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Re: "labial trimming"From: Clifford J. Goodman, Jr., MD (momdoc@getnet.com)Tue Jun 17 21:22:35 1997
I think that you're talking about labia minora. In 23 years of practice I have encountered this complaint about 10 times (although I must admit that I've seen a few women with rather spectacularly elongated labia minora who had no complaints at all), and have operated on six (the others found they could cope with reassurance that this is an anatomical variant that only requires surgery if symptomatic and with the use of K-Y, etc.). I have had good results and happy patients, but have learned a couple of things, which I would give as caveats: 1) As always, you have to listen to your patient and get to know her well. Most complaints center around coition ("lips are dragged in and hurt with intercourse), tights clothes and mechanical interference with everyday activities. 2) It's easy to take off too much, leaving the patient with little or no labia. I use a sterile skin pen, and have found that, similar to carpentry, it is better to cut off too little than too much. You're goal is not to restore "normal" anatomy, but to shorten the labia somewhat (usually less than half). People are happy with that. 4) As in most vulvar surgery, your goal in suturing is hemostasis, not tight approximation of tissue. I've never seen any significant scarring of the labia minora. 5) Sitz baths are the patient's best friend for the first four weeks post op. 6) Good luck on getting third-party payers to regard this as anything deserving more reimbursement than a simple vulvar biopsy!
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