Labiaplasty Nightmare

I would love a support group. My botched surgery has caused my “lips” to constantly be sore, especially since they are uneven and are now pointy! I don’t know if I can find this site again, so I was wondering if you could please email me at ***this post is edited by moderator *** *** posting of private e-mails is not allowed*** *** all questions should be discussed on our website *** Please read our Terms of Use​

Hi doctor, I need help!! I had labyal reduction about a month ago. Doctor removed all my labya and it looks like she stitched my clitoris. I feel a piece of thread sticking out my clitorys. It looks like i am getting an infection because the spot where the labya is supposed to be you see nothing but busted red skiing with whitish discharge. No body called me for my follow up. I called another doctor for an assessment (planning to sue her) and they advised me I have to go see her so that it can be on the record in case they say " she never told me" what is your advice??? Should I go see the doctor who did the surgery or go straight to a different doctor for an assessment????????

Hi, the biggest problem is that OB/GYNs and Plastic Surgeons doing these surgeries are not formally trained to do them during residency. They lack education in the surgical anatomy involved. Because my surgeon was an OB/GYN, I have mainly been focused on trying to change OB/GYN education and training standards so they at least have to be educated in vulvar anatomy.

Currently, operative vulvar anatomy considered sufficient excludes the neuroanatomy of the labia minora, clitoral hood, and clitoris. The distal course of the dorsal nerve of the clitoris along the clitoral bodies is completely absent from OB/GYN literature. It is put at risk during clitoral hood reductions without thought or consideration. This is a large issue as insufficient knowledge of anatomy also impacts treatment of vulvar cancer and precludes accurate diagnosis of physical causes of female sexual dysfunction.

The labia minora are sexually sensitive tissue with an active role in sexual arousal and orgasm. Even in women where the labia minora may not be that sensitive, their structural relationships with the clitoral hood and clitoris are important in biomechanically facilitating stimulation of the clitoris. As someone with a BME degree, I find the lack of consideration for vulvar biomechanics among surgeons appalling. The labia minora also play an important protective role. For this reason, overresection is an unacceptable outcome and should be considered a never event.

I have been in communication with the director of ABOG and he refuses to acknowledge this problem or change anything. I have changed credentialing policies at my local hospital but I feel very frustrated with how little difference I am making. I could really use help. If you are interested in helping, please contact me at ***this post is edited by moderator *** *** posting of private e-mails is not allowed*** *** all questions should be discussed on our website *** Please read our Terms of Use

Ideally I also want to make it so that doctors cannot get privileges to perform these surgeries at hospitals or surgery centers unless they can demonstrate formal training and knowledge of anatomy. This is very tricky because many of the surgeons offering training do not have sufficient knowledge of surgical anatomy.

I have done years of research on these problems and am very good at understanding and explaining the problem. I’ve also read and analyzed all the labiaplasty literature, all the relevant OB/GYN literature (every article containing the term “sexual function,” “labia minora,” “clitoris,” every section of major OB/GYN textbooks containing vulvar anatomy or info on sexual function). There is a large systemic pattern of pervasive ignorance regarding vulvar anatomy and female sexual function. OB/GYNs in the early 19th century were actually better educated about vulvar anatomy before they realized female orgasm wasn’t necessary for reproduction. Our cultural discomfort with external female genital anatomy and sexual function is key to understanding this gap. Causes for motivations for surgery and causes of lack of education in surgical anatomy are closely intertwined.

If anyone wants to help change things and has potential contacts that may be able to help, I would really appreciate it. One problem I’ve noticed is most women don’t describe what happened to them very accurately. I can help you understand and communicate those details. I also think it’s realky important to communicate the ignorance you’ve no doubt encountered among physicians. 

Potential avenues for change:
1. Local hospitals and surgery centers. Contact heads of departments, heads of patient safety, whoever is in charge of credentialing. I have succeeded at this, so if you want to get credentialing policies changed at your local hospital and affiliated surgery centers (easiest if connected), I can tell you how.

2. ABOG - if I can just convince this one stubborn old man that current operative anatomy learned in residency is inadequate, I can change the working clinical knowledge of OB/GYNs. This would have a HUGE impact. If you want to contact me, I can help you write an email telling him your story and explaining the need for better education. Also, if you have any OB/GYN friends or friends of friends, I have also crafted a template email for them. So far none have sent it yet but they at least claim to agree with me.

3. ACOG - I have been unable to get any leadership at ACOG to respond to me. But ACOG is negligent in a million ways. For one, they have factual errors in their committee opinions on labiaplasty. They condone these surgeries even for women under 18, while neglecting to establish standards and actually resisting efforts to train OB/GYNs as part of CME. If anyone knows leadership at ACOG, this would be an avenue for change. I can help you write to them.

4. ACGME - I just tried contacting them yesterday. I honestly don’t know if they can do anything. They are responsible for accrediting residency programs.

