What is nymphoplasty?
Nymphoplasty, also known as reduction nymphoplasty, is cosmetic surgery on the labia minora of the female genitalia. Classified as part of
nymphoplasty is an aesthetic surgery of the body, and more specifically of women's intimate surgery, which reduces the size of the labia minora to match the volume of the vulva. This operation uses techniques such as resection.
Objectives of nymphoplasty
Anatomically, the vulval cleft is composed of two labia minora and two labia majora. The main objective of labia minora reduction nymphoplasty is to treathypertrophy of the labia minora. This deformity affects women's private parts, and is characterized by an excessively large size of the labia minora in relation to the labia majora. In fact, the labia minora take on an abnormal size, even exceeding the volume of the vulva in the upright position. This deformity is often accompanied by hyperpigmentation, and generally affects both labia minora (bilaterally), but can sometimes be unilateral, i.e. affecting just one labia minora.
In short, the aim of nymphoplasty is to correct and reduce the size of the labia minora in order to restore a harmonious vulva.
Candidates for nymphoplasty
Labia minora hypertrophy generally occurs after puberty. It can also occur after maternity or at menopause.
Patients wishing to undergo nymphoplasty usually present with at least one of the following conditions, which are often described by candidates at Dr. Delobaux's practice.
These disorders mainly concern:
- Discomfort due to rubbing or "jamming" of the labia minora, in all kinds of daily activities.
- Painful labia minora when wearing tight pants or thongs.
- Pain during physical exercise, such as cycling or horseback riding,
- Discomfort during coitus, with pain on penetration due to blockage of the labia minora
- Psychological embarrassment: ashamed to be naked in front of your partner
- Aesthetic discomfort
All these concerns are legitimate and serious, and when a patient mentions one of them, nymphoplasty is justified.
Principles of nymphoplasty surgery
Surgery consists in removing the excess portion of the labia minora, using a variety of techniques:
The triangular technique: This involves hiding the scar as much as possible, to avoid rubbing, irritation or scar retraction.
Longitudinal technique: This nymphoplasty technique involves removing the excess lip longitudinally (i.e. along the entire length of the lip). The advantage of the triangular technique is that it allows more of the excess lip to be removed, which appeals to and satisfies many patients. Thanks to these "invisible" suturing methods, the scar is completely concealed and invisible.
For many years, these longitudinal or triangular excision techniques have been surgical standards. It is not legitimate to think that there is just one technique, as many people often mistakenly believe, but that there are several. Together with Dr. Delobaux, you'll decide which technique is best suited to your needs and your body's anatomy.
Nymphoplasty or labiaplasty?
The two terms seem to mean the same thing. According to usage and habit, some call it labiaplasty. But the term most commonly used in scientific circles is nymphoplasty.
Longitudinal nymphoplasty method
This method removes the excess mucosa along the labia minora.
This procedure offers excellent results when the excess labia minora is distributed along the entire length of the lip. Thanks to buried suturing techniques, the scar is totally invisible, and the lip maintains its natural appearance.
It is often reported that contact of the scar with underwear can slow healing or even cause pain during intimate intercourse (dyspareunia). This is purely a belief, not a reality.
On the other hand, this so-called longitudinal technique has a major advantage over triangular nymphoplasty. The advantage is that the risk of suture loosening is exceptional. Even if it does happen, the consequences are minimal, as the lip will heal spontaneously. Another important advantage is that the height of the lip next to the clitoral hood can be reduced, which is not possible with other methods.
This technique is highly effective, reliable, safe and delivers impressive results. It is the first nymphoplasty method proposed by the Société Française de Chirurgie Plastique Reconstructrice et Esthétique.
Triangular or wedge-shaped nymphoplasty method
The aim is to remove an excess mucosal triangle from the labia minora. The mucosal triangle can be removed at different levels of the lip, but the best triangular method is to remove a triangle from the posterior half of the lip.
In this way, the appearance of the lip folds is preserved, and the scar is perfectly invisible at the junction of the labia majora and labia minora.
The main risk of this nymphoplasty technique remains scar disunion, with the scar coming loose. This problem occurs in a minority of patients (10%), despite appropriate care. This is one of the reasons why this technique is less frequently used by Dr. Delobaux.
Posterior triangular nymphoplasty method: the small lip triangle is removed on the posterior half of the lip, not in the middle.
We do not perform resections of a triangle in the middle of the labia minora, as suture loosening is common due to the difference in thickness of the 2 parts of the sutured lip after removal of the excess. Also, there is often a demarcation between the pinkish lip in front, and the darker color of the back lip.
All these risks are reduced when a triangle of mucosa is removed posteriorly. This is the only triangular technique we use, as a second resort when the longitudinal method is not suitable.
Which nymphoplasty technique should I choose?
The choice of technique for nymphoplasty is made on a case-by-case basis. However, the longitudinal method is preferred for the quality of its aesthetic results and its reliability, with very few risks.
