Labia majora reduction is a cosmetic procedure to reduce the size and volume of the outer lips of the vulva and is part of the many designer vagina surgeries available to improve the aesthetics of the female genitalia.
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Labia majora reduction indications
The labia majora, like other parts of the body such as the face, with aging lose volume, which can result in drooping or sagging. Obesity may cause them to increase volume, become puffy and stretch and a subsequent weight loss may result in stretched, wrinkled, deflated labia majora with considerable skin laxity.
There is also great genetic variability as well as environmental factors that play a role in the shape and size of the labia majora. Pregnancy and childbirth may also contribute to a change in shape and size of the vulva.
Voluminous labia majora may cause embarrassment in women, due to what is commonly known as “camel toe”, the visible bulging when wearing swimsuits, underwear or tight pants. They may also cause hygiene issues or discomfort while performing certain activities such as riding a bicycle.
Labia majora reduction may address all of these issues with:
- Skin excision, when only excess skin is present
- Liposuction, in selected patient with too much fullness of the labia majora
- Skin and subcutaneous fat excision, with or without liposuction, when wanting to address both the skin laxity and the excess volume.
- Labia majora augmentation may also be performed to address deflated labia majora and is generally done with autologous fat grafting.
Labia majora reduction surgery
The majoraplasty procedure may be carried out in the OR with IV sedation or in the doctor’s office with local anesthesia depending on the case. It takes about 1 hour when performed by an experienced surgeon and it is an outpatient procedure. After careful planning the surgeon draws the markings outlining the tissue to remove. The area is sterilized and the surgeon proceeds to cut using a traditional scalpel, or a radiofrequency, laser or electrocautery device; the labia majora are very vascular so using such devices may help with controlling the bleeding. After the skin or skin and subcutaneous fatty tissue are removed, the surgeon places resorbable sutures with great care to minimize post-op scarring.
Patients can return to work after 1 week. During recovery to reduce the swelling the patient should lie with the bottom elevated and apply cold packs several times a day for 20 minutes at a time. Sexual intercourse, use of tampons and exercise can be resumed 4-6 weeks after surgery and residual minimal swelling can last for about 6 months after the procedure. Minimal pain or discomfort can be controlled with oral analgesics for the first few days after surgery.
Labia majora reduction is often performed in conjunction with other vagina rejuvenation procedures, either during the same surgical session or as a staged surgery requiring multiple appointments. This is because addressing a single component of the vulvar region may result in an imbalance or overexposure of other parts, such as the clitoral hood or the labia minora.
Contraindications to majoraplasty
Contraindication to labia majora reduction surgery include active infections, which would need to be addressed first, pregnancy and planning to lose a considerable amount of body weight.
Risks and complications
Unlike labia minora reduction, which is performed on mucosal tissue, surgery on the labia majora leaves scars and for this reason the cutting, stitching and aftercare need to be appropriate to minimize the resulting scars. Some creams may help in the healing process.
Edema and bruising may last for one week. Hematoma and hypersensitivity may last up to 4-6 weeks after surgery.
Over resection may cause exposure of the vagina causing dryness or irritation.
When resecting excess tissue, care must be taken to avoid bringing hair bearing skin close to the vaginal opening as it would be uncomfortable for the patient.
Asymmetry, dissatisfaction with the surgery, reopening of the surgical wound, infection, are among other possible risks and complications.
When performed by experienced professionals, aesthetic female genital surgeries can yield excellent aesthetic results, with low complication rates and high patient satisfaction.
Costs of labia majora reduction surgery
Prices for labia majora reduction vary greatly depending on the type of anesthesia, chosen surgeon and clinic, geographic location and surgical technique.
In the USA, majoraplasty costs 3,000-6,000 USD.
In the UK, the procedure price is 2,500-4,500 GBP (3,200-5,800 USD).
In Thailand, labia majora reduction costs 56,000-101,000 THB (1,800-3,200 USD).
Sources
- Aesthetic Vaginal Plastic Surgery
L Triana – Springer, 2020 - Female Cosmetic Genital Surgery – Concepts, Classification, and Techniques.
C Hamori – Thieme, 2017 - Labia Minora, Labia Majora, and Clitoral Hood Alteration: Experience-Based Recommendation.
JG Hunter – Aesthetic Surgery Journal, Jan 2016 - American Society of Plastic Surgeons (ASPS)