5. Authors of OB/GYN textbooks, especially authors of chapters on vulvar anatomy and female sexual function. They need to be updated, corrected, and made to include more detailed vulvar anatomy and a more modern approach to female sexual function.

6. Local residency programs. Contact directors of residency programs asking them to change curriculums.

7. Reporters. There have been articles in the media but none of them really approach the fundamental issue correctly. These surgeries don’t need to be so dangerous. Rather, injuries occur due to a lack of education and training standards. OB/GYNs ignorance of vulvar anatomy is especially egregious. I think a focus on this lack of education is key here, as it has implications for far more women. It impacts women needing treatment for vulvar cancer, women who have suffered straddle injuries, women with unexplained sexual dysfunction who should be evaluated for physical injury, etc. In an era where women’s sexual health is supposed to be important and taken seriously, an understanding of this anatomy should be fundamental.

8. Social media. I am in my 30s and not active on social media. I do not have many friends or much of a social network so I feel a bit silly going that route. Honestly, my experience with my surgery has been incredibly isolating for me. I spent 3 years not talking to people at all. However, social media has be a very effective way to spread awareness about an issue, and I have been told repeatedly that I cannot succeed as a solo hero. i did actually try posting on twitter and I got reposted a few times, but then I got self conscious. I do technically have some contacts that have thousands of followers and could maybe help, but they are all in tech. I’ve thought about trying to link credentialing and training problems in with blockchain technology, VR, and AI to get their interest, but I get so self conscious about this issue. Two women I know have a sex toy company that broke the Indiegogo campaign. One expressed interest in helping 2 years ago. But I honestly have avoided her since I told her. I guess I could really use support from anyone interested in helping. I’m not the type to ever ask for emotional support, but I guess my emotions have been really holding me back. I was also thinking of maybe making a YouTube video. I just worry about looking ridiculous. I’d post one where I go through OB/GYN textbook anatomy and read the most ridiculous sections from textbooks and journals to bring awareness to that if I could make sure I get like 100 likes so I don’t look ridiculous to people who might know me. I am just afraid.

9. Legal. I want to support individuals filing claims or reports to state boards in any way I can and am happy to talk to anyone who wants to talk. In an ideal world, this systemic negligence would be grounds for a class action lawsuit against boards, professorial societies, residency programs, etc. There is no precedent for that and I don’t know if it’s even possible. No lawyer friends of mine have had any ideas but I’m still wondering if there’s a potential solution there. Lawsuits against individuals have done little to change what now amounts to 30+ years of fundamental systemic negligence. It is unacceptable that surgeons have continued to do surgery on anatomy they do not know for this long.

10. Strength in numbers. I think it is really important for women who have been hurt by these procedures to connect with each other if possible. I do think that a support group would help. I personally struggled with PTSD symptoms, especially after my doctor lies to me and blamed me, after other doctors initially told me what I said happened *couldnt* have happened (I recommend going to Goodman, Alter, or if you need local, then to a urogynecolist for evaluation) and after I started looking into why/how this happened. One thing that makes me crazy is how people act like these surgeries are so safe and like people like us don’t exist, as if we don’t matter.

My doctor, recommended as the best ob gyn surgeon at my hospital and previously president of state medical association, completely removed my labia minora, performed a clitoral hood reduction without my consent, and damaged the dorsal nerve of my clitoris so I have no sensation distal to my scars. The glans of my clitoris is completely numb. I was told by multiple doctors that I had a good result, looked normal (despite completely amputated labia minora), that my surgery could not have resulted in my loss of sensation, etc. I was young, sexually inexperienced, ignorant about my anatomy, and trusting of my doctors. I really worry about how difficult it is for harmed patients to be recognized and heard. I have a disagreeable-type personality where I am difficult to intimidate and not afraid to be assertive, but it was still very difficult for me. It was like getting gaslighted for years.

I also experienced a lot of secondary wounding. On one hand, I would get told I should have known all surgery carries risks and was stupid to get this surgery in the first place. Even my doctor blamed me. I was barely 18 years old, but the way he told the story, I made him do it. He lied and denied the clitoral hood reduction even though I have visible scars to prove it. On the other hand, I would get told these surgeries are safe and that it was my fault for picking a bad doctor. No matter how you spun it, no matter who I talked to, it was my fault, or not a big deal, or something I should just get over. My mom told me to stop making mountains out of mole hills, asked me when I’d ever learn to get over things, questioned why I needed justice, asked why I was so obsessed with sex. My dad and psychiatrist told me that if I reported it, the board would blame me and take my doctors side. They said they wouldn’t see the clitoral hood reduction as wrong site surgery. I never consented. That is a never event. It involves different anatomy with different risks: But they said they’d see it as “basically the same thing.” My psychiatrist said I was only struggling because I hadn’t gotten over getting abused when I was 15.

