Labiaplasty: Indications and Predictors of Postoperative Sequelae in 451 Consecutive Cases.

BACKGROUND: The increasing demand for labiaplasty is well recognized; however, the procedure remains contentious.

OBJECTIVES: We aim to provide a large-scale, up-to-date analysis of labiaplasty outcomes and factors influencing postoperative sequelae (POS).

METHODS: We analyzed a single-center, prospectively maintained database of females undergoing labiaplasty between 2002 and 2017. Demographic, procedural, and outcomes' data were retrieved. Binary logistic regressions were used to evaluate the odds of developing POS (revisional surgery and complications); presented as odds ratios (OR) with 95% confidence intervals (CI).

RESULTS: Data for 451 consecutive patients were retrieved, ten of whom were <18 years of age. Overall, 86% were Caucasian, mean age was 32.6 years, and 11.8% were smokers. Concomitant labia majora reduction was performed in 7.3%, and clitoral hood reduction in 5.8%. There were 32 cases of POS (7.1%), while the complication rate was 3.8%. Comparing those with POS to those without, there were no differences in age (32.8 vs 29.9 years, P = 0.210), operative time (78.5 vs 80.6 minutes, P = 0.246), or comorbidities (P > 0.05 for all). On univariable analysis, increased odds of POS occurred with sexual dysfunction as an indication for surgery (OR 3.778, CI 1.682-8.483). On subgroup analysis of those ≥18 years, both smoking (2.576, CI 1.044-6.357) and sexual dysfunction as an indication (OR 4.022, CI 1.772-9.131) increased the odds of POS. On multivariable analysis of the subgroup, sexual dysfunction as an indication persisted in significance (OR 3.850, CI 1.683-8.807).

CONCLUSIONS: Results compare favorably with previously reported complication and revisional surgery rates. Smoking and sexual dysfunction may increase the risk of complications.