What You Need To Know About Labiaplasty

As Told From The Perspective of an Experienced Female Plastic Surgeon

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While the principles of vaginal rejuvenation were integrated into my surgical training, my years in residency did not present me with many opportunities for exposure. It wasn’t until I started in private practice with Dr. Donaldson that I had the opportunity to observe his technique and integrate vaginal rejuvenation into my own practice. It was only then that I really understood the positive impact a labiaplasty can have on a woman’s life.

Vaginal rejuvenation is not a topic frequently or openly discussed, and I can’t blame anyone for that! Vaginal rejuvenation can be broken down into external procedures (those performed on the labia), and internal procedures (those performed on the vagina itself).  Here we will be talking about procedures performed externally on the labia majora and minora, a collection of procedures commonly referred to as  “labiaplasty”. Labiaplasty is performed more commonly than most would imagine, with about 12,000 procedures being performed each year, according to the American Society of Plastic Surgeons. Given that both Plastic Surgeons and Gynecologists perform labiaplasty, this is likely an underestimate of the total number performed nationwide.

So, what is labiaplasty? 

A labiaplasty is a plastic surgical procedure that alters the appearance of the labia majora or minora. The most common procedure reduces the length of the inner “lips” (labia minora) to sit within the outer “lips” (labia majora) to create a tucked in appearance. As a popular form of vaginal rejuvenation, labiaplasty can correct cosmetic concerns as well as provide relief of symptoms associated with labial hypertrophy.

Labiaplasty encompasses three major categories of procedures:

1. Reductive surgery for the thinner inner “lips” (the labia minora) which become hypertrophic or overgrown
2. Reductive surgery of the thicker and more fleshy outer “lips” (the labia majora) which lose volume and appear deflated
3. Augmentation surgery of the labia majora when the volume loss is mild

A Better Understanding Leads to More Procedures Performed 

As awareness of these procedures grows, more women are seeking vaginal rejuvenation with an increase of 20% in the number of labiaplasty procedures performed annually by plastic surgeons between 2015 and 2019¹. 

Benefits of Labiaplasty: Giving You An Option for Greater Physical & Personal Comfort

I encounter women of all ages who struggle with discomfort during intimacy, exercise, or while using tampons. They also report difficulty wearing specific clothing, embarrassment about their appearance, and questions like, “Can anything be done to help me?”, and “Is this normal?”.  

First, let me say, YES! “Normal” spans a wide range of appearances, including having extra skin “down there.” It is very commonplace and doesn’t suggest that there is anything wrong with your anatomy.  Second, labiaplasty is a very straightforward in-office procedure that not only alters appearance but also diminishes the symptoms associated with labial hypertrophy.  Some ladies with labia minora hypertrophy don’t notice or aren’t bothered by the appearance or the presence of symptoms, while others may experience daily disturbances of their activities or desire a rejuvenated appearance. 

The choice to have a labiaplasty is an incredibly personal one – and the first step to deciding if it’s right for you is to get educated! 

Why Undergo A Labiaplasty Procedure? 

The labia minora can become enlarged for many reasons, but most often it’s just “the way you’re made”.  Most common in my practice, a labiaplasty of the labia minora removes extra tissue using a specialized “wedge” or “edge trim” technique, both of which have excellent and consistent results. I choose the best technique during a consultation with my patients, taking into account their specific anatomy, personal desires, and expected incisional recovery.  

Labiaplasty Recovery: What To Expect After The Procedure 

The procedure is performed comfortably in our office procedure room under local anesthesia, which includes a topical numbing gel (left on for 30 minutes, completely removes feeling in the area) and a series of painless injections to ensure your complete comfort. The procedure takes approximately an hour, and you can drive home immediately after.

The numbing medicines last 4-6 hours, and a prescription of mild pain relievers is used in the first 24-48 hours to maintain comfort. I ask my patients to refrain from intimacy, tampon use, tight clothing, and strenuous exercise for 4 weeks, but you can otherwise return to normal activity within 2-3 days of your procedure. Routine incision care is performed 3-4x/day and is straightforward. 

Having surgery while awake may seem intimidating or painful, but almost universally women say, “That was WAY easier than I expected,” and, “I didn’t feel anything!”. I take special care to ensure my patients  are totally satisfied with their comfort during the procedure, the ease of recovery, and their results. 

Labia Majora Surgery & Its Benefits 

While labiaplasty of the labia minora is the most common, changes of the labia majora can also be corrected with labiaplasty, including loss of fullness of the labia majora due to weight loss or aging.  When the volume loss is severe, the labia majora can appear like a deflated balloon, and a removal procedure similar in nature to the “edge trim” technique for the labia minora is performed to remove excess skin. When the volume loss is mild, the labia majora lose fullness and their youthful appearance. In this case fat can be grafted from the lower abdomen or inner thighs to the labia majora to restore its youthful fullness.  These procedures can also be combined in severe cases.

Depending on the procedure recommended for you, labiaplasty on the labia majora can be performed in the operating room under twilight sedation, or in our procedure room under local anesthesia with topical numbing cream and a series of numbing injections.

Labia Majora Surgery Recovery 

Recovery includes four weeks of refraining from strenuous activity, tight clothing wear, intimacy, and tampon use and may have slightly more associated post-operative discomfort. While somewhat more involved than labia minora surgery, labia majora surgery also leaves women very satisfied with the experience and their results! 

The Confidence & Comfort You Deserve 

While we haven’t gone into every detail of vaginal rejuvenation, I hope that this brief look into my experience with the life-changing labiaplasty procedure gives you the confidence to take the next step in your journey. During your consultation, I will take the time to discuss more intricate points and, of course, answer any questions that you have. No two women are exactly the same and the techniques used in our practice ensure that you receive beautiful results in our comfortable and safe environment. 

Until Next Time!

Sincerely Yours-

Dr. S