Prior to 2014, the neuroanatomy of the clitoris had not even been properly published. There were only 3 adult studies (Ginger, O’Connell, Vaze) which contradicted each other and only provided abstract illustrations and slides, so it was difficult to figure out exactly what could have happened. I had to try to work out whether I could have a dorsal nerve injury largely by referencing the literature on men.

I could really use help making changes.

I actually did find a lawyer a long time ago. I was just trying to find out about these cases. It would be really helpful to know how difficult it is to get a lawyer to take your case though, as my belief is systemic negligence makes it difficult for harmed patients to get any kind of justice through the legal system. If you’re still looking for a lawyer, I could probably fine his contact info but it would be in emails from 2010 so I’m not sure I would have it anymore but he does take these cases. But he’s in Virginia.

Hey I hope you see my recent posts at the end of this thread

Thanks for sharing your story. I especially like how you explained that pursuing a lawsuit would add to your trauma. I think cases like this are much more common than people realize because of how difficult it is to speak up about such a horrible trauma. I also think this is predictable and preventable due to systemic negligence and pervasive ignorance of vulvar anatomy.

Uh it definitely does not always get better. For many of us, the loss is permanent. I have no sensation in most of my clitoris, including the clitoral glans. The base of the shaft of my clitoris is very difficult to stimulate. This is typically not an area women depend on for stimulation, but it’s all that is still sensitive. No partner can ever give me an orgasm and I essentially cannot even feel oral sex. It has been 13 years. The main branches of my dorsal nerve were obviously cut. I will never regain the sensation I had prior to my surgery unless someone figures out how to regenerate nerves or transplant a vulva.

I hate seeing posts like this. It is victim blaming at best. My surgeon was chosen by my dad, who is the head of the plastic surgery department at a major hospital. My surgeon was recommended as the best ob gyn surgeon at the hospital by the head of the ob gyn department. I did find out he hadn’t done many of these surgeries, but he is seen as a rock star surgeon and he said he could do it.

He completely removed all of my labia minora, performed a clitoral hood reduction without my consent, and injured the dorsal nerve of the clitoris.

Having analyzed ALL the labiaplasty literature, it is obviously that most of these doctors, including the experts, have no clue about vulvar anatomy and female sexual function. Those that claim good results are evaluating their own results. Outcomes are rarely, if ever, properly evaluated in an objective way. Also, while certainly doctors who have done 100+ procedures get good results, what about the first 100 patients? What about the first 10? What about the fact that most of these doctors do not receive formal training? What about how the dorsal nerve of the clitoris was not even mentioned in the literature until 2015?

I cannot find a single other instance where surgeons are considered qualified, by virtue of residency completion and board certification, to perform surgeries they are not trained to perform on anatomy they do not learn about in residency. This anatomy is not in a single OB/GYN textbook.

Lol. Alsinod actually insists the labia minora serve no function - sexual or protective. He actually advocates the complete removal of the labia minora. And like nearly every other vulvar cosmetic surgeon, he does not consider the risk of dorsal nerve injury with clitoral hood reductions.

I actually think most women who have been horrifically and irreversibly mutilated don’t get on the internet and post about it because it is too traumatic for them. Seeing people actually blame victims and invalidate their experiences is legitimately painful.

Regardless of how many women are happy, the fact is surgeons are doing these surgeries without formal training and without adequate knowledge of the surgical anatomy involved. Even as recently as last year Alter published that no one has ever proven the labia minora play a role in sexual function, despite significant evidence that they do.

Furthermore, there are only 2 mentions of the dorsal nerve in the literature to date. Most surgeons don’t have a f*****g clue.

I’ve written a 200 page research paper on this. I couldn’t ever finish it. But I spent 80 pages analyzing motivation. It includes a review of all studies of motivation and also analysis of internet content, medical literature content, etc. Women actually are more influenced by medical literature content than porn according to studies.

Wtf? And what do you think that accomplished? You think people who have been mutilated want to read about your experience?

Most women seeking surgery are well within the normal range and do not have any significant physical issues that would justify a need for surgery.

Most women have no idea that surgeons performing these surgeries are not formally trained or educated about the anatomy. There are no education and training standards. Even experts are ignorant about vulvar neuroanatomy and sexual function.

The mean is 2.18 cm and standard deviation is 0.94. If you are outside of 2 standard deviations, I would recommend seeing Dr. Michael Goodman. Otherwise I think your insecurities can be solved with education. Watch amateur and European porn.

Hey sorry I just saw this. My email is ***this post is edited by moderator *** *** posting of private information such as name, phone number or email address is not allowed in order to protect your privacy*** Please read our Terms of Use​

I know it’s ptobavly too late for me to help but it would be useful to know how your lawsuit went as I am trying to get ABOG certification requirements changed

ABOG does not require OB/GYNs to know operative anatomy of the labia minora, clitoris, and clitoral hood (the proximal segment of which is effectively shaft skin). They are not trained to do labiaplasties during residency. Board certification means nothing. Lol