Outcomes, Techniques and Risk Factors for Dehiscence in Central Wedge Labiaplasty
Catherine J. Sinnott, MD, Martin Benjamin, MD, Ahmed E. Nasser, MD, Richard G. Reish, MD, Laurence T. Glickman, MD, Noel B. Natoli, MD, Michael Dobryanky, MD, Malack Hamade, MD, Haritha B. Veeramachaneni, MD.
Long Island Plastic Surgical Group, Garden City, NY, USA.
BACKGROUND: Outcomes after female cosmetic genital surgery (FCGS) performed by plastic surgeons working in a group practice setting have not been well-documented. This paper aimed to assess outcomes and to describe FCGS techniques utilized in a large group private plastic surgery practice. METHODS: A retrospective chart review identified patients who underwent FCGS from 2009 to 2018. Demographic, clinical and operative information were reviewed and recorded. Outcomes were assessed by evaluating postoperative complications and the need for revision surgery. RESULTS: 77 women between the ages of 14 and 53 years underwent FCGS performed by one of six surgeons. 45 patients underwent central wedge excision for labia minora hypertrophy alone, while 32 patients underwent extended central wedge excision for labia minora and clitoral hood hypertrophy. 4 patients underwent liposuction of the mons pubis as an additional procedure. Over a mean follow-up of 37.4 months, postoperative asymmetry/redundancy occurred in 12 patients, requiring revision in 10. Wound dehiscence occurred in 12 patients, requiring revision in 9. There was one hematoma postoperatively requiring evacuation, one case of dyspareunia and one case of decreased sensation. A single-layer wound closure (p=0.050) and mons liposuction (p=0.011) were risk factors for wound dehiscence. CONCLUSIONS: FCGS was performed for correction of labia minora hypertrophy with or without clitoral hood hypertrophy using the central wedge excision labiaplasty technique. Postoperative asymmetry/redundancy and dehiscence were the most common complications and the revision surgery rate was high. A single-layer wound closure and mons liposuction were risk factors for dehiscence after central wedge labiaplasty.
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