Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

Category: Labiaplasty

My preferred labiaplasty technique.

August 31st, 2012 — 12:56pm

Seattle Plastic Surgeon prefers the “wedge excision” technique for labiaplasty.

Labiaplasty is an operation that I never do exactly the same way twice.  That’s because there is so much variation “down there” and every woman presents with her own unique anatomy.

One thing I almost always do, however, is to try to leave a natural looking labial edge.  In the adult female, the edge of the labia is pigmented and textured.  The “wedge excision” technique preserves a natural looking edge.

I started doing labiaplasty this way in 2008 after learning about this technique from Dr. Gary Alter.  He is a plastic surgeon in California who pioneered aesthetic genital surgery.

Prior to that, I was doing a zig zag incision along the labial edge and then interdigitating the zigs with the zags on either side of the incision.  This left a smooth edge without a suture line running along it but it removed the unique skin along the edge.

Labiaplasty is a great example of a procedure that has evolved.  What started out as a simple snipping off of the excess labia has been refined into a procedure that can shorten and reduce the bulk of the labia but preserve the natural form.

It’s this sort of constant tweaking that keeps my vocation so interesting and fulfilling.

Thanks for reading!  Dr. Lisa Lynn Sowder


Labiaplasty is a great procedure what gets very little attention, even from gynecologists.

November 29th, 2011 — 5:24pm

Seattle plastic surgeon does labiaplastyMaybe Eve just needs a labiaplasty and she can lose that fig leaf.

Seattle Plastic Surgeon blogs about Labiaplasty, a very private and very appreciated procedure.

Okay, let’s talk about something really. really private – the labia minora.  These are the inner lips surrounding a woman’s vaginal opening and, as is all bodily structures, there is a wide variation of “normal”.

 An adult woman’s labia can be very small, moderate sized, too big or in some cases very asymmetric.  Some women with large and elongated labia have real issues with these private parts.  Elongated labia can cause discomfort with biking, sitting, horse back riding (ouch!), tight clothing, intercourse, etc.  They can also cause embarrassment in the health club dressing room or in the bed room.

So what causes “labial hypertrophy”?  Who knows?   There has never, to my knowledge, been any research conducted in this area.   It’s my opinion that some ladies just have it and most don’t.  It also makes sense that difficult vaginal delivery could stretch the labia out to some degree but I do not base that on anything other than what patients have told me.

What ever the cause of labial hypertrophy, labiaplasty is a procedure that is very effective, has a fairly quick recovery and has a high patient satisfaction rate.  The technical details depend on the patient’s individual anatomy and it’s important to women to understand that I cannot make their “down there” look like someone else’s “down there”.    And I certainly cannot make a grown woman’s bits look like her prepubescent daughter’s.

In the right patient with realistic expectations, labiaplasty can really make a woman more comfortable both physically and emotionally.  I am always shocked, shocked when I see a woman in my office who says she has mentioned her labial concerns with her family doc, her internist and even her gynecologist and her concerns were dismissed as trivial.

  Oh well, I am very pleased to be able to offer patients this procedure.  It usually goes very well and patients are usually very grateful.

Thanks for reading and spread the word about labiaplasty!  Maybe Rosie will do a show on the procedure!  Dr. Lisa Lynn Sowder


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