Labia Reduction Surgery: Labiaplasty

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Enlarged labia minora can be functionally or psycho-socially bothersome. Local irritation, problems with personal hygiene, interference or discomfort with sexual intercourse and discomfort during cycling, horseback riding, wearing exercise clothing, walking or sitting are common complaints related to enlarged labia minora.

For these patients, judicious reduction of the labia minora may serve to improve the physical comfort during specific activity. Often, patients may not have symptoms related to the labia minora but are simply not pleased with the appearance of the redundant and/or dark skin. Surgical correction for these patients may help improve the patient’s self image or confidence. In these cases, like any procedure performed for “aesthetic” reasons, it is important to ascertain that the patient is internally motivated (doing the procedure for herself) not motivated by another party. Patients should be made aware that psychological or relational components of dysfunctional vaginal or intercourse experience cannot be treated with surgery.

Surgical Procedure

I will meet the patient prior to surgery to mark the area. This marking is done with the patient’s assistance while she holds a mirror. This allows the patient to communicate her goals again with her surgeon. Sometimes, the markings extend above the clitoris and/or below to the perineum (closer to the anus). Pre-existing asymmetry of the labia minora is very common and this should be corrected as much as possible. Extreme care is taken to avoid over-resection during the markings or the procedure.

The procedure is usually performed under general anesthesia (although, local anesthesia may be used for select patients). Regardless, long acting local anesthesia is used to help with patient’s post-operative pain control. The exact technique used is individualized and depends on the patient’s anatomy. For some patients, a triangular segment of excess labia minora tissue is removed; for others, a gentle curvilinear excision is performed. Excess tissue on the sides of the clitoris may also be removed judiciously. During the procedure, certain principles are adhered to strictly:

1. Avoid over-resection
2. Avoid encroachment upon the clitoris, urethra, or vaginal opening
3. Achieve as much symmetry as possible

Closure is done with sutures that dissolve – no suture removal is necessary. Scars will be minimally or not visible after several months. Ice and surgical pad are applied immediately.

After Surgery

I ask that a responsible adult transport the patient home. Bed rest is requested for 2 days with ice on the area during that time. Patients may resume light activity and “desk job” after 3 days but should avoid strenuous activity / sports for at least 3 weeks. Sexual intercourse may be resumed carefully after 4 weeks. I will want to see the patient for a post-operative visit 4-7 days after surgery and then again in a month (if possible).

Frequently Asked Questions

Q: Can labia minora reduction surgery cause loss of sensation?
A: Theoretically, but we have not seen this in our office. The excision is kept away from the nerve supplying the clitoris and the labia minora tissue itself contains very little sensory innervation. The patient’s symptoms will improve with surgery

Q: Why do women develop redundant labia minora?
A: No one knows for sure and it is a problem for women of all ages. However, many patients have noted that the redundancy of tissue has worsened after pregnancy or weight loss.

Q: Will my sexual partner notice that I have had the procedure done?
A: Only for the better as the loss of redundant tissue will be aesthetically pleasing. Pre-operative problems such as inward movement of the elongated labia minora with sexual intercourse may also be alleviated resulting in an improved sexual experience for both parties. Also, improvement in “self confidence” may allow the patient to wear clothing and/or lingerie show would not have been comfortable wearing before.

Q: How much time should I take for recovery.
A: 2 days of bed rest and about 1 month off of strenuous exercise or work.

Article by
San Diego Plastic Surgeon