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Why Women Request Labiaplasty

2017; Lippincott Williams & Wilkins; Volume: 140; Issue: 6 Linguagem: Inglês

10.1097/prs.0000000000003871

1529-4242

Carlo M. Oranges, Kristin M. Schaefer, Daniel F. Kalbermatten, Martin Haug, Dirk J. Schaefer,

Genital Health and Disease

Sir: We read with extreme interest the article by Sorice et al. entitled "Why Women Request Labiaplasty" published in the April 2017 issue of the Journal.1,2 We greatly commend the authors for this meritorious undertaking that clarifies women's needs and thus enables us to tailor our actions accordingly. To determine the motivation to seek labiaplasty, 50 patients were prospectively evaluated with a questionnaire assessing 11 physical and appearance-related symptoms associated with labia minora hypertrophy. Notably, the majority of the patients experienced both physical and appearance-related symptoms, the most relevant of which were tugging or pain during intercourse, labia exposure in swimsuits, discomfort while wearing tight pants, twisting of the labia, increased self-consciousness, labia visibility in yoga pants, and feeling less attractive to their partners or others.1,2 These results appear to be in line with previous studies on the subject, as we recently reported in an investigation that reviewed the entire body of the literature.3 Indeed, we found that, of a total of five studies on 735 patients that reported the reasons to request labia minora reduction, four studies on 604 patients indicated a combination between aesthetic and functional concerns as the most represented motivation for seeking labiaplasty. However, in our daily practice, we observe that the majority of patients requesting this operation do so for purely aesthetic reasons. As a result, they achieve excellent outcomes, experience very few and modest complications, and improve substantially their quality of life. Colleagues with expertise in this field report the same experience. It is therefore surprising and worthy of attentive reflection that there is a continuing atmosphere of fear generated by our gynecologic counterparts, also mentioned by the authors of this articles. Gynecologists tend indeed to express concerns regarding the positive outcomes and safety of labiaplasty, despite the totality of the plastic surgery research strongly supporting its benefits. Our comprehensive review of the literature, which included 1981 patients within 38 English and non-English studies performed from 1971 through 2014, reported satisfaction rates always exceeding 90 percent, with few postoperative complications that reportedly occurred in 6.8 percent of the patients.4,5 No complications were serious and all resolved easily.4 Moreover, very importantly, it was also observed that sexual function improvement was achieved using the different techniques.6 This was explained by the consistent overall high aesthetic satisfaction rates of the patients and associated with a relevant self-esteem improvement, especially considering how much one's sex life can be influenced by emotional and psychological concerns, which can easily be correlated with aesthetic concerns.6 Therefore, in conclusion, based on the evidence available, we believe that there is no foundation for opposing an operation that meets women's needs, both cosmetic and functional, and has been shown to ameliorate our patients' well-being to a relevant extent. However, as with all cosmetic surgery operations, we believe that labia minora reduction requires being performed by well-trained, board-certified plastic surgeons with a specific expertise in the field. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication. No funding was received for this work. Carlo M. Oranges, M.D.Kristin M. Schaefer, M.Sc.Daniel F. Kalbermatten, M.D., Ph.D.Martin Haug, M.D.Dirk J. Schaefer, M.D.Department of Plastic, Reconstructive, Aesthetic, and Hand SurgeryBasel University HospitalBasel, Switzerland