Smart Beauty Guide Blog/Posts

Below are blog articles of interest including breast augmentation, breast implants, lip enhancement, facial capillaries, labiaplasty, breast implant associated ALCL, and the latest trends in plastic surgery.

Click here for more information about plastic surgery of the labia (Labiaplasty)

Breast Implants

BIA-ALCL Resources
Frequently Asked Questions

1. Do I need to have my implants removed?

No, the FDA has specifically stated that implant removal is not necessary at this point unless you are diagnosed with BIA-ALCL. Having symptoms such as breast swelling, a lump in your breast or armpit, persistent breast pain, a rash or any change in your implants should be investigated by your physician. If you have any of these symptoms you should make an appointment to see a board-certified plastic surgeon and member of the American Society of Plastic Surgeons.

2. I have Allergan BIOCELL implants. What should I do?

Unless you are having the symptoms noted below, there is nothing to do at the present time other than routine continual breast examinations. Any changes in your breast should be examined and discussed with a board-certified plastic surgeon. The current recommendation from the FDA is that women with Allergan BIOCELL implants that do not have symptoms do not require removal. If you have Allergan BIOCELL implants, you should understand that textured surface implants are associated with a low but real risk of BIA-ALCL, a cancer of the lymphatic system. You should know the signs and symptoms of the disease. As long as you have your breast implant(s), you should monitor your breast area for any changes.

It is important to note that on September 12, 2019 the FDA released an update identifying Allergan BIOCELL Textured Breast Implant(s) as a Class I recall, the most serious type of recall. If changes to your breast(s) arise, you should seek evaluation promptly. More information about BIA-ALCL can be found at:

3. I have a textured implant(s) but my implant(s) have not been recalled. What is my risk for developing BIA-ALCL?At the present time, your exact risk is not known. However, it appears to be significantly less than the risk noted below in question 4. The FDA and a 2017 study of US epidemiology of BIA-ALCL noted that Allergan BIOCELL implants appeared to be 6x more likely to be associated with the development of BIA-ALCL than other textured implants currently on the market.

4. What is my risk of BIA-ALCL? Is my risk of BIA-ALCL lower if I remove my implants and do not have them replaced?The risk and incidence of BIA-ALCL in patients with Allergan BIOCELL textured implants ranges from 1:443 (median of 7 years) to 1:3345. The overall risk of BIA-ALCL in the US is 1:30,000 which is an average of several high and lower risk textured implants. There is no known procedure that can reduce risk for the development of the disease in the future. Patients have developed BIA-ALCL with a history of a retained scar capsule and a history of only simple implant exchange. However, patients should note that the current risks associated with any surgery are higher than the risk of developing BIA-ALCL. Discuss all benefits and risks with your board-certified plastic surgeon. Understanding all potential risk factors will help with better decision-making that is best for you and your health.

5. I had (or currently have) textured tissue expanders. Should I be worried? What is my risk of BIA-ALCL?

Risk of disease with tissue expanders has not been determined at this time. It is important to stay vigilant and upon noticing any changes in your breasts, consult a board-certified plastic surgeon.

6. Is there a screening test for BIA-ALCL?

At present there is no screening test or tool for BIA-ALCL. The best course of action is careful routine breast examination. If you have symptoms such as breast swelling, a mass in your breast or armpit, a new rash on your breast or persistent breast pain, or any change whatsoever in your breasts, you should see your plastic surgeon for evaluation.

7. I have symptoms of BIA-ALCL. What should I do?

The most common sign of BIA-ALCL is fluid or swelling around a breast implant. This usually happens many years after the implant was originally placed. BIA-ALCL can also cause tumors that arise from the scar capsule around the implant. Less commonly, BIA-ALCL can cause a breast to become lumpy or misshapen with the development of thick scar capsule around an implant.

If you have any of these symptoms of BIA-ALCL or other changes in your breast(s), your health care provider should evaluate you promptly. It is important to note that these signs and symptoms do not necessarily mean a diagnosis of BIA-ALCL. These changes, for example, can also result from a leaking implant or trauma to the breast area. To evaluate for BIA-ALCL, your health care provider will take your history, perform a physical exam and may order imaging or an assessment of any fluid or tissue around your implant.

8. If I choose to have my implants removed and/or replaced, do I need to have the capsule (scar around my implant) removed? What is an En-Bloc resection?

