Labiaplasty

Labiaplasty, also known as  labia reduction, is a procedure for altering the labia minora (inner labia) and the labia majora (outer labia). A 2008 study in the Journal of Sexual Medicine reported that 37 per cent of patients have the surgery for aesthetic reasons alone (1).

The size, color, shape and symmetry of the labia minora and labia majora vary and can change as a result of childbirth, weight gain and weight loss and aging.  The labia minora may be asymmetrical or may hang down in the standing position and be visible in clothing and cause embarrassment. The labia majora may hang down or be overly developed so that they are visible in clothing and cause embarrassment.  The mons may have an excessive amount of fat or have lost volume. Age, menopause and weight loss may affect the labia majora and the mons pubis and may result in loss of volume with wrinkling and loss of contour as well as pain on intercourse (dyspareunia). According to a 2011 review, also in the Journal of Sexual Medicine, overall patient satisfaction is in the 90–95 percent range (2).

Ideal youthful appearance of mons and labia majora and minora.

Aesthetic surgery of the female genitalia includes labioplasty (reduction and reshaping) of the labia minora and labia majora as well as reduction of the clitoral hood. Liposuction or fat injection of the mons pubis and the labia majora can be combined with these procedures to give the best aesthetic result.

Surgery of the labia minora can be performed under local anesthesia only. The other procedures can be performed as an outpatient under MAC anesthesia*

Labiaplasty Procedure

Labia minora reduction

There are two techniques for reduction of the labia minora: Edge Resection and ‘Alter’ Wedge Excision (3,4)

Edge resection technique

This is a simple resection of tissues at the edge of the labia minora.

‘Alter’ wedge excision

This is a wedge resection of the labia minora which preserves the natural edge of the labia. It can be combined with a reduction of the clitoral hood.

Labia majora reduction

The labia majora is reduced with an elliptical excision with the inside scar at the junction of the inner lining and the external skin.

Post-operative management

After surgery wear cotton underwear, keep the area dry and clean with warm water irrigation once a day. Vaginal discharge for several days is not uncommon. Depending on your progress, you can resume physically un-strenuous work three to four days after surgery. Avoid sitting for prolonged periods. To allow the wounds to heal, do not use tampons, or wear tight clothes (e.g. thong underwear), and abstain from sexual intercourse for four weeks after surgery. Avoid high impact exercises including jogging for four weeks after surgery. Use a laxative, drink plenty of fluids and eat lots fruit and fiber to keep your stools soft.

Potential complications of surgery

These include dehiscence or separation of the wound. This is more common in patients are obese, and smokers and also in cases where there is excessive tension on the suture lines or trauma to the repair as a result of sexual intercourse. Other possible complications include infection, a ‘dog-ear’, notching or webbing, a hematoma, pigment changes and a posterior constriction as well as nerve damage leading to increased or decreased sensitivity.
After the procedure it will take 4-6 weeks before being completely healed and a full 3-4 months before being able to truly assess the results of surgery. A second stage may be necessary to fully reduce the size to your liking. The exact results cannot be guaranteed. Although good results are expected it is possible that the result might not live up to your expectations or goals.

*According to the American Society of Anesthesiologists (ASA), a monitored anesthesia care (MAC) is a planned procedure during which the patient undergoes local anesthesia together with sedation and analgesia

References:

  1. Miklos J.R. and Moore R.D. “Labiaplasty of the labia minora: patients’ indications for pursuing surgery”Journal of Sexual Medicine, 5(6), 2008, pp. 1492–1495.
  2. Goodman, M.P. “Female genital cosmetic and plastic surgery: a review”Journal of Sexual Medicine, 8(6), June 2011, pp. 1813–1825.
  3. Alter G.J. Aesthetic labia minora and clitoral hood reduction using extended central wedge resection. Plastic & Reconstructive Surgery.2008; 122(6): 1780-1789.
  4. Alter G.J. Labia Minora reconstruction using clitoral hood flaps, wedge excisions and YV advancement flaps Plastic & Reconstructive Surgery. 2011; 127:2356-2363.

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