Labiaplasty
Vaginal rejuvenation is not a topic frequently or openly discussed. It can be broken down into external procedures (those performed on the labia) and internal procedures (those performed on the vagina itself). Here we will discuss procedures performed externally on the labia majora and minora, a collection of procedures commonly referred to as “labiaplasty”. According to the American Society of Plastic Surgeons, labiaplasty is performed more commonly than most would imagine, with about 12,000 procedures being performed each year. Why are more and more women getting this procedure? And, is it something that you could benefit from? We’re sharing everything you need to know about labiaplasty surgery to help you decide if it could be right for you.
What Is Labiaplasty?
Labiaplasty is an outpatient surgical procedure that involves reshaping the labia majora (outer “lips” of the vulva) or the labia minora (the inner “lips” of the vulva) to sit within the outer labia majora. This procedure is done in the doctor’s office under local anaesthesia. Labiaplasty can help address the size, shape or symmetry of your labia. In addition, it can help reduce discomfort from wearing tight clothing and discomfort during exercise or intercourse. While a vaginoplasty addresses the size of the vaginal opening, a labiaplasty rejuvenates the inner and outer labia in the vulva area and creates a more youthful appearance that matches the rest of the body. Labiaplasty can also make hygiene easier and helps reduce the risk of urinary tract infections by eliminating tissues that can harbour unwanted bacteria.
Labiaplasty Encompasses Three Major Categories of Procedures:
- Reductive surgery for the thinner inner “lips” (the labia minora) which has become hypertrophic or overgrown
- Reductive surgery of the thicker and fleshier outer “lips” (the labia majora), which has lost volume and appear deflated
- Augmentation surgery of the labia majora when the volume loss is mild
Labiaplasty, also known as labia reduction surgery, is performed for several reasons. Suppose your labia minora protrudes beyond your labia majora. In that case, you can experience uncomfortable sexual intercourse, pain from twisting or tugging of the labia as you engage in physical activities like riding a bike, general itching and irritation, as well as personal displeasure with the appearance of your labia minor.
Regardless of the reasoning, a labiaplasty procedure can address everything from sexual health to general well-being. In some circumstances, psychosocial factors are motivations for women to undergo the procedure.
Two Types of Labiaplasty
You might want a reduction in the size of either your labia minora or labia majora. A labia majora reduction reduces the size and shape of the outer lips of your vulva, whereas a labia minora reduction reduces the size and shape of the inner lips.These reductions are either made using the trim technique or the wedge technique.
Trim Labiaplasty
Your doctor will reduce the size of your labia by removing excess skin along the outer edge of the labia and stitching it back up. The downside to this procedure is that the scar line becomes the new border.
Wedge Labiaplasty
Your doctor will reduce the size of your labia by removing a wedge or V-shaped section of your labia at the widest point and then stitching the edges together. The wedge excision leaves the natural border of the labia intact. The scar is on the inside of the labia, which is less visible.
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 ageing. 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 sedation or the procedure room under local anaesthesia with topical numbing cream and a series of numbing injections.
Complimentary procedures include a clitoral hood reduction, mons pubis liposuction and Viveve, a non-surgical vaginal tightening treatment. You may decide to have one or more of these procedures done during your labiaplasty procedure. To create a more seamless result, a new type of labiaplasty procedure, known as the Trim-V, incorporates a traditional labia minor reduction with a clitoral hood.
What should you expect in your initial consultation about labiaplasty?
During your initial consultation, your plastic surgeon will conduct a thorough exam and help determine if labiaplasty is the right option for you. You need to let the surgeon know how your current labia structure impacts your daily life and what you expect from surgery. This is the time to ask any questions you may have about your surgery.
Is Labiaplasty Right for You?
Even if you are in excellent physical health and do not smoke, not every woman will be a good candidate for labiaplasty. But what makes a good candidate for labiaplasty? Suppose the size or shape of your labia affects your self-confidence or interferes with your daily activities. In that case, you may be an ideal candidate for labiaplasty.
Is Labiaplasty It Ever Medically Necessary?
The short answer is that for most people, labiaplasty isn’t medically necessary. Instead, it’s a cosmetic procedure they elect to have because they’ve decided that a smaller or shorter labia is desirable. For most people, this is a result of cultural messaging and media.
However, sometimes it is medically necessary. It’s considered medically necessary if your labia get “sucked” or “tucked” into the vagina during intercourse. This can result in painful tears in the vulva skin. The same applies if things like wearing underwear or a bathing suit, walking, running, biking, or even sitting are painful or irritate or chafe the vulvar skin.
Some women are born with longer labia, but doctors note that childbirth and simply getting older can also result in labia elongation, making the procedure necessary later in life.
What to Think About Before You Have a Labiaplasty?