If you choose to have your breast implant(s) removed out of concern for BIA-ALCL, you should have a discussion with your surgeon about implant removal, implant exchange, and partial or total scar capsule removal. The surgical removal of the scar capsule around your implant is called a “capsulectomy” in an otherwise healthy patient. Having a total capsulectomy at the time of implant removal is not known to change the risk of developing BIA-ALCL. The risk of performing a capsulectomy includes, but is not limited to, bleeding and other wound complications. For reconstruction patients, a capsulectomy could result in a change of shape to your breast or loss of the reconstruction.

En-Bloc resection is often a misused term that means a cancer removal in a BIA-ALCL diagnosed patient with removal of the implant, complete capsule in conjunction with any associated mass and a rim or margin of surrounding healthy tissue.

9. I didn’t receive an implant card. How do I find out what kind of implant I have?

The best and easiest way is to contact the surgeon who performed your surgery or the hospital where you had your surgery performed and ask for your medical records. If your surgeon is no longer in practice or a significant time has elapsed since your surgery, the implant manufacturers may have this information through their device tracking mechanisms. Call the medical information division at one of the companies to find out about your implants.

10. Am I in the NBIR/PROFILE registries?

The aggregate NBIR and PROFILE registry data sets do not contain any personal identifying information. Contact your plastic surgeon and/or treating physician to determine whether or not your information was entered in either registry.

Breast Augmentation Blog

So Many Options for Breast Augmentation— Which One Makes Sense for You?

See Below for information about Labiaplasty.

For decades, breast augmentation has been among the top 5 most popular aesthetic surgical procedures for women. In fact, according to the American Society for Aesthetic Plastic Surgery, it has been one of the top 2 most popular procedures since they began surveying physicians 20 years ago! But, while breast augmentation has remained consistently popular, what has changed significantly over the past few decades are the myriad options available to women looking to add volume to their chest. Technological innovations and improvements in procedural techniques have advanced the procedure, making it much more accessible with less downtime and more tailor-made options for individual patients as opposed to a one-size-fits-all implant.

This is why it’s critical for anyone seeking breast augmentation to seek out a board-certified plastic surgeon specializing in the procedure, who is also well-versed on all of the options available and adept at guiding a patient to which choice might be best-suited for them.

Here are the augmentation options we share with our patients:


Among the most popular choices, silicone implants are available in a wide range of shapes, sizes and profiles to accommodate nearly everybody. Silicone gel-filled breast implants are filled with soft, elastic gel and are available in a variety of shapes. All silicone gel breast implants are pre-filled and may require a longer incision for implant placement.

Cohesive gel silicone gel-filled breast implants, also known as “gummy bear” or “form stable” implants, are filled with a cohesive gel, made of cross-linked molecules of silicone, which makes them a bit thicker and firmer than traditional silicone gel implants. This enables them to hold their shape better. Approved by the FDA for use in the United States in 2012, these implants have been available in much of the world since 1992.
Women tend to like these implants due to their tendency to have a natural look and feel and because the chances of complications like breast rippling are reduced.


Saline-filled breast implants are filled with sterile salt water. They may be prefilled at a predetermined size, or filled at the time of surgery to allow for minor modifications in implant size. Structured saline-filled breast implants are filled with sterile salt water, but contain a structure inside so they behave as if filled with soft, elastic silicone gel. This structure enables them to hold their shape better than traditional saline implants. Approved by the FDA and Health Canada in 2014, these implants have been available since 2015.

While not as popular as silicone, saline appeals to certain women due to the ability to customize the sizing on a fairly pinpointed scale.


Autologous fat transfer, (AKA Fat Grafting) removes fat through liposuction from an area of your body in which there are abundant fat cells, such as your thighs, abdomen and hips. After a process of preparation and refinement, the fat cells are injected into your breast. This can be used independent of implants to achieve a small volume increase, (about a cup size), or in concert with implants to add an element of a natural look and feel. Mammography can be a real concern, so this technique is used more for reconstructive indications and in selected  cases only.

There are many choices in breast augmentation these days, designed to provide patients with customized results that will look both natural and beautiful. While we rarely see women requesting disproportionately large implants these days, many women come in looking for a small amount of added volume that is discrete and perfectly proportioned to their size and shape. It requires a skilled breast augmentation surgeon to deliver the right results for each individual patient. Make sure you look for an ASAPS board-certified plastic surgeon if you’re considering breast enhancing surgery.

Facial Treatments Capillaries Veins Blog

Common Causes of So-Called “Broken Capillaries” and How to Treat Them

See below for information about Labiaplasty.

I’ve had allergies for as long as I can remember. Like clockwork, every time a plant blooms (or the wind blows, or I haven’t dusted in a while,) I get a sneezing attack. Likewise, I’ve always got Kleenex at the ready. My seemingly incessant sneezing, chronically excessive nose blowing, and rubbing/itching has put too much pressure on the skin around my nose and after several years, has resulted in a few broken capillaries.

