A 26-year-old female presented following prior aesthetic vaginal surgery performed abroad, which included labiaplasty, lateral clitoral hood reduction, and perineoplasty. Postoperatively, she reported dyspareunia, describing a sensation of excessive tightness, as well as dissatisfaction with the aesthetic outcome, noting persistent excess labia minora tissue.
On examination, the labia minora extended beyond the level of the labia majora. Scarring was noted at the sites of prior lateral clitoral hood reduction. The introitus was narrowed, and a fistulous tract was identified as illustrated with the lacrimal duct probe in the photos.
After a thorough discussion of findings and goals, a surgical plan was developed to address both functional and aesthetic concerns. This included revision labiaplasty and perineoplasty, along with radiofrequency feathering. The primary objectives were to widen the introitus, eliminate the fistula to alleviate dyspareunia, and improve the contour of the labia minora.
Learning Point:
Exceptional results in aesthetic vaginal surgery require meticulous attention to both technique and anatomy. Strategic placement of clitoral hood incisions within natural creases helps minimize visible scarring, while careful multilayer closure supports proper healing and reduces the risk of complications such as wound breakdown and fistula formation. This thoughtful, detail-oriented approach ensures outcomes that are not only aesthetically refined, but also comfortable and durable over time.
