Labiaplasty, sometimes referred to as labia reduction, is plastic surgery to reduce the size of the labia majora and/or the labia minora, which are the external folds of skin surrounding the structures of the external female genitalia or vulva. It may reduce the size of one or both sides of the labia or one or both sets of labia. It may also be employed to repair the labia following disease or injury, or more often, after childbirth.
Patients ask for labiaplasty for either functional or aesthetic reasons, or a combination of the two. Many patients complain that elongated labia become painful during exercise, or while sitting for long periods of time. Other patients explain to physicians that the elongated lips can be painfully drawn inside them during sexual penetration. Some even report feeling embarrassment with their sex partners. Trends such as thong underwear, bikini waxes, or shaved pubic hair add to the noticeability of protruding labia. Some patients, particularly models, dancers, and actresses, feel embarrassment when wearing swimsuits and other revealing clothing because their labia are visible through form-fitting clothing, or because their labia slip out of skimpy garments altogether. And some patients desire surgery merely to appear what they believe to be “normal”.
Labiaplasty is controversial amongst some professionals and nonprofessionals who raise concerns that the desire for this procedure is driven by marketing, and by an unhealthy self-image derived from media images of what the ‘ideal’ female genitalia should look like when, in reality, there is a large diversity in female genital appearance. The increasing attention this procedure is receiving in various media is believed to be generating a growing market for this surgery. Those opposed to labiaplasty believe it is cosmetically unwarranted, and constitutes a needless exposure to the risks inherent in any surgery.
Labiaplasty is almost always an outpatient procedure which can be performed in a surgery center under general or sedative anesthesia, or in some instances, in an office procedure room under local anesthesia. Patient preference, in consultation with the surgeon, usually determines where the procedure is performed and which mode of anesthesia is selected. After surgery, patients may experience some mild discomfort and variable swelling, which usually resolve after one to two weeks. Recovery times range from three days to two weeks, depending on the extent of reduction required. Return to activities that may cause undue local trauma, such as bicycling or horseback riding, are delayed to permit long term healing.
As this surgery is performed more and more frequently on younger women, a concern is that some surgeons may not warn these women of the long-term physical risks they may incur by electing to have labiaplasty or other female genital surgeries. Scar tissue may be created at the vaginal opening which could later cause pain and complications during childbirth. As with any surgical procedure, surgeons who perform this surgery need to discuss potential risks associated with labiaplasty such as infection, altered sensation, dyspareunia, adhesions, and scarring. It is also the responsibility of the surgeon to inform the patient that variations in the appearance of the vulva are normal. But after consultation, and provided there are no medical contraindications to labia reduction, it is the woman’s right to choose surgery. Overall, women who have labia reduction show a high rate of satisfaction with few complications!