I will admit that I’ve gotten pretty good at covering them up with makeup. The annoying thing about having a series of small broken capillaries around my nose is that without makeup I constantly look like I have a cold.

The older I get, the more I worry about how little things like this will prematurely age me. How exactly do I deal with these little veins on my nose? Is there anything I can do about them, other than pile on concealer? To uncover what is really going on with broken capillaries and spider veins, I spoke with board-certified plastic surgeon, Tracy M. Pfeifer, MD, MS

Dr. Pfeifer started by clearing up a huge myth: broken capillaries aren’t actually broken at all! Broken capillaries are actually dilated capillaries, also known as spider veins or telangiectasias. Who knew?!?


So what causes telangiectasias? According to Dr. Pfeifer, there are many. Everything from sun exposure, genetics, obesity, hormonal changes associated with pregnancy, hormone replacement therapy, birth control pills, conditions such as rosacea or other inflammatory conditions and even alcohol consumption.

Dr. Pfeifer said that the pressure from prolonged standing can contribute to the development of spider veins in the legs. For those who are on their legs all the time, (teachers, nurses, etc.), whose job requires extended periods of standing, this tends to be more pronounced.


If you know that you are susceptible to any of the possible triggers listed above, but haven’t yet noticed any pesky little red spots or veins, it’s a good idea to take preventative action now.

For those who have rosacea, Dr. Pfeifer suggests a lifestyle and skincare program to ensure it is under control. “Avoiding the rosacea triggers can help reduce the inflammation and therefore the redness. Sulfur-containing masks are very good for treating inflammation.”

For non-rosacea related spider veins, Dr. Pfeifer says that taking oral vitamin C can help along with a thoughtful and consistent skincare routine. “The idea is to make the skin as healthy as possible, prevent additional spider veins and minimize the appearance of existing spider veins.”

Dr. Pfeifer also says that using sunscreen daily is a must for people who are prone to spider veins/transgielactasias. She also suggests using skincare products that contain antioxidants like vitamin C, and anti-inflammatories like witch hazel and sulfur. Dr. Pfeifer notes, “There is no scientific data to support the claim that vitamin K helps. Building the thickness of the skin by using retinol and retinoids can also help.”

In-Office Treatment Options

If you do have spider veins/telangiectasias that bother you, there are definitely ways you can treat them with the help of a doctor. Essentially, all treatments achieve the same result using different methodologies: Collapse the capillary which prevents it from filling with blood, which effectively removes it.

For dilated blood vessels on the face, Dr. Pfeifer says they are typically treated with a laser, either with IPL, V-Beam laser (pulsed dye) or electrocautery. In the legs, where spider veins are typically larger, she explains that all of the above therapies will work as well as sclerotherapy, which involves injecting hypertonic saline into the capillary. This will make the vessel react leading to scarring of the vessel and causing the vessel to collapse. For this she explains that two solutions are used in the United States: Hypertonic saline (off-label use of FDA-approved product) and sodium tetradecyl sulfate, which is FDA approved.

“In general, I think that sclerotherapy is the most effective treatment for leg spider veins. In my practice, we inject leg spider veins with hypertonic saline. For the face, we use electrocautery to treat a few, isolated spider veins.  Fortunately, in recent years, Asclera (polidocanol) has been FDA approved, and is rapidly becoming the most common sclerosing agent used, due to its excellent safety record.

After chatting with Dr. Pfeifer, it’s clear to me that my best bet for treating the annoying dilated capillaries around my nose is through skincare. Because of their small size and ease of concealing with makeup, I’m more concerned with preventing more of these suckers from appearing in the future.

Lip Enhancement Blog

Lip Enhancement at Any Age

See below for information about Labiaplasty.

Lips are the most sensual place on the face. Sure, bat your lashes all you want, but the lips can pout, entice, and excite… all at once.

The team over at New Beauty did a deep dive into what lip enhancement looks like at every age. Subtle enhancements with nonsurgical treatments can make a significant and positive change to one’s overall look.

If your lips have never been as alluring as you’d like (or aren’t what they once were), here are the best lip enhancement treatments to maintain that youthful pout at any age.

20s: What’s happening: Lip enhancements in your more youthful years seek to remedy natural asymmetry, too-thin lips or that perfectly descriptive “Resting Bitch Face” that can happen when the corners droop down. Thankfully fillers (like Juvederm and Restylane) can be used to address any of these issues.

