexy) and removing the extra skin. His plastic surgical and urological training and experience provides the tools to correct so many of these deformities.
Adequate corrective labiaplasty revision reconstruction usually depends on the amount of remaining labia minora and clitoral hood tissue. He needs as much labia and clitoral hood as possible to fix the labia properly for a successful cosmetic vaginal surgery to ensure. The woman usually needs at least five months after the failed labiaplasty to allow healing, new blood supply, and swelling to go down. Too often, patients and surgeons rush to fix a botched labiaplasty by operating too soon or removing more tissue. This rush to treatment due to anxiety of both the patient and the surgeon needs to be controlled, since it can destroy any opportunity for Dr. Alter to repair the problem. Waiting will allow Dr. Alter to fix the labia and clitoral hood as well as possible.
It is remarkable how well Dr. Alter can reconstruct and repair so many of these botched labioplasty surgeries. Please send photos of your failed labiaplasty to Dr. Alter for him to evaluate. Hope for a normal appearance without pain is here!
As a best in class plastic surgeon, Dr. Gary Alter provides highly personalized and comprehensive care. His philosophy regarding the physician / patient relationship is based on trust and has earned him one of the most respected reputations in the world.
For more information about the surgeries we offer or to schedule a consultation with the board certified plastic surgeon, please contact either our Beverly Hills of New York City plastic surgery practice:
416 N Bedford Dr, Suite 400
Beverly Hills, CA 90210
Tel: (310) 275-5566
NEW YORK CITY
461 Park Ave South, 7th Floor
New York, NY 10016
Tel: (212) 321-0749