If you’re thinking about having a labiaplasty, discuss it with your GP first. You may have a condition that’s causing discomfort, which can be treated. Or there may be a reason why the operation is not suitable for you. Your GP may advise you to speak to a counsellor or psychologist before committing to surgery. 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!
Who should not have labiaplasty?
Once you decide that labiaplasty is right for you, you need to plan your procedure and recovery. It would be best if you plan on taking at least a week off from work. In the time leading up to the procedure, make sure you eat healthy, drink water, and get plenty of sleep. Establishing healthy habits before your surgery can help support a quicker recovery.
The first few days after the procedure should be devoted to rest, so talk with family and friends about helping around the house, especially if you have young children. Stock up on groceries, prescriptions and any items you may need during recovery before the procedure.
What to expect after labiaplasty?
The procedure is performed comfortably in the procedure room of your doctor’s office under local anaesthesia, 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. You can return to regular activity within 2-3 days after your procedure. In the immediate period after your labiaplasty, you’ll be unable to shower. You must wait 48 hours before you shower and clean the affected area. If you experience discomfort while urinating, you can either ease the pain by urinating in the shower or running warm water over the affected area.
Having surgery while awake may seem intimidating or painful, but almost universally, women claim that the procedure was way easier than expected and didn’t feel anything. Patients get assured when they find out that the procedure comes with a low risk of infection and causes only minimal scarring that’s no longer visible after a few months. Most doctors will prescribe antibiotics to reduce the risk of infection and anti-inflammatories to reduce pain. In the case that anti-inflammatory meds aren’t prescribed, OTC anti-inflammatories are recommended. Stitches used in labiaplasty are generally absorbable and will dissolve over a few weeks. You will have a follow-up appointment with your doctor to check the stitches and how you are healing.
Labiaplasty Post-Operative Care
Our goal is to make sure that you are comfortable after you leave the office/hospital and received proper instructions on how to take care of yourself for you to have a safe and successful surgical experience.
Recovery time for both types of labiaplasty is usually around two weeks, but the downtime is minimal (if any). Patients will likely experience a bit of pain and swelling, which can be relieved with ice pads and medication (as directed by your surgeon). Intercourse and soaking in baths should be avoided for up to 40 days post-op.
Immediate Labiaplasty Post-Op Instructions:
- Immediately following labiaplasty, you should lie down as flat as possible.
- Ice packs should be applied every 4-6 hours for the first 24 hours while awake, placed over a thin pad. Ice packs should never be applied directly to the skin. Use of ice packs will remarkably reduce the amount of post-operative swelling and discomfort.
- It is normal to have swelling and bruising of the labia. This will resolve over the next two weeks.
Taking Care of the Incision
- The surgical dressings can be removed anytime they are saturated with blood and then replaced with a sanitary napkin or pad.
- There will be bloody or blood-tinged drainage for a minimum of 1- 2 weeks following your labiaplasty.
- Try to keep the incisions dry, especially the first 24 hours after the surgery.
- Antibiotic ointment should be applied to the incisions twice a day for 14 days. Please apply a thin coating only. Excessive amounts are not necessary.
Pain Medication
- You will be given a prescription of a nonsteroidal, anti-inflammatory drug (NSAID), such as Ibuprofen and a mild narcotic pain medication, such as Vicodin.
- You should take the NSAID as directed regularly for the first 3-5 days. It is not narcotic and won’t cause sedation or interfere with driving. It will help to reduce swelling and decrease your overall need for stronger pain medications.
- You can use the narcotic pain medication in addition to the NSAID if you are not getting adequate pain relief, especially in the first 24 hours. Keep in mind that narcotic pain meds are sedating, so you shouldn’t drive while taking them. They can also be constipating. Using a stool softener and a fiber laxative can reduce constipation associated with these medications.
Activities
- Most patients will experience relatively minor discomfort after labiaplasty. However, some patients do experience moderate to severe swelling that can cause much discomfort.
- Patients who experience minimal swelling and bleeding should be able to resume sedentary work activities within a few days, resume light exercise after one week, and have no restrictions after two weeks (following your post-operative visit).
- Patients with more excessive swelling and discomfort may want to limit their activities until they feel comfortable and gradually progress to their normal activities.
- Refrain from tampon use for at least 6 weeks after your procedure.
Sexual Activities
- As a general rule, you may resume sexual activity 6 to 12 weeks after surgery. This is totally patient-dependent. Your doctor will let you know when you are sufficiently healed during your regular visits.
Healing of sensory nerves
- The skin of the labia may be partially numb for several months while the wounds are healing.
- Permanent numbness is sporadic.
Call your doctor immediately (even outside regular office hours) if you have:
- Significant bleeding from the surgical site
- A fever over 100.4° F within the first three days following the procedure
- Considerable pain in the area that is not relieved with pain relievers
- Drainage from the site or redness around the surgical site
Are labiaplasty results guaranteed?