30s: The body’s loss of collagen and elastin, and years of drying sun exposure contributes to wrinkles on and around the lips. Again, fillers here can be used to gently alleviate these concerns. Since youthful lips require fairly little enhancement to get them back on track, it’s key to work with a doctor who uses fillers judiciously. We’ve all seen bad examples where too much of a good thing is a bad thing. Do I really need to cite any celebrity examples here? I don’t think so.

While enhancements in our 20s and 30s are focused on correcting that which nature did not naturally bestow upon us, the focus of enhancements in our 40s, 50s, and beyond is to restore to our previously youthful appearance.

40s: With that in mind, in our 40s treatments are used to counteract even MORE drying and thinning. (Mother Nature, man – she just doesn’t stop.) Laugh lines have become more pronounced, etching grooves into the skin around the lips. And the lip shape itself, as well as areas around the lips, begins to change structurally. The corners of the mouth may become weaker, drawing the mouth — and likely the overall facial expression — down into a frown. Fillers will, well, fill in wrinkles to counteract the appearance of aging and bring fullness back to the other areas surrounding the lips as well.

50s: Overall changes to your entire visage may be morphing the lips even more. So much to look forward to, right? The lack of elasticity in the skin due to the loss of collagen and elastin and incremental drooping that starts mid-face can extend the space between the nose and lips meaning that, with time, the lips themselves have dropped a bit. {Shakes fist at Mother Nature and genetics}.

According to the New Beauty article, doctors can carefully and elegantly use a mix of fillers and neurotoxins to recreate the curve at top of the lip (AKA Cupid’s bow) and the vertical columns that run from the base of the nose to the top points of the lips, restoring the youthfulness of yore.

60s and Beyond: At this stage, an aesthetic professional will continue reconstructing key areas, including restoring the fullness of the lips and facial structures around the mouth. The same advice holds true in your 60s as your 20s: Trust your enhancements to a doctor who is on the same page as you in terms of your desired look. Remember too much filler alters your facial anatomy instead of enhancing you.

In your 50s, 60s and beyond, plastic surgeons can offer more than fillers and neurotoxins –they can offer fat grafting during simultaneous facial rejuvenation procedures. No matter what stage you find yourself in, find a trusted professional to consult with on the solution that suits your face, and your cosmetic goals. Board-certified plastic surgeons who are members of the American Society for Aesthetic Plastic Surgery have the knowledge and years of experience performing these lip-enhancing/rejuvenation procedures.

Our bodies are in a constant state of change. That we can’t control. But whether we’re searching for the perfect lips we once had, or never had in the first place, nonsurgical solutions are as easy as the next visit to the office of a plastic surgeon certified by the American Board of Plastic Surgery (ABPS).

Patients who have had this procedure give a 93% patient satisfaction rating.


Cosmetic SurgeryIf you’re searching Instagram using hashtags for a good #plasticsurgeon, you may end up with a #plasticsurgerydisaster performed by a hair stylist, a barber or an ER doc offering cosmetic surgery on the side.  This is a Blog article
More than four of five top Instagram posts with plastic surgery-related hashtags come from providers who aren’t eligible for membership in the American Society for Aesthetic Plastic Surgery, the premier professional organization for cosmetic surgery, a new study found.
About 26 percent of top Instagram posts about plastic surgery come from physicians in other specialties, such as gynecologists, dermatologists, general surgeons, family doctors, ear-nose-throat doctors, and — in one case — an ER doc, researchers found.
Even though they were not specially trained in plastic surgery, all these physicians marketed themselves as “cosmetic surgeons,” the study showed.
Even worse, more than 5 percent of posts were from non-physicians doing plastic surgery at dentist offices, spas and hair salons.
The consequences of using a poorly trained plastic surgery provider can be much more dire than a bad tummy tuck or ugly scar, said senior researcher Dr. Clark Schierle, director of aesthetic surgery at Northwestern Medicine in Chicago.
A Georgia doctor specializing in emergency medicine faced felony murder charges last year after two patients died during botched liposuction procedures she performed at her Cobb County cosmetic surgery clinic, Schierle said. The doctor lost her license to practice medicine in Georgia, but prosecutors decided to drop the charges, a published report said.
And in August, a 31-year-old New York City mother of two died from enhancement injections to her buttocks that she received in a residential apartment building, according to a published report.

