All About Labiaplasty: A Primer for Patients. Part 1: Labia Minoraplasty

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The labia majora, the clitoral hood and the labia minora display a wide range of shapes and sizes. As a group, they're known as the vulva. The popularity of bikini waxing, shaving and laser hair removal have put these features into focus to be either appreciated or not. Treatments are available to reshape the labia majora, the labia minora and the clitoral hood. Some requests are purely cosmetic, others address pain or irritation associated with certain activities such as sex, horseback riding and other sports. Like noses, breasts and bodies, the only opinion that counts is your own.

Symmetry, balance and comfort are the most common reasons why my clientele request labiaplasty. Sometimes the color of the edges of the labia minora have become much darker (hyperpigmentation) than the surrounding vulva or the tissues have become enlarged (labial hypertrophy). In other instances, the labia majora have become deflated from weight loss or aging or they sag after massive weight loss.

It is not uncommon for women to experience damage to the labia during childbirth or from surgery or disease. These situations too, may lead to the desire for labiaplasty.

Cosmetic surgery of the labia minora is focused on reshaping these delicate structures carefully and precisely. Reshaping of the labia minora is commonly referred to as reduction labiaplasty, labia minoraplasty or simply labiaplasty. These terms are not sufficiently descriptive to establish an accurate cosmetic assessment of finer details of the contours that are involved in defining the features and endpoints of a well-planned aesthetic procedure.

Labia minoraplasty is divided into three categories based on the primary reason for which reshaping is requested.

Some procedures are limited to one side only. Others may involve surrounding anatomical structures of the vulva such as the clitoral hood, the fourchette (the zone where the labia meet posteriorly), the labia majora or the perineum (the deeper muscular tissues between the vagina and the anus.


COSMETIC REDUCTION LABIAPLASTY

Reshapes the labia minora to a shape and contour desired by the patient. Some of the frequent reasons why women request this type of surgery are to make the labia minora more symmetric when there is large visible difference between the two sides, to reduce undesired bulging of labial tissue when wearing certain types of swimsuits, lingerie or other tight fashions, to display less hyperpigmented skin (labial skin that is much darker than the vulva which surrounds it), or to achieve less protrusion (hanging) of the labia when nude.

Most women who seek these procedures prefer to keep the entire bikini zone including the vulva smooth and free of body hair & often request laser hair removal of the bikini zone to reduce the need for frequent and painful brazilian waxing or shaving and razor burn.


THERAPEUTIC REDUCTION LABIAPLASTY

Focuses on the resection of elastic, loose or pendulous labia minora tissue which has become a source of chronic discomfort as these tissues experience traction or pulling pain during normal activities, sports or sexual relations. Currently, medical healthcare insurance plans do not view the symptoms which drive women to seek reconstructive labiaplasty or therapeutic reduction labiaplasty as indications for surgical treatments.

RECONSTRUCTIVE LABIAPLASTY

Targets the restoration or repair of labia minora tissues and is usually performed to relieve symptoms arising as a result of damaged tissue. Typically, these procedures involve minimal resection of tissue, but make use surrounding tissue to achieve the desired result.


About the Labia Minora

The labia minora are composed of connective tissue covered with skin on their lateral (outer) surface. They extend from the clitoris anteriorly to the fourchette posteriorly. The anterior (front) portion of the labium minus splits into an outer portion which forms the clitoral hood (clitoral prepuce) and an inner portion which fuses with the undersurface of the clitoral head to form the frenulum.

The labia minora display their greatest span halfway between the clitoris and the fourchette. When measured from the base to the edge, most labia measure 4 to 5 centimeters in this dimension. The width of the labia minora is typically around 5 milllimeters.


The labia minora contain many sebaceous glands. They do not contain sweat glands or hair follicles. Mucus present on the labia minora is produced from glands within the vestibule

Microscopically, the lateral (outer surface) of the labium minus displays inner and outer layers of squamous epithelium (normal skin cells) sandwiching a central layer of connective tissue.

The medial (vaginal or inner surface) of the labia minora is partially covered with skin, along the edge, and with a thinner layer of pale skin near the base. The borderline between these two types of skin is known as Hart's line. The skin of the vaginal opening inside of Hart's line is called the vestibule.
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Jersey City OB/GYN