Objectives: - Describe the use of radiofrequency (bipolar and fractional) for minimally invasive labiaplasty
- Discuss demand for labiaplasty
- Discuss technique and treatment parameters
- Discuss pearls/pitfalls
- Discuss how to avoid and manage complications
Introduction: Labiaplasty has rapidly increased in popularity over the past 5 years. Traditional labiaplasty is associated with potential complications such as dehiscence, hematoma, flap necrosis, narrowed introitus, pain, and asymmetry. Minimally invasive techniques such as radiofrequency have emerged as viable alternatives to traditional labiaplasty through a temperature controlled bipolar mechanism to heat tissues to target temperatures of 40-45C. This controlled energy delivery leads to an inflammatory cascade initiating neocollagenesis, angiogenesis, and elastogenesis over the coming 3-4 months
Materials / method: A single surgeon series of labia minora and majora treatment by RF was reviewed between April 2018-October 2019. Demographic data was collected as well grade of hypertrophy (pre/post treatment), number of vaginal deliveries, and reason for treatment. Procedural parameters were recorded, including internal/external temperatures, total energy used, and time of treatment. All adverse events were recorded. Objective and subjective data points were obtained in the form of patient surveys and photographic evaluation.
Results: 45 consecutive patients were treated with bipolar radiofrequency between April 2018-October 2018. Mean age was 44 (29- 54). Average number of pregnancies was 2 (STD 1.1). 15 patients were treated for aesthetic concerns, 12 for functional complaints, and 18 desired improvement in both. Overall graded improvement in labia size/contour was +50% (STD +/-15.3). Patient satisfaction scale data demonstrated 9.5/10 (+/-1.7). All patients (45/45) stated that they would undergo treatment again. In all cases, the surgeon observed tightening of the clitoral hood, introitus, and forchett.
Conclusion: Treatment of labia hyperplasia and laxity with bipolar radiofrequency may potentially fill a treatment gap of females seeking aesthetic and functional improvements without surgical labiaplasty. A powered prospective randomized double blinded study is needed to further elucidate the role of this technology.
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