“It’s kind of like the wild west out there. Cosmetic surgery is really unregulated,” said Dr. Clyde Ishii, president of the American Society for Aesthetic Plastic Surgery. “Consumers have to understand that cosmetic surgery is real surgery, with real complications.”
Schierle and his colleagues decided to investigate Instagram posts because “it is a uniquely visual social media channel, and plastic surgery is a uniquely visual medical specialty,” he said.
They reviewed more than 1.7 million Instagram posts to find popular posts associated with 21 plastic surgery-related hashtags. These included #plasticsurgery, #facelift, #cosmeticsurgery, #breastlift, #boobjob, #rhinoplasty, #brazilianbuttlift, #tummytuck and #liposuction.
The researchers collected the nine most popular posts for each hashtag, and checked the source for each post.
Two-thirds of the top posts promoted the person’s cosmetic surgery practice, as opposed to educating the public about plastic surgery, the researchers found. However, board-certified plastic surgeons were nearly twice as likely to use Instagram to post educational content rather than self-promotion.
The problem is that medicine is largely unregulated, and someone with a medical license is considered under the law capable of performing just about any procedure, Schierle said.
Doctors hoping to make a little extra money on the side can take some training in cosmetic surgery procedures and hang their shingle, Schierle said.
These doctors won’t be able to get board certification in plastic surgery. But they can say they’re board-certified because they have been certified by the board governing their own specialty, he said.
“An internist could perform brain surgery in the eyes of the law,” Schierle said. “That doesn’t mean it’s a good idea.”

13 Photos
Latest trends in plastic surgery
Barbers and hair stylists can legally promote plastic surgery, but they would be breaking the law if they used a knife or needle on someone, Schierle continued.
It’s likely these places are doing a “bait and switch,” seeming to offer plastic surgery services but actually steering incoming clients to other alternatives, Schierle said. For example, they might sell the person a garment that makes them sweat or offer an ostensibly fat-burning massage.
People considering cosmetic surgery need to take it more seriously, and do their homework, Ishii said.
“A lot of people view cosmetic surgery as frivolous and harmless,” Ishii said. “Because it’s treated lightly on social media, they don’t give it the respect it’s due.”
Before undergoing a procedure, ask your provider if he or she is credentialed to perform that procedure in a hospital, Ishii said. Hospitals have very stringent credentialing standards.
You also should ask whether the person is board-certified specifically in plastic surgery, and whether their board is recognized by the American Board of Medical Specialties, Ishii added.
The ABMS is the United States’ governing body for credentialing medical professionals. Some alternative boards have popped up that will provide doctors with credentials for “cosmetic surgery,” but these boards are not recognized by the ABMS, Ishii said.
A board-certified plastic surgeon has more than six years of surgical training and experience, with at least three years specifically in plastic surgery, the researchers said.
A practitioner referring to herself or himself as a cosmetic surgeon could belong to any medical specialty, and may have received training that varies from a one-year cosmetic surgery fellowship to a handful of short weekend courses on liposuction, injectables or breast implants.
The study was published Aug. 30 in the Aesthetic Surgery Journal.
© 2017 HealthDay. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Latest Trends in Plastic Surgery

Facial Surgery

Blog article:  Check out the latest trends in plastic surgery in Allure magazine, but take with a grain of salt!


Breast Augmentation Blog

Blog Article:  ASJ Study Puts the Risk of Death From Breast Implant-Associated Anaplastic Large Cell Lymphoma into Plain Perspective for Patients

