Labiaplasty: labia minora reduction surgery

The labiaplasty procedure is a female cosmetic genital surgery to reshape and reduce the size of the labia minora, the flaps of skin on either side of the vaginal opening also known as inner lips.

The labiaplasty is one of the many “designer vagina” procedures available today, sometimes called vaginal rejuvenation treatments and surgeries.

Although there is no standard aesthetic for the female genitalia, due to celebrity trends and media attention, the growing inclination to wax, shave or permanently remove hair from the genital area, and to the widespread availability of images on the internet as well as pornography, women are becoming more self-conscious about their genital appearance; the inner labia have great genetic variability as well as they change during life due to pregnancy and childbirth, weight gain and weight loss, physiologic aging process, trauma and several other factors. Nevertheless, ideally most people nowadays would describe the perfect inner labia as small and thin, symmetrical, straight, not visible in the standing position, meaning not protruding past the labia majora, and light colored.

labiaplasty procedure for cosmetic labia minora reduction

Indications for labia minora reduction surgery

Beside willing to improve the look of the genitalia, other reasons to seek a labiaplasty are for a better hygiene and chronic urinary tract infections, irritation, to address pain or discomfort during activities such as riding the bicycle or while wearing tight clothing, and to address sexual issues such as the labia minora tendency to get tucked in during penetration making it difficult or painful.

The labiaplasty procedure

There are a few different surgical techniques available when performing labia minora reduction surgery. Moreover, the procedure is often coupled with other cosmetic genital surgeries: this is because addressing one single component of the external female genitalia may cause an imbalance in the others; in the case of the labiaplasty, not considering the clitoral hood may lead to an excessively protruding and visible clitoral hood, which previously may have been harmonious with the labia minora. In other cases, a perineoplasty or vaginoplasty may be combined with labia minora reduction to achieve both external and internal rejuvenation. For this reason, a patient may have more than one procedure performed either at the same time or in multiple stages.

The choice of the surgical technique depends upon the surgeon’s experience and the patient’s anatomy and expectations or aesthetic goals; the labiaplasty in general has a high satisfaction rate exceeding 90% of patients.

All techniques may be performed with local anesthesia with or without sedation, or with general anesthesia and it is most commonly an outpatient procedure that can be performed in a doctor’s office. Antibiotics may be given prior to the procedure in order to minimize the risk of infections. The whole procedure takes 1 to 2 hours depending on the anesthesia, surgical technique, anatomical characteristics of the patient, and patient’s goals.

Edge trim labiaplasty

The edge trim labiaplasty is the first technique that was used in labia minora reduction surgery. It consists in the excision of the excess skin with a scalpel, surgical scissors, or a laser, radiofrequency, electrocautery device. After removing the redundant tissue, the wound is closed using resorbable sutures. This is the easiest technique to perform with shortest operative time, but the disadvantage is the scar along the labia minora edge which may cause discomfort, the possibility of having an irregular or asymmetric labial edge, visible color difference between the edge and the labia, and increased risk of over resection when compared to the wedge technique.

Wedge labiaplasty

The wedge labiaplasty consists in the excision of a V-shaped wedge out of the central portion of the labia, pulling the remaining skin together with absorbable sutures.  The advantages of the wedge labiaplasty include the preservation of the natural edge of the labia minora and a hidden scar which is less likely to cause discomfort or pain. Among the disadvantages of the wedge technique there is the possible color mismatch between the two flaps of inner lip stitched together.

Recovery from labia minora reduction surgery

The patient can usually go home on the same day after the procedure. An icepack may help reduce the discomfort and swelling and laying with the pelvis elevated will help reduce the swelling as well. Loose underwear and clothing are advisable to prevent rubbing on the surgical site. Return to work is usually possible within one week. The surgical wound should be kept dry and clean.

A follow-up appointment is usually scheduled about 3 weeks after the procedure to evaluate the healing and remove any suture not yet dissolved. Some itching is to be expected while the wound heals and stitches are resorbed. The patient should refrain from sexual activity and any strenuous exercise for about 6 weeks. Activities that put pressure on the area should also be avoided, such as riding a motorbike. Some bruising, swelling and soreness are normal and will take few weeks to subside. Pain medication will be prescribed to cope with the pain or discomfort.

Complete healing with no more residual swelling takes about 6 months, after which any revision surgery may be scheduled in case of dissatisfaction with the results.

Risks and complications of the labiaplasty

Like any other medical or surgical procedure, there are some risks involved when undergoing a labiaplasty. Among the possible risks and complications there are the risk of reaction to the anesthesia, bleeding, infection, wound dehiscence (reopening of the surgical wound), scarring, over resection, changes in sensitivity, and dissatisfaction with the aesthetic result.

Price of Labiaplasty

The cost of labiaplasty depends on many variables such as the geographical location, the chosen clinic and surgeon, type of anesthesia and surgical technique.

On average, the price for a labiaplasty in the USA is 3,000-8,000 USD.

In the UK labia minora reduction costs 1,500-5,000 GBP (1,950-6,500 USD).

In Australia the labiaplasty costs 4,500-6,500 AUD (3,200-4,650 USD).

In Thailand the price for the labia minora reduction is 38,500-90,000 THB (1,250-2,900 USD).

Performing more than one procedure at the same time will likely result in some savings.


Sources
  • Aesthetic and Functional Labiaplasty.
    S Gress – Springer, 2017
  • Female Cosmetic Genital Surgery – Concepts, Classification and Techniques
    CA Hamori – Thieme, 2017
  • Essentials of Aesthetic Surgery.
    JE Janis – Thieme, 2018
  • Labia Minora Reduction Techniques: A Comprehensive Literature Review.
    CM Oranges, A Sisti – Aesthetic Surgery Journal, Jun 2015
  • Labia Minora, Labia Majora, and Clitoral Hood Alteration: Experience-Based Recommendations.
    JG Hunter – Aesthetic Surgery Journal, Jan 2016
  • American Society of Plastic Surgeons (ASPS)
  • Labiaplasty Minora Reduction.
    RN Willis, CS Wong – StatPearls, Sep 2020
  • Indications, Techniques and Complications of Labiaplasty.
    AU Gowda, N Chopra – Open Access Journal of Plastic Surgery, Aug 2015

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