Liposome Bupivacaine for Postoperative Pain Control for Labiaplasty

Purpose: Labiaplasty has first reported by Honore and O'Hara in 1978. According to ISAPS global statistics, it increased by 45 percent in 2016 as the most increasing aesthetic surgery. The same is true in Japan, I operate more than 400 patients every year. As the patients feel inconvenience with their oversized labia,　they are highly satisfied after surgery. However, postoperative pain seems to be severer than other parts of the body. We report some results in postoperative pain control for labiaplasty using liposome bupivacaine.

Methods and materials : For the patients who had labiaplasty in our clinic from May to October 2017, we injected liposome bupivacaine (Exparel®, Pacira Pharmaceuticals, USA) to one side of labia and Lidocaine Injection 1％ with Epinephrine to the other at the last of the surgery, and analyzed the pain with Numerical Rating Scale (NRS) and the number of times of analgesic use until the postoperative day 7.

Results: Throughout six-month follow-up, no patients had any complication or complaint with operation. The pain was 82% less severe on the side with Exparel® on the day of operation, 69% on 1POD, 66% on 2POD, 56% on 3POD and 57% on 7POD. Average number of analgesic use was 4.0±4.1, and Exparel® provided greater effects to the patients who used more analgesic than average. It was more effective as earlier postoperative time.

Conclusions: It's considered to be effective to use liposome bupivacaine for the postoperative pain control of labiaplasty. However, the surgeon should be careful not to miss the perioperative complication with less pain.