Micromort Measurement Calibrates Actual Risk Based on Everyday Comparisons
New York, NY (August 23, 2017) – Findings from a recent study published in the Aesthetic Surgery Journal showed that the risk of dying from breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is 0.4, based on a micromort analysis, a unique tool measuring relative risk of activities, and exposures, defined by Ronald Howard in 1979 as 1 micromort = 1:1 million chance of death. The study will help with patient education about this rare condition that has recently been featured in the news. Its findings demonstrate the following:
The micromort of a woman skiing for 1 day = 0.77, 2x that of a patient having a breast implant for life
Drinking 2 glasses of wine or riding a bike for 17 miles = 1, 2.5x the micromort of having a breast implant for life
Driving a car for 8 hours = 16, 40x the micromort of having a breast implant for life
The lifetime risk of developing BIA-ALCL from breast implants in previous epidemiological studies ranges from .003% to .005% for those with textured implants based on U.S. data. Although rare, these numbers are not very tangible to patients or surgeons, especially with some recent inaccurate reports in the media.
According to the annual statistics of the American Society for Aesthetic Plastic Surgery, 310,444 women had breast augmentation surgery in 2016. Since 1997, (when ASAPS began collecting aesthetic surgical data), the number of women who have received breast implants in the United States is 5,701,317. Since the FDA began tracking data for reported cases of BIA-ALCL in the United States in 1997, there have been 9 deaths to-date which were likely attributable to a then lack of knowledge about the condition. On a global scale, approximately 30,000,000 women have breast implants worldwide, (not including breast reconstruction) and there have been approximately 12 deaths worldwide. BIA-ALCL is a rare spectrum of disorders that can range from a benign accumulation of fluids around the breast (seroma) to an extremely rare lymphoma, that when caught early, is readily curable. It is not a cancer of the breast tissue itself.
William P. Adams, Jr. MD, one of the study’s authors explains, “Unfortunately, patients are getting the wrong information, and this study is critical to correcting that. Furthermore, with this data, we are now confident that this condition needs a reclassification as a lymphoproliferative disorder and not a lymphoma. We conducted this micromort study to bring real life perspective for all existing and potential breast augmentation patients who might have reservations about implants based on the recent media coverage indicating that breast implants can be fatal – a sensationalized take on a very rare and very treatable condition.”
“The findings of this study are very important for patient education. The clear lymphoproliferative nature of BIA-ALCL along with the calculated risks associated with its diagnosis should be used for discussion during new consultations or at the time of presentation for evaluation of delayed onset seromas,” explains David A. Sieber, MD, the co-author of the study.
”This analysis resonates with patients,” Adams says. “They get it, when you explain to a patient that their micromort risk from skiing for one day is 2 times higher than the micromort risk of having a textured breast implant for their lifetime – or that traveling 8 hours by car carries a 40 times higher micromort risk than having two textured breast implants for their lifetime,” he continues.
The study’s authors explain that this is not data to downplay risk, (as there is risk with any surgical procedure), but merely a tool to add to a physician’s arsenal to properly explain the actual risk based on fact-based reporting and figures.
The full study can be found here: and a video featuring the study’s authors can be seen here:
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About the Aesthetic Surgery Journal
The Aesthetic Society Journal is the official publication of the American Society for Aesthetic Plastic Surgery. It is published eight times per year and contains scholarly articles on new advances and procedures pertaining to cosmetic medicine and the plastic surgery industry. ASJ was indexed with MEDLINE/PubMed in 2008 and with the Thomson Reuters Journal Citation Report (JCR; formerly ISI) in 2011. It is the official English-language journal of many major international societies of plastic, aesthetic, and reconstructive surgery representing South America, Central America, Europe, Asia, and the Middle East. It is also the official journal of The Rhinoplasty Society. The Journal also includes Continuing Medical Education articles and exams.
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The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; Active Members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International Active Members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.

Labiaplasty (Plastic Surgery of the Labia) & Vaginal Rejuvenation


Labiaplasty (Vaginal Rejuvenation)

Labiaplasty, also known as female genital plastic surgery or aesthetic vaginal surgery

Vaginal rejuvenation usually combines vaginoplasty (“tightening” of the vagina) and/or labiaplasty or vulvaplasty (reshaping of the vulva or labia, the outer and inner lips of the vagina). It has become an increasingly popular option for women. For individuals who desire recontouring after childbirth, significant weight loss, aging or injury to genital structures, vaginal rejuvenation offers increased self-confidence and comfort.

When to Consider Labiaplasty and/or Vaginal Rejuvenation

  • If the contours of your vaginal structures have altered and stretched over time.
  • If you experience soreness or pain with sexual activity, bicycle riding or horseback riding.
  • If the effects of multiple vaginal deliveries have led to reduced sensation during intercourse.

Considerations for Labiaplasty and/or Vaginal Rejuvenation

Pros of Labiaplasty and/or Vaginal Rejuvenation

  • Your vagina and surrounding muscles will return to nearly the tightness you had in your youth or before pregnancies.
  • A recontoured, trim vagina may boost your self-confidence.
  • You may find that wearing clothing, such as bikini bottoms or panties, is enhanced by your sleek new shape.

Cons of Labiaplasty and/or Vaginal Rejuvenation

  • Bladder injury, hemorrhage and infection might occur.
  • Your partner and you may need some time to adjust to the new sensations resulting from your tightened vaginal walls.
  • You may need to experiment to find positions and approaches that are comfortable and pleasurable for both you and your partner.

These are the top three pros and cons to weigh when considering labiaplasty and/or vaginal rejuvenation. If you want to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Are you a good candidate for labiaplasty and/or vaginal rejuvenation?

The following are some common reasons why you may want to consider a labiaplasty and/or vaginal rejuvenation:

  • Your vaginal structures sag and have become more lax due to aging, weight loss or pregnancies.
  • You have discomfort from scarring as a result of previous genital surgeries.
  • You have stress urinary incontinence and wish to combine a “vaginal lift” with a corrective procedure.
  • You desire a sleeker, more refined contour to your labia and vulva.