Most labiaplasties do as they’re intended to do: shorten the labia.
A labiaplasty can also be performed to make the labia more symmetrical. Most women who experienced discomfort during sexual intercourse, pain while performing certain physical activities, or were displeased with the appearance of their vagina, claim relief of symptoms and happiness with their genital appearance after surgery. Multiple studies report labiaplasty is a safe and effective procedure with patient satisfaction rates over 94%.
According to a 2014 study, 91 percent of people who had the procedure felt more satisfied with their genital appearance afterwards and concluded that labiaplasty effectively improves the genital appearance and sexual satisfaction.
It’s worth adding that the procedure is still new enough that there’s no data on how things like menopause and childbirth affect the results obtained by the labiaplasty.
Are there any potential risks to labiaplasty surgery?
Anytime you go under the knife, there are risks.
Here, the main risks include:
- decreased vulvar sensitivity
- chronic dryness
- numbness
- scarring that results in painful vaginal sex
- Contour deformities or asymmetry
- Infection
The ASPS notes that risks also include bleeding, hematoma, and infection.
While some patients elect to have a drastic reduction in labial length, if the labia are over-resected or too much skin is removed, it can prevent the labia from doing their job: protecting the vaginal opening. As a result, the vaginal opening may become more accessible and cause imbalances in the PH of the vagina. This could result in more vaginal infections.
Misconceptions about Labiaplasty
Labiaplasty procedures are growing in popularity. As this procedure grows in popularity, it is often seen that the misconceptions about this procedure can grow just as quickly. If you have considered labiaplasty or are just curious, you can find the list of common myths below. Have you heard any of these?
Myth number 1 : Labiaplasty is only for cosmetic purposes.
Labiaplasty can be performed for functional, emotional, and cosmetic reasons. A woman may experience discomfort when engaging in physical activities due to excess labia skin and avoid those situations. A woman might also seek labiaplasty for emotional reasons to restore confidence and a good body image. Labiaplasty doesn’t have a “type” of the customer; it empowers many different women with an entire range of concerns and desired results for the procedure.
Myth number 2 : Labiaplasty is only for women who have children.
We probably cannot emphasize this enough: labiaplasty is a procedure that can benefit several different women. Excess skin on the labia may also be due to genetics or ageing, as well as childbirth. Often young women seek a way to alleviate physical discomfort and a positive body image after growing up with excess labia skin. The procedure will not interfere with a woman’s ability to give birth. However, it is recommended that new moms wait at least six months after a vaginal birth to allow the tissues to stabilize and inflammation to resolve.
Myth number 3 : Labiaplasty is a painful procedure and requires a long recovery.
There will be some discomfort from the procedure; however, labiaplasty is no more painful than other procedures. Local or general anaesthesia will be administered to ensure your labiaplasty experience is comfortable. Furthermore, the recovery time might be shorter than what you once thought. Many women return to their typical schedule after a week of recovery.
Myth number 4 : My partner will be able to see my labiaplasty scars.
When performed meticulously using the wedge-type technique—instead of the edge-trim approach—scars from labiaplasty are virtually undetectable. Many doctors prefer the wedge labiaplasty technique due to its ability to conceal scarring. By placing the incisions in hidden areas, doctors can make sure the final results look exceptionally natural, with minimal signs of surgery.
Myth number 5 : Beauty seekers will lose some sensation after labiaplasty.
Labiaplasty should not cause any long-term sensation changes when correctly done. However, if the procedure includes a clitoral hood skin reduction, there may be increased sensitivity and pleasure during sexual intimacy. While recovery time can vary, it is typically recommended to wait for 6 to 12 weeks after surgery to resume intimacy and any activities that may stress the groin region. In general, sensation after labiaplasty is usually similar to what it was before the surgery.
Myth number 6 : Labiaplasty will have to be redone if performed before having children.
Labiaplasty results are considered permanent and, therefore, should not have to be revised following a future vaginal birth. This is because labia minora, once reduced in size, will not enlarge or revert to their previous shape and size due to pregnancy or vaginal delivery. However, new changes can occur, such as a torn labia minora after childbirth. While the timing of labiaplasty ultimately depends on the patient’s individual needs, many patients wish they had undergone the procedure sooner!
Myth number 7 : Virginity will be lost after the procedure.
A labiaplasty only trims low-hanging, darkly pigmented, and extra labia minora tissue. Before a woman has sexual intercourse for the first time, there is a tight band of tissue at the vaginal opening called the “hymen” that often tears during the initial time she has sex. Labiaplasty does not address this area. Since it does not go deep into the vagina, a young woman will still be a virgin after labiaplasty surgery.
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