Clitoral Hood Reduction Surgery in Delhi NCR

Why large clitoral hood should be reduced?

There are 3 main reasons for this :

1. Inability to reach the climax and orgasm and lack of sexual pleasure - When there is sexual arousal, glans clitoris gets engorged with blood flow and swells up.This often causes retraction of the hood automatically, exposing the glans. If the hood is larger, it may not retract as easily. This fold of skin reduces the sensitivity of the clitoris and makes it difficult for stimulation and sexual arousal less pleasurable.
2. Overhanging large foreskin can also rub against tight clothing or can interfere in normal daily activities like walking, swimming or exercising.
3. It can also usually form clitoral adhesions due to building up of bacteria, skin cells, and sebum under the hood. If left untreated, adhesions can cause extreme pain and interfere with sexual pleasure and orgasm.

We should all be clear that the clitoral hood reduction is not meant for treating low sex drive.

Pre-Operative assessment

Patient is expected to show up at least once before surgery and is examined by our team of doctors before the procedure. Expectations of the patient are also noted and scientifically the required corrected length and shape of the hood are finalised. Patient is asked to quit smoking at least 2-4 weeks prior to surgery and to stop blood thinners 2-3 days prior. Alcohol should not be taken 2 days prior to the surgery. General blood investigations are required to be done prior to the surgery. Surgery is preferably done in immediate post menstrual time or next menses can be postponed if wearing pads is troublesome till healing phase is complete.

What to expect on surgery day

1. Patient is allowed to come only with one attendant to avoid overcrowding.
2. Patient can have light meals and come if the surgery is decided for local anaesthesia, however, if the patient has opted for general anaesthesia, patient should be nil by mouth for at least 8 hours prior to surgery.
3. There should not be any upper respiratory tract infection or any fever at the day of surgery or any other major contraindication.
4. Patient is asked to fill the consent form which also briefs about the possible complications
5. It is preferable if pubic hair trimming is done 2 days prior to the surgery to avoid any fresh cuts.
6. Preoperative photograph is taken.
7. Local anaesthesia sensitivity testing is done.
8. Patient is asked to pass urine and proceed to OT room.

Operative procedure

1. Positioning - patient is usually put on table in lithotomy position with both legs separated apart.
2. Anaesthesia - The surgery is usually done under local anaesthesia but patients with low threshold for pain may be given an oral sedative for increased comfort.
3. Transparent dissolvable sutures are usually used and the technique of the surgery usually depends on the final result desired and the surgeon.
4. An incision is made in the center of the clitoral hood, extending the length of the prepuce and lateral folds of the vagina, if only greater exposure of the clitoris is required.But the incisions for the labiaplasty is extended into a “Y” shape to reduce redundant skin above the clitoris if labiaplasty is also planned along with the hood reduction.
5. Some patients may only need skin excision to reveal a hidden clitoris.

Post-Operative care

• Local ice pack is to be applied for initial first 24 hours.
• A set of antibiotics and anti inflammatory drugs is prescribed to be taken for a week.
• Local hygiene is to be strictly maintained.
• The area has to be washed with water each time urine or stools are passed.
• Loose lower garments are usually promoted to be worn till acute healing phase is over. Sexual activity has to be avoided for 4 weeks.
• Exercise involving that area to be avoided for 4-6 weeks.

Immediate complications

Patients may experience localised swelling, spotting, mild pain and bruising at the local site. These usually settle down with the prescribed antibiotics and anti inflammatory drugs.

Late complications

Some patients can have asymmetry, under resection or over resection.Few can have wound discharge and infection if proper hygiene in post operative period is not maintained.