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

Detailed Procedural Info for Labiaplasty and/or Vaginal Rejuvenation

How is a labiaplasty and/or vaginal rejuvenation procedure performed?

The most common vaginal procedure today is laser vaginal rejuvenation; your surgeon will discuss the most appropriate technique for you. A pudendal block is given to provide 18 to 24 hours of postoperative pain control. The laser is used very much like a scalpel, but it allows a precise aesthetic result, with less bleeding. Redundant (extra) tissue will be removed and the incisions will be sutured inside the vagina.

For a labiaplasty, the desired labial/vulval contours are outlined with a surgical marker and sutures are then placed. The excess or redundant tissue is removed (surgical or with laser) to achieve the desired contour.  Absorbable sutures are used to realign the natural anatomy of the labia to achieve the most optimal result.

Labiaplasty  Labiaplasty

  1. Natural aging, childbirth or a hereditary condition may lead to a woman to seek vaginal rejuvenation.
  2. The results are long-lasting and can help you feel more comfortable wearing certain types of clothes, exercising and during sex.

What are my options for a Labiaplasty and/or Vaginal Rejuvenation?

Your surgeon will discuss with you which areas of correction or enhancement are best for you:

  • Reduction of the labia minora (inner lips of the vagina) as part of the labiaplasty
  • Reduction or augmentation of the labia majora (outer lips) as part of the labiaplasgty
  • Mons pubis reduction
  • Clitoral hood remodeling as part of the Labiaplasty

Labiaplasty   Labiaplasty

  1. Labiaplasty removes redundant tissue along the ruffled edge, reducing the size and protrusion of the labia minora
  2. Labia majora reduction removes excess skin and tissue from the outer lips of the vulva, hiding the incisions on the inner edge of the labia.

Labiaplasty   Labiaplasty

  1. Excess bulk of the mons can be disproportionate with the rest of your body.
  2. Liposuction or surgical resection can improve the contour with minimal scars.


E. Clitoral hood reduction removes excess protrusive tissue overlying the clitoris.

What will my Labiaplasty and/or vaginal rejuvenation incisions and scars be like?

For the vaginoplasty, the incisions are made to the mucosal walls inside the vagina. For a labiaplasty, the incisions are made to the labia minora or majora so that excess tissue can be removed.

Selecting a Surgeon for your Labiaplasty and/or Vaginal Rejuvenation

Select a surgeon you can trust

It’s important to choose your labiaplasty and/or vaginal rejuvenation surgeon based on:

  • Education, training and certification
  • Experience with vaginal rejuvenation surgery
  • Your comfort level with him or her

Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a surgeon.

After finding a board-certified plastic surgeon in your area who is experienced in performing Labiaplasty and/or vaginal rejuvenation, you will need to make an office appointment for your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.

Your initial consultation appointment

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for a Labiaplasty and/or vaginal rejuvenation and clarify what a vaginoplasty and/or labiaplasty can do for you. Understanding your goals and medical condition, both alternative and additional treatments may be considered.

You should come to the consultation prepared to discuss your complete medical history. This will include information about:

  • Previous surgeries
  • Past and present medical conditions
  • Allergies and current medications

Your treatment plan for a Labiaplasty and/or Vaginal Rejuvenation

Based on your goals, physical characteristics, and the surgeon’s training and experience, your surgeon will share recommendations and information with you, including:

  • An approach to your surgery, including the type of procedure or combination of procedures.
  • The outcomes that you can anticipate.
  • Your financial investment in the procedure.
  • Associated risks and complications.
  • Options for anesthesia and surgery location.
  • What you need to prepare for your surgery.
  • What you can expect to experience after surgery.
  • Show before-and-after photos of cases similar to yours and answer any questions.

Questions to ask your aesthetic plastic surgeon regarding Labiaplasty and/or Vaginal Rejuvenation

We developed these questions to help you:

  • Make the most informed and intelligent decisions about your procedure.
  • Confirm that you have the right surgeon for your procedure.
  • Make your initial consultation as rewarding as possible.
  • Understand your options, potential outcomes and risks.

It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation.

  • Am I a good candidate for a Labiaplasty and/or vaginal rejuvenation?
  • Are the results I am seeking reasonable and realistic?
  • Do you have before-and-after photos I can look at for the procedure I am undergoing?
  • Will my scars be visible? Where will my scars be located?
  • What kind of anesthesia do you recommend for me?
  • What will be the costs associated with my surgery?
  • What will you expect of me to get the best results?
  • What kind of recovery period can I expect and when can I resume normal activities?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • What are my options if the cosmetic outcome of my surgery does not meet the goals we agreed on?

