You may visit your surgeon as many times as you wish, to have all of your questions answered. At your preoperative visit (which takes an hour or more), your final questions will be answered and you will confirm that you understood the procedure to be performed, that this material has been explained to you, that you have read and understood these information sheets, and that you accept the risks by signing the informed consent forms. You will be given prescriptions for surgical soap that will be used before surgery, as well as for pain pills and antibiotics, along with instructions for their use. Certain laboratory tests will also be required within two weeks of surgery. If you are over the age of 50, you will have to obtain a cardiogram at your doctor’s office or any licensed laboratory. You may have blood drawn by our office nurse during your final preoperative visit, or, if you prefer, at your family doctor’s office or other laboratory (e.g. Kaiser Hospital, etc.).

It will be necessary to wash the groin area for ten minutes the evening prior to surgery and a final time the morning of surgery before leaving home. Washing the surgical site these two times with Hibiclens® soap will lower the possibility of an infection occurring after surgery.

Ordinarily, your anesthesiologist will call you the night before surgery to discuss the anesthetic care plan with you. But if you miss the call or your anesthesiologist does not call you, do not worry as you will be able to discuss your anesthesia and have all your questions answered in the morning, at the Surgery Center, prior to your procedure. You must make arrangements to have someone drive you to and from the Laguna Hills

Surgery Center and stay with you at home until the next morning. Wound care is negligible but it is a good idea to have a responsible adult around for a day anytime one has received sedatives or any other type of an anesthetic.

The operation will be performed in an outpatient facility under very deep sedation or light general anesthesia, supplemented by local anesthetics. Incision are made around the redundant labial tissue and it is excised, care being taken not to injure underlying nerves or other sensitive tissues. The incisions are all closed in layers with absorbable sutures.

Adequate pain medication will be prescribed. All patients, who go home on the day of surgery, will find that an assistant at home is a necessity for the first day. High bulk foods are highly encouraged after any surgical procedure and laxatives may be necessary to prevent straining associated with constipation.

Normal bathing is permitted immediately after surgery. Patients will be encouraged to walk as much as possible at home after surgery as this will reduce the possibility of pneumonia or of clots forming in your calf veins. The incisions are covered with Vaseline or other ointment three or four times a day to prevent the suture lines from dying out or crusts from forming. The sutures will fall out or dissolve in a week or two, and no other care is required. A sanitary napkin may be desirable for the first week or so to keep underwear clean.

Your first post-operative visit will generally be scheduled three to five days after surgery at which time the incisions will be inspected.

Serious complications after a labial reduction are relatively uncommon. The scar very rarely may remain itchy or otherwise uncomfortable but is usually imperceptible. The usual complications after any surgical procedure such as infection or bleeding are a very rare possibility as well. Perfect symmetry does not exist before or after labial reduction surgery. The two enlarged labia are never symmetrical to begin with, and neither will be the reduced labia. Patient satisfaction, however, is almost universal following this procedure.

Secondary procedures may rarely be desirable to revise excise more tissue. The patient will be responsible for all costs associated with secondary surgical procedures. It is not possible to list every conceivable complication. As with any operation, there could be potential complications, which could even be fatal. The foregoing is not intended to frighten or upset you but to enable you to make your decision with an understanding of some of the involved risks.

Insurance carriers will not pay for labioplasty or other purely cosmetic procedures. All fees are due prior to the surgical procedure. If desired, the office staff can also help you arrange financing for your procedure. In compliance with suggestions adopted by the American Society of Plastic Surgeons, it is customary for the patient to pay all fees for cosmetic surgery prior to the desired operation. This insures that the patient is sincere in her motivation and can afford the surgery, thus creating a better patient/physician relationship. A non-refundable deposit will be required to secure your desired surgery date when booking your procedure. The remainder of the fees must be paid prior to the surgery, usually at the time of the preoperative visit, but never later than one week before surgery. Additional fees are also required for laboratory tests, surgical facility fees and the anesthesiologist. If additional surgical procedures become necessary, additional facility, laboratory, anesthesia, and professional fees will be incurred. The surgical facility and anesthesiologist fees quoted will be based on our best faith estimate; the final fee may vary as these fees are based on surgical time, and it is not always possible to predict exactly how long a procedure will take to complete. It is important that you understand that the patient is responsible for all costs associated with all secondary surgical procedures or for the treatment of any complications that may arise as a result of this elective surgery.

Pre and post-op photos will be taken of the treatment site for record purposes. I understand that these photos/videos will be the property of the attending physician. I do____, do not ___ agree to allow these pictures to be used for publication, teaching purposes or the practice web site. If I agree, I understand that my name will be kept confidential and protected.

IF YOU HAVE ANY QUESTIONS, DO NOT HESITATE TO CALL THE OFFICE DURING BUSINESS HOURS (949-888-9700) OR AFTER HOURS, CALL YOUR SURGEON – DR BUNKIS CELL PHONE NUMBER IS (949) 500-8856, OR REGISTERED NURSE, TRACEY PRESCOTT’S NUMBER IS (949) 338-6072.

WITH AN EMERGENCY THAT REQUIRES IMMEDIATE ATTENTION, CALL 911 BUT PLEASE HAVE YOUR FAMILY NOTIFY DR. BUNKIS OF ANY PROBLEMS YOU MAY HAVE!

I, _________________________________________________certify that I have read and understand the “Labioplasty/Labial Reduction” information sheets dated March 2008, that my surgeon has answered all of my questions to my satisfaction, and that I give my informed consent for this procedure.

Witness_______________________________ Date__________________

I certify that I or a member of my staff has discussed all of the above with the patient and have offered to answer any questions regarding the procedure. We believe that the patient fully understands the explanation and answers.

Surgeon’s Signature_____________________ Date_________________

Initial if copy requested/given to patient____________________________
Copy placed in chart __________________________________________

Copyright 11/87 Last revised 03/08
Juris Bunkis, M.D., F.A.C.S.

Social activity should be limited while the patient is uncomfortable. A good general rule of thumb is that patients should avoid any physical activity (including sexual activity) that causes discomfort. There is no set time table for resuming strenuous activity or having sex – just avoid activities that cause discomfort – but as a general rule of thumb for most patients, it takes approximately three months for the tissues to feel relatively normal. Basically, most patients find that they can return to normal activity as the discomfort of the operation fades away. Office work can usually be resumed within 2-3 days of surgery, but the patient should expect a six-week delay before returning to sexual activity, physical labor or strenuous exercise.