Anthony J. Gingo Jr., MD, MBA, FACOG

No. Let’s face it: Some people may not necessarily need BOTOX, but most who have tried it keep coming back. It is a personal choice to fight those signs of aging. Preventive BOTOX has surged in popularity over the last few years, with more 20-somethings requesting BOTOX. Everyone’s skin ages at its own pace, depending on your lifestyle, skin type, ethnicity, and genetics. If you have been a sun goddess for years and possibly a smoker, your skin is going to age differently than someone who doesn’t have these habits. Preventive BOTOX is favored by women in particular who want to ward off the signs of fine lines and wrinkles before they start. Preventive BOTOX treatments can help you maintain a youthful appearance. Most individuals in their 20's don’t display many visible lines or wrinkles. However, fine lines around the eyes or on the forehead can be stopped in their tracks so you can maintain a youthful appearance as you enter your 40s or 50s.

Simply, yes. Your procedure would be limited due to the minor discrepancy between the sides. The repair would be no different than any labiaplasty, just less extensive. You will feel much better, much sooner than if an extensive repair was required. Hope this helps.

There is no one answer. An experienced surgeon can offer multiple options. Depending on your desire, a labiaplasty will be done differently. Some women want the reduction with removal of the darker skin, others want a reduction without concern for color variation, others want the labia to just peak out from the labia majora, and still others are looking for removal of tissue that will hide the clitoris and labia minora within the labia majora. Be sure you see an experienced genital surgeon, and more importantly ... tell your surgeon specifically what you want. If your surgeon is not asking you the right questions, you may get a cookie cutter procedure. Hope this helps.

Unfortunately, a medically covered procedure will not result in the 'look' that you are expecting to end up with. If the procedure is for comfort only, then the medically covered procedure will work. But if you want a visually pleasing result, this requires the specialty skills of a cosmetic surgeon. The time and effort involved with a cosmetic repair is much more complicated than a simple amputation of excess tissue. Take care to seek out the repair you desire long term. The first repair is the best repair if done correctly. Hope this helps.

Your photos reveal the typical anatomy of a woman who desires a labiaplasty with clitoral hood reduction. Keep in mind that your anatomy is completely normal, and common. The typical symptoms one experiences is discomfort from pulling and tugging on the area with exertion and tight fitting clothing as well as with sex. Some women feel uncomfortable in bathing suits due to the fear of the labia showing, or slipping out the sides of a suit when in need of adjustment after going in the pool or water. The procedure for repair is quite simple and has a relatively quick recovery period. The only person that can decide if you need the surgery is you. If you feel uncomfortable with the look or with the feel then you need a repair. Seek out an experienced surgeon for best results. Good luck.