What is labiaplasty?

Sexual discomfort
A majority of labiaplasties are performed on sexually mature women to reduce the labia size or achieve symmetry, for aesthetic reasons.

Labiaplasty is a surgical procedure to alter the shape and size of the labia minora. Labia minora are the inner “lips” of the vulva, a woman’s external genitals. Labiaplasty is the removal of excess tissue from enlarged labia minora to make them symmetrical with the labia majora, which are the outer lips of the vulva.

Why would someone get a labiaplasty?

A majority of labiaplasties are performed on sexually mature women to reduce the labia size or achieve symmetry, for aesthetic reasons. Occasionally, labiaplasty may be performed on girls as young as 12, in case the enlarged labia minora cause discomfort in performing normal activities.

Labia enlargement (hypertrophy) is most often a congenital condition, but some women may have the complaint after childbirth, hormone treatment, or with age. 

There are many reasons why a woman might consider getting a labiaplasty:

  • Physical discomfort: Enlarged and protruding labia minora can cause irritation because of skin rubbing together with movement. Persistent irritation can make the skin raw, leading to hygiene issues and infections.
  • Difficulty wearing certain clothing: Unusually large labia minora can make it uncomfortable to wear certain types of clothing such as bathing suits, tight jeans, or workout clothes. They can also create a visible bulge, which may prevent some women from wearing such form-fitting clothes.
  • Difficulty with physical activities: Enlarged labia can get tender and prevent a woman from participating in certain activities. For instance, the labia can get sore rubbing against the seat while riding a bike, or protruding labia can make hiking and running difficult.
  • Sexual reasons: Protruding labia minora may impact a woman’s sexual life. It may interfere with sexual intercourse, cause pain or affect the ability to reach orgasm. It may also make a woman self-conscious and affect her ability to enjoy intimacy with her partner.
  • Psychological impact: Distress over the appearance of the vulva, inability to freely participate in all physical activities and wear any clothes that she wants to, can affect self-confidence and lower self-esteem in a woman. It can have an emotional impact and affect intimate relationships.

How is a labiaplasty performed?

A plastic surgeon or a gynecologist performs a labiaplasty. The procedure is typically performed with local anesthesia and moderate sedation, but some women may have general anesthesia. The procedure takes approximately an hour and most women can go home the same day.

Primarily, surgeons follow one of the following two techniques:

  • Trim labiaplasty: The surgeon trims the edges of the labia minora with a surgical knife, scissors, or laser. This is a relatively short and simple procedure and leaves a lighter colored labial edge, which some women prefer. The disadvantage is a long scar along the edge which may be irregular and cause discomfort.
  • Wedge labiaplasty: Wedge labiaplasty takes longer than the trim method. The surgeon removes excess tissue from the labia in a wedge shape but preserves the labia edges.

Preparation

Prior to the procedure, the surgeon will

  • Examine your labia minora
  • Discuss with you and plan the desired area of correction
  • Mark the exact area to be excised

Procedure

  • During the procedure
  • You will lie in the lithotomy position, the position commonly used during gynecological examinations and childbirth.
  • The surgeon will
  • Administer sedation
  • Sterilize the labia with an antiseptic solution
  • Inject local anesthetic into the labia minora to prevent pain
  • Excise the excess tissue after taking precise measurements
  • Close the wound with sutures and applies antibiotic ointment

Post-procedure

Post-procedure, the surgeon will instruct you on after-care which may include the following:

  • Take antibiotics for a week
  • Wash the area gently with soap and water, pat dry, and apply antibiotic ointment on the sutures
  • Avoid vaginal intercourse for six weeks
  • Refrain from activities that can put pressure on the area, until the labia heal completely 

The follow-up consultation is usually after three weeks when the surgeon will evaluate the healing and remove any remaining sutures. 

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What are the complications from labiaplasty?

Labiaplasty is a relatively minor procedure and risks are minimal. Symptoms during the healing period include:

Though uncommon, a few complications may arise, most of which can be corrected with a second procedure. Complications include:

  • Separation of the stitched edges
  • Formation of an unnatural passage (fistula) in the tissue
  • Discomfort from scarring
  • Inadequate tissue removal
  • Infection
  • Potential sexual complications such as loss of sensation
  • DVT (deep venous thrombosis)
  • Hematoma

How long does a labiaplasty take to heal?

Pain, swelling, and itching usually subside within one or two weeks and most women can return to a normal routine in two weeks. Most women can also resume strenuous fitness activities within a month but must refrain from vaginal intercourse for at least six weeks. It is advisable to check with the surgeon before resuming sexual activity.

Does labiaplasty leave scars?

Plastic surgeons most often use self-dissolving sutures which usually dissolve within a month after the procedure. After the stitches dissolve, the scar tissue usually gets firm first before softening. The scar is generally barely visible or palpable because of the natural wrinkles and folds in the labia minora.

Does labiaplasty affect sensation?

Sexual complications from labiaplasty are not very well-studied. The nerve supply to the labia is unaffected by both trim and wedge techniques of labiaplasty, and unlikely to affect sensation, but there are no studies to clarify how much role the labia minora plays in a woman’s sexual pleasure.

Many women report enhanced sensation, though it may simply be because of the “feel-good” factor from the improved appearance of the labia. Some women may have unpleasant hypersensitivity, possibly from poor labiaplasty technique.

In the labiaplasty technique known as “Barbie look,” the entire labia minora is removed, but it is not clear if it affects a woman’s sensation and capacity for orgasm.

How much does labiaplasty cost?

The cost of labiaplasty may vary from institution to institution and is also usually tailored to meet individual needs. A labiaplasty may cost approximately USD 2500 to USD 4000, depending on the hospital, qualification of the surgeon, and the exact procedure required.

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Medically Reviewed on 3/15/2021
References
https://www.statpearls.com/ArticleLibrary/viewarticle/23972

https://www.nygplasticsurgery.com/nygps-news/5-reasons-to-consider-labiaplasty/

https://academic.oup.com/asj/article/36/6/710/2664485