Sadly, it’s not rare that I encounter patients who’ve had a labiaplasty or vaginoplasty performed by another surgeon with less-than-satisfactory results, so much so that they wish to have the outcome revised, modified, “saved” or otherwise “redone.”
By far the wisest choice for a revision is the surgeon who did your original work (it’s certainly much more financially favorable)—so long as that surgeon is well-experienced and well-respected in their field. Not all results are ideal, and your surgeon—if they are reputable, experienced and secure in their talents—certainly desires for you to be satisfied. They should go out of their way, for little or no cost, to revise your results to your satisfaction, provided a minimum of 3-4 months has passed from your original operation and healing is at 100%. Often it just takes a little “shave,” a small edge or polyp, or removing a modest amount of tissue to achieve better symmetry.
Unfortunately, however, many unsuspecting women let relatively inexperienced gynecological surgeons operate on them with disastrous results. Poorly performed (or “botched”) procedures are usually done at the hands of gynecologists; most plastic surgeons will not do vulvovaginal plastic work unless they have been specifically trained in vulvovaginal aesthetic work, but many GYNs (even though they’re not specifically trained in vaginal tightening or aesthetic labiaplasty) think that just because they know the anatomy they can figure out on their own how to do a vulvovaginal procedure. In most cases, they remove far too much tissue and frequently leave a hypertrophic clitoral hood untouched, which does not leave to an aesthetically pleasing result.
Different Types of Revisions & “Redos”
Reduction revisions (performed when not enough was taken off) and shaping revisions are relatively easy and successful—when performed by a well-experienced plastic or cosmetic gynecologic surgeon. (I’d recommend at least 100 cases before I would trust a surgeon with a patient’s revision.)
More difficult are situations where far too much was taken off. It is impossible to “put some back” or build new labia from nothing; however, if there is enough redundant tissue above in the clitoral hood area, a “flap” of hood skin may be brought down and anastomosed to the sides of the vaginal opening to fashion a rudimentary, aesthetic and functional labia.
This type of revision, as well as other complicated revisions, should only be performed by a well-experienced surgeon adept and experienced in performing revision surgery… and this usually does not come cheap. Most surgeons charge more for a redo than a first-time labiaplasty as redos are usually harder and more time-consuming (and fraught with failure) than the original surgery. For this reason, it is so important to choose the right surgeon in the first place; this is definitely not a time to skimp or to go with any doctor who “accepts insurance” or charges much less because they are just starting out. Such doctors are rarely equipped to properly perform your surgery, especially if your anatomy is challenging.
Dr. Goodman Is Skilled at Most Types of Revisions and Redos
Dr. Goodman has performed more than 500 labiaplasties, and 10+ major total revisions or flaps. His revision charges are modest and only include what’s necessary to bring the results up to the patient’s standards. He understands each revision patient has already paid once for a procedure she now needs to have done over, and he rarely charges more than the cost of a primary labiaplasty (the one exception being a V-Y flap revision).
There are also times when the best course is not surgical at all, and Dr. Goodman is also highly experienced in working with hormonal (estrogen + testosterone) and sexual counseling therapy. And he will always be honest—if your individual revision is especially challenging, he will refer you to the good care of Dr. Gary Alter in Los Angeles, the most experienced “reviser” in the world. (Referrals are judiciously provided, as Dr. Alter’s fees are generally well over $10,000.)
Below are several pre-and post-revision photosets. Feel free to click here to read a recent blog post on the subject.