Nymphoplasty procedure
There are several methods available for reducing the labia minora. Each surgeon has his or her own particular approach to successful surgery. The aim is to eliminate excess tissue. Usually, the operation involves resection of the excess labia on a case-by-case basis, i.e. personalized and modular, based on a preoperatively defined scheme. In this way, problems of hyperpigmentation are also resolved. Similarly, around the clitoris, the anterior extensions can also be reduced. Dr. Delobaux concludes the operation with the placement of absorbable sutures and a light dressing. The procedure takes between 45 minutes and 1 hour. Labia minora surgery can also be combined with other surgical procedures. One example is labia majora augmentation.
What happens before the nymphoplasty procedure?
As a general rule, two pre-operative consultations are required for nymphoplasty.
Medications such as aspirin, anticoagulants and non-steroidal anti-inflammatory drugs, which facilitate post-operative bleeding, should be stopped 10 days before surgery.
Ask for a short period of professional downtime of about one week, depending on your profession.
Hospitalization for nymphoplasty
Hospitalization takes place in a clinic. It is an outpatient procedure, with the possibility of returning home the same day.
What type of anesthesia is used?
Reduction nymphoplasty is usually performed under general anaesthetic. A locoregional anaesthetic (spinal anaesthesia) or a local anaesthetic may also be used, thus avoiding the need for a general anaesthetic. A local anaesthetic is always associated with the lips to reduce post-operative pain.
Post-operative follow-up and advice after nymphoplasty
Post-operative recovery from nymphoplasty is generally straightforward. Nymphoplasty is an operation that allows rapid recovery and is usually painless. It requires virtually no time off work.
Here are a few tips and recommendations for a successful cosmetic surgery.
- Post-op nymphoplasty are immediate in the clinic:
Hospitalization generally lasts just a few hours. The patient is admitted in the morning and discharged in the evening ("day hospital"). However, in certain special circumstances, the surgeon may propose conventional overnight hospitalization.
Pain is often minor, but can be relieved by simple analgesics.
Some discrete bleeding may occur, but this is not serious.
Simple intimate protection is sufficient to cover the sutures.
- Follow-up and advice for the 1st month after returning home
There is little pain after the operation. Exceptionally, however, there may be some discomfort when walking in the first few days.
The lips may be slightly swollen. The swelling may be asymmetrical, but if this happens, don't worry. It goes away naturally once the swelling disappears.
There's no need to apply a bandage, but a simple wash with tap water (shower) and soap is all that's needed. After each visit to the toilet, it's important to clean the labia minora without rubbing with tap water. It's also important to dry them thoroughly to avoid maceration. Intimate protection is sufficient to cover sutures in the event of minor bleeding. Pants should not be worn during the first week, to avoid maceration.
Professional activities can be resumed between 2 and 7 days post-operatively.
- Operative follow-up 1 month after nymphoplasty
There is virtually no pain. There may be some slight swelling, but this is harmless, as the appearance of the lips has already been significantly improved. Sutures are absorbable and disappear spontaneously about 2 weeks after the procedure. The hygiene measures outlined above must be observed. No sporting activities for 1 month. Sexual abstinence for 1 month
- Post-operative nymphoplasty after 1 month
If the longitudinal method is used, sexual relations can be resumed 1 month after nymphoplasty. However, if the triangular method is used, sexual relations should be resumed only after 6 weeks. The lips regain their smoothness between 2 and 3 months after surgery. After 1 month, scars are generally invisible. They take on their definitive appearance in 1 year. So don't worry if they are sensitive.
What is the result of nymphoplasty?
The result is immediately visible, with correction of the excess labia minora. Most of our patients experience little or no pain.
The final result of nymphoplasty can be seen after 3 months, when the swelling has disappeared and the labia minora have regained their smoothness and suppleness.
Sexual intercourse with coitus is permitted after one month and is not painful.
Healing normally progresses like any other scar on the body, over a period of at least 6 to 12 months, with a phase of redness and initial induration of the scar lasting 2 to 3 months.
On the other hand, healing of the mucous membranes of the vulva is usually rapid and excellent, with non-visible scars visible after 1 to 2 months.
Nymphoplasty prices and coverage
The cost of nymphoplasty depends on whether or not it is covered by social security. Surgery of the labia minora is partially covered by social security, with no restrictions. The remainder is covered by your mutual insurance company, depending on the quality of your contract.
Risks of nymphoplasty
Complications of nymphoplasty are fortunately very rare. In the vast majority of cases, patients are very satisfied with the result. Nevertheless, as no human work is perfect, some complications are unpredictable, and may arise even when the surgeon has all the skills required for the practice of plastic, reconstructive and aesthetic surgery.
General complications of nymphoplasty:
- Risks associated with general anaesthesia,
- Hematomas likely to lead to further surgery
- Surgical site infections are rare, and can be prevented by good hygiene and local care, particularly after each micturition.
Complications specific to nymphoplasty:
Sensitivity of the operated area may be affected by insensitivity or hypersensitivity. They may be associated with pain due to pressure on the scar area. These symptoms last only a short time and disappear a few months after nymphoplasty.
Scarring disorders can also become apparent. This is the case with large, hypertrophic or keloid scars. These are actually more or less complete disunions of the sutures, which constitute a major specific complication. In this case, further surgery will be scheduled once the disunion has completely healed.
Sexual intercourse may exceptionally be painful, but this pain lasts only for a short time.
