| 1. This patient had undergone vaginoplasty with Dr.
Meltzer three months earlier. Here is what her result looked like, prior
to labiaplasty.
病人在早在三個月前已經讓Dr.
Meltzer做了陰道塑形手術，這裡看到的是她在陰唇塑形前的樣子。
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| 2. About 90 minutes before she came to the operating
room, the lower part of her pubic hair was shaved, and EMLA cream was
applied to her vulva, under plastic-wrap occlusion. She was also given
10 mg of Valium to take orally. [Note to consumers: one 5cc tube of EMLA
probably won't be enough. This patient asked for and received three
5cc tubes -- about the right amount. Also, be sure not to take your
Valium too early -- 30 minutes before the operation actually begins
is about right. Usually this will mean just before they take you to the
operating room.]
大約在病人進入手術室前九十分鐘，下半部的陰毛需要剃除，並且在陰戶塗上EMLA軟膏，蓋上塑膠薄膜。她還得喝下10公克的安定劑。（消費者要注意：一管5cc的EMLA軟膏劑量很可能不夠，這位病人要求3管，醫生也同意──這樣劑量才差不多。還要注意，不要太早喝安定劑──大約在手術真正開始前的三十分鐘剛剛好，也就是正要進入手術室以前。） |
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| 3. Once in the operating room, the EMLA cream was
removed, the patient's vulva was washed with Betadine, and blue surgical
drapes were applied. Here we see the operative site after completion of
these preparations. Surgery is about to begin.
一旦進入手術房就會除掉EMLA軟膏，用Betadine清洗陰戶，蓋上藍色外科用布帷。我們看到的畫面是以上所說的步驟已經完成後的手術區。就要開始手術了。
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| 4. Here some of the Betadine has been wiped off, and
the skin incision lines, as well as a few alignment marks, have been
drawn on the skin with purple surgical marker. Local anesthetic is now
being injected to further numb the skin. The anesthetic solution also
contains epinephrine, a vasoconstrictive agent, which will greatly
reduce bleeding. Note that the lines drawn above the clitoris form an
inverted "V". We will see what happens to this "V"
shape a few images later.
在這張照片中，一部分的Betadine已經擦掉，皮膚上也已經用外科紫色筆標示出切割線和對齊線。現在打了局部麻醉劑，進一步消除皮膚的知覺。麻醉劑本身含有腎上腺素，有收縮血管的功用，可以大大的減少出血量。請注意畫在陰蒂上的線呈現倒V字型，再看幾個圖之後就可以看到這個V形的變化。
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| 5. The skin is now incised with the scalpel along the
previously-drawn lines.
現在用手術刀依照之前所畫的線切割表皮。
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| 6. Next, the skin is gently freed from the underlying
tissue. This will allow the skin to be re-draped to hood the clitoris
and create the labia minora.
接下來，輕輕的把表皮和下面的皮層組織分離，這樣，表皮重新摺疊後，覆蓋過陰蒂，並製造出大陰唇。
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| 7. Here we see the results of the first part of the
operation. The skin has been freed-up, and is now ready to be
rearranged. The next step will be to bring together the skin edges that
lie between the surgeon's fingers.
這裡看到的是第一部份手術後的結果。表皮已經分離而且準備重整。下一個步驟會將外科醫生手指間的表皮邊緣併合。
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| 8. In this photograph, sutures placed just beneath the
skin surface have been used to bring the skin edges together above the
clitoris. The former inverted "V" now looks like an inverted
"Y" -- which is why plastic surgeons call this particular
tissue rearrangement technique a "V-Y-plasty." The use of a
V-Y-plasty to create the clitoral hood is an elegant alternative to the
older "double Z-plasty" technique used by Drs. Schrang and
Hage. Unlike the double Z, which leaves multiple vertical scars, the V-Y
leaves only a single vertical scar.
如圖，表皮之下的縫線把表皮邊緣縫合在陰蒂的上方。之前的倒V字形現在看來像一個倒Y字──這也就是為什麼外科整形師會將這部分的組織重整術叫做「V-Y塑形」。這種「V-Y塑形」所做出的陰道遮蓋，比早期Schrang和Hage醫師的「雙重Z塑形」看起來優雅得多。雙重Z會留下多條垂直傷疤，V-Y則只留下一條垂直疤痕。
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| 9. Next the labia minora are created. This involves
suturing the skin edges together, and also placing sutures through
each labrum, from one side to the other, creating thin lips of tissue.
下一步就是製造小陰唇。這部分的手術包括將表皮邊緣縫合，並在每片陰唇的兩邊都縫上線，製造出薄薄的唇狀組織。
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| 10. In this photograph, the labrum on the left
(patient's right) has been formed, and a small drain has been placed
between the skin edges at its lowest point. The labrum on the right
(patient's left) is now being constructed.
如圖，左邊陰唇（病人的右邊）的形狀已經出來了，陰唇下端的表皮邊緣接合處也做了一個小小的排泄口。右邊的陰唇（病人的左邊）現在也已經做好了
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| 11. Here is the finished result. The construction of
the labia has been completed, and the vertical incision line above the
clitoris has also been closed. It is now even easier to see the inverted
"Y" shape, created by the V-Y-plasty.
這就是完成的作品。陰唇已經做好了，陰蒂上的垂直切割線也已經縫好，現在更容易看到由V-Y塑形所做出來的倒Y字型。
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| 12. Here is the result 24 hours later, with the
Betadine washed off completely, and the drains removed. There is more
swelling of the labia now, and more evidence of early bruising. The
bruising and swelling will peak at 48 to 72 hours, and will take several
weeks to disappear. Nevertheless, we can get some sense of what the
final result will look like.
這是手術後經過24小時的結果。Betadine已經完全洗掉，排泄管也移除了。陰唇較為腫脹，初期的瘀傷更明顯，這些瘀傷和腫脹在48至72小時內最明顯，幾個星期之後就會消失。無論如何，這個圖可以讓我們多少看到手術的最後結果。
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| 13. A second photograph at 24 hours shows the
appearance with the labia spread.
24小時後的第二張照片顯示陰唇張開時的樣子。
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| 14. This is what the result looks like 10 months
postoperatively, with the labia together. I thinks the overall
appearance is very pleasing.
術後10個月陰唇合起來的樣子。我認為整個外觀十分美觀。
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| 15. Another view of the result 10 months
postoperatively shows the appearance with the labia spread.
另一張術後10個月的照片，顯示陰唇張開時的樣子。
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