Preparing for Your Procedure Labiaplasty and/or Vaginal Rejuvenation

How do I prepare for a  labiaplasty and/or vaginal rejuvenation procedure?

Your surgeon will provide you with preoperative instructions, answer any questions that you may have, take a detailed medical history and perform a physical exam to determine your fitness for surgery.

In advance of your procedure, your surgeon will ask you to:

  • Stop smoking before undergoing surgery to promote better healing.
  • Avoid taking aspirin, certain anti-inflammatory drugs and some herbal medications that can cause increased bleeding.
  • Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.

Vaginal rejuvenation is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night after surgery.

What can I expect on the day of a Labiaplasty and/or vaginal rejuvenation surgery?

Your surgery may be performed in an accredited hospital, a freestanding ambulatory facility or an office-based surgical suite. Most Labiaplasty surgery and/or vaginal rejuvenation procedures take at least one to two hours to complete but may take longer.

  • Medications are given for your comfort during the surgical procedure. A nerve block will be administered to numb the entire vaginal area and will provide 18 to 24 hours of pain control.
  • General anesthesia is commonly used during a vaginal rejuvenation procedure, although local anesthesia or intravenous sedation may be desirable in some instances.
  • For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
  • Your surgeon will follow the surgical plan discussed with you before surgery.
  • After your procedure is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will have drainage tubes in place. After surgery, you will be placed in a surgical dressing that includes a support or compression garment over your vagina.

You will probably be permitted to go home after a short observation period, unless you and your plastic surgeon have made other plans for your immediate postoperative recovery or additional corrective procedures have been performed that require longer observation in the facility.

Aftercare and Recovery Labiaplasty and/or Vaginal Rejuvenation

Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about:

  • Drains, if they have been placed
  • Normal symptoms you will experience
  • Potential signs of complications

Immediately after your Labiaplasty and/or vaginal rejuvenation
There may be some bruising and swelling in the initial postoperative period. In addition, you may experience minor discomfort, which can be controlled by medication. Bed rest the day of surgery is recommended and you may return to work within five to seven days, depending on your activity level. You should refrain from engaging in sexual intercourse for one month.

Recovery time frame after vaginal rejuvenation
It is vitally important that you follow all patient care instructions provided by your surgeon. This will include information about wearing compression garments, care of your drains, taking an antibiotic if prescribed and the level and type of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

How Long Will the Results Last?

The results of a labiaplasty and/or vaginal rejuvenation procedure are intended to be permanent, but significant weight gain or a subsequent pregnancy can alter the results.

Maintain a relationship with your aesthetic plastic surgeon regarding Labiaplasty surgery and/or Vaginal Rejuvenation
For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon’s office for follow-up evaluation at prescribed times and whenever you notice any changes in your vagina. Do not hesitate to contact your surgeon when you have any questions or concerns.

Associated Costs of Labiaplasty and/or Vaginal Reconstruction

The cost of Labiaplasty and/or vaginal rejuvenation varies from doctor to doctor and from one geographic area to another. Because vaginal rejuvenation is elective surgery, insurance typically does not cover these costs. The practice of Michael P. Vincent MD FACS participates with almost all insurance plans and our office can check about possible coverage for Labiaplasty and/or Rejuvenation.  Our practice participates with CareCredit which is a patient financing plan that can help make the procedure more affordable.

Blog Cosmetic Surgery Financing

Choose your surgeon based on quality, training and experience—not cost.

See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training and certifications.

Limitations and Risks Labiaplasty and/or Vaginal Rejuvenation

Fortunately, significant complications from Labiaplasty surgery and/or vaginal rejuvenation are infrequent. Your specific risks will be discussed during your consultation.

All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:

  • Adverse reaction to anesthesia
  • Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
  • Infection and bleeding
  • Changes in sensation
  • Scarring
  • Allergic reactions
  • Damage to underlying structures
  • Unsatisfactory results that may necessitate additional procedures

You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your vaginal rejuvenation surgery

This article on Labiaplasty and Vaginal Rejuvenation can be found on Dr. Vincent’s American Society for Aesthetic Plastic Surgery Smart Beauty Guide home page

The Smart Beauty Guide is sponsored by the American Society For Aesthetic Plastic Surgery (ASAPS) which is an organization of approximately 2,600 plastic surgeons worldwide devoted to the advancement of cosmetic surgery.  Additional blog articles can be found on our Smart Beauty Guide Homepage.