Vagina Anatomy
The vulva and labia form the entrance, and the cervix of the uterus protrudes into the vagina, forming the interior end.

Both innie and outie vaginas are equally common, although some studies suggest that over 50% of women have outies. The length of the labia minora and labia majora determines whether a person has an innie or outie vagina.

  • Labia minora (inner labia): Protects the clitoris and can vary in color, shape, and size. Because there are blood vessels surrounding the inner labia, they are darker in color. They grow larger with increased stimulation during sex.
  • Labia majora (outer labia): Equivalent to the male scrotum and protects the rest of the sexual organs. They produce sweat to help regulate the body's temperature.

When the labia minora protrudes out of the labia majora, a person is said to have an outie vagina. This is completely normal.

Can surgery change the appearance of innie or outie vaginas?

Vaginal rejuvenation surgery, medically called labiaplasty, is a cosmetic procedure that restores the shape of the vaginal lips or labia. Many women seek labiaplasties to improve the appearance of their labia, as, with age, many factors influence the appearance and function of the labia. Recent trends have brought this to the forefront. 

Women who choose to have this treatment have frequently reported physical and cosmetic issues, such as:

  • Elongated labial tissue
  • Asymmetric labial folds
  • Discomfort or soreness for a period after labial tissue is maladjusted
  • Pain or soreness during tampon use, intercourse, or exercise
  • More care is required when washing the vagina because of the delicate or stretched labial tissue

What is a labiaplasty?

Labiaplasty is a surgical procedure that is used to improve the appearance of the female genitalia by reducing the labia majora or minora, which are the tissue folds that surround the vagina. Labiaplasty is frequently done for cosmetic reasons, but excess skin can also cause issues if the labia are excessively wide or uneven.

To make the patient more comfortable during the procedure, doctors may use general anesthesia or sedation. The surgery will take at least 2 hours, although this may vary.

Surgeons often use a device called iris scissors to reshape the inner folds of the labia. To reduce the size of the vaginal lips, a clean "V"-shaped wedge is made and removed during the procedure. The surgeon then reshapes and reconstructs the lips to meet the patient's aesthetic goals. Dissolvable sutures are used to close the incision.

Another method to reduce labia is to use laser treatment. This works for some patients but is only recommended when the skin defect is minor.

QUESTION

The vagina includes the labia, clitoris, and uterus. See Answer

What are potential complications of labiaplasty?

  • Bleeding: After the surgery, a little spotting is common. In rare cases, bleeding can occur, causing pain and swelling and necessitating a return to the operating room to stop the bleeding or remove the clot.
  • Swelling: Swelling is common in the first few days. It usually takes 10 days for it to settle.
  • Infection: This is a rare complication. The doctor may prescribe prophylactic antibiotics to reduce the risk of infection.
  • Delayed wound healing: This is rare, but it can cause the wound to open and not heal properly, resulting in notching along the rim of the labia or a hole in the middle.
  • Scars: Scars created by the "wedge technique" are largely undetectable and resolve quickly. Scars may be sensitive and uncomfortable in rare cases, but this normally fades with time.
  • Asymmetry: Asymmetry of varying degrees may occur.
  • Revision: A small percentage of patients (less than 5%) may require additional surgery to rectify unresolved issues.
  • Under or over correction: Issues can occur if the surgeon does not remove enough tissue or removes too much tissue.

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Medically Reviewed on 9/8/2022
References
Image Source: iStock Images

American Society of Plastic Surgeons. Aesthetic Genital Plastic Surgery. https://www.plasticsurgery.org/cosmetic-procedures/aesthetic-genital-plastic-surgery/labiaplasty

Lykkebo AW, Drue HC, Lam JUH, Guldberg R. The Size of Labia Minora and Perception of Genital Appearance: A Cross-Sectional Study. J Low Genit Tract Dis. 2017 Jul;21(3):198-203. https://pubmed.ncbi.nlm.nih.gov/28369012/