Comprehensive Assessment of Labiaplasty Techniques and Tools, Satisfaction Rates, and Risk Factors: A Systematic Review and Meta-analysis.

ABSTRACT

BACKGROUND: Various surgical techniques have been devised for the surgical cosmetic enhancement of female outer genitalia. The selection of an optimal method should be based on satisfaction rates and safety; however, a comprehensive, contemporary systematic assessment of these factors in has been limited in the literature. OBJECTIVES: Our aim was to conduct a comprehensive systematic review and meta-analysis to evaluate the overall satisfaction rates and risk factors associated with various labiaplasty techniques and tools. METHODS: The authors performed a systematic literature search in three medical databases PubMed, Elsevier and Cochrane Library (CENTRAL) with the closing date of October 2023. Original articles with quantitative satisfaction rates and frequencies of most common complications (hematoma, dehiscence, swelling, bleeding and infection) were included. RESULTS: Systematic search provided a total of 3954 records. After selection and review of the articles, 86 eligible, peer-reviewed studies were identified, of which 53 provided quantitative data. High overall satisfaction rate was found for all methods (Prop 94%; CI 93-95%), with highest satisfaction for deepithelization (Prop 97%; CI 85%-99%). Complications were generally rare, with elevated incidences for some techniques (wedge resection - dehiscence Prop 8%; CI 5%-13% and composite reduction - swelling Prop 13%; CI 2%-54%). Scalpel has significantly higher incidence of complications than laser, namely for bleeding, swelling and hematoma. CONCLUSIONS: Labiaplasty can be considered a generally effective approach to outer female genitalia beautification, with low associated risks. Surgeons must tailor their approach to the patients' needs and anatomy to achieve maximal satisfaction, given the differences in the frequency of complications for each method.