Clitoral hood reduction is a surgical procedure that reduces the length, width, or protrusion of the folds of skin around the clitoris, called the clitoral hood. Removing excess skin can increase clitoral stimulation and sexual pleasure, while improving the aesthetics of the vulva.Â
Also known as a clitoral hoodectomy, hoodoplasty, or unhooding, the procedure can also reduce discomfort, since a large clitoral hood can rub against clothing and cause irritation. In some women, it can also trigger yeast infections and urinary tract infections.Â
Clitoral hood reduction surgery is commonly paired with a labiaplasty, which removes excess tissue from the labia minora, the inner lips that surround your vaginal opening. âThe clitoral hood is connected to the labia minora, and frequently when you have to reshape the labia minora, you also have to reshape the hood,â says Dr. Marco Pelosi, III, an OB-GYN in Bayonne, New Jersey. Clitoral hood reduction can also be done as part of a full vaginal rejuvenation.
The clitoral hood is a fold of skin (aka prepuce) that protects your clitoris (aka the glans), which is the small nub thatâs just above your urethral opening, the tiny hole that you pee out of.Â
The clitoris is filled with nerve endingsâabout 8,000, according to the Cleveland Clinicâthat make it very sensitive to touch and play a critical role in achieving orgasm. Without any clitoral hood, your clitoris would be overly sensitive to touch and irritants, like friction from clothing rubbing against it. Your clitoral hood makes a lubricant called sebum that helps it glide smoothly over your clitoris.
âThe clitoral hood is there to protect the glans when youâre not sexually aroused, but elevates out of the way during sexual stimulation,â says Dr. Mark Scheinberg, an OB-GYN in Deerfield Beach, Florida, who specializes in vaginal rejuvenation.Â
Though it plays an important function, the clitoral hood can sometimes be too large or lengthy, or not retract during intimacy. Excess clitoral hood tissue is usually genetic and, contrary to what you might have heard, not caused by masturbation, explains Dr. Leila Kasrai, a plastic surgeon in Toronto.
Some women are just fine with a significantly hooded clitoris, but others struggle with the physical, cosmetic, or emotional symptoms related to this excess skin. âSometimes women complain about the excess tissue,â says Dr. Gary Alter, a plastic surgeon in Beverly Hills, California, who helped pioneer clitoral hood reduction surgery. âIt makes it look like a little penis.â
Pros
- The surgery is relatively quick (around an hour), with a speedy recovery back to work and normal activities.
- It typically doesnât require general anesthesia.
- Removing excess skin can make your clitoris look more proportional with your labia and vulva contours. It can also reduce irritation, pain, and embarrassment that may result from having an overly prominent clitoral hood.
- To improve symmetry, the procedure can be performed on just one side ifâlike many womenâyour anatomy isnât completely even.Â
- There is some evidence that clitoral hood reduction can enhance or improve orgasm, but âthis is quite difficult to guarantee,â says London-based plastic surgeon Dr. Amir Nakhdjevani, who notes that orgasm is dependent on more than just physical manipulation. However, the procedure will expose the clitoris, making it easier to access for stimulationâand potentially create stronger, more frequent orgasms.Â
- Scars from a hoodectomy are concealed and practically invisible. âBecause this tissue typically heals so well, scarring should be minimal enough to be imperceptible in the majority of patients,â according to Dr. Ryan Stanton, a plastic surgeon in Beverly Hills, California, who specializes in genital surgery.Â
- Most people who have the surgery are satisfied. âI canât stop looking at my vagina,â says RealSelf member Makemebeautiful, who is âreally pleased with my results.â Clitoral hood reduction has a 100% Worth It Rating from RealSelf members, who report increased self-esteem and sexual pleasure.
Cons
- Like any surgery, it comes with risks, including excess bleeding, hematoma, infection, asymmetry, and an unsatisfactory outcome. However, when performed by a specialist on an appropriate candidate, these risks are quite rare, according to Dr. Stanton.Â
- Removing too much or too little skin can lead to not enoughâor too muchâsensitivity. This may lead to sexual dysfunction, though it may be corrected with revisional or reconstructive surgery.
- Youâll need to wait six weeks before returning to heavy workouts and sexual intercourse. If it feels comfortable, gentle oral sex (aggressive suckling can irritate healing tissue) may be okay sooner than thatâjust check with your surgeon first.Â
- The surgery is expensive (especially when performed in tandem with a labiaplasty) and, because itâs considered cosmetic, is not covered by insurance.
The clitoral hood is very delicate tissue and requires careful surgical technique to avoid complications, such as scarring and removing too little or too much skin, and create the best results.Â
Itâs essential to choose a board-certified expert in female genital surgery. This procedure is highly specialized and delicate and should only be performed by someone who performs clitoral hood contouring on a regular basis âand can prove this to you with at least dozens of before-and-after pics,â advises Dr. Michael Goodman, an OB-GYN in Davis, California. âGetting the procedure correct the first time is critical, since revising imprecise surgeries can lead to a loss in sensation and irreparable outcomes,â says Dr. Stanton.Â
Clitoral hood reductions are typically performed by surgical specialists:
- Gynecologic or urogynecologic surgeons, medical doctors who performs surgery on the female reproductive systemÂ
- Plastic surgeons, medical doctors who specialize in cosmetic and reconstructive procedures
Your clitoral hood reduction cost will depend on your surgeonâs level of experience, expertise, and/or their practice location. Choosing an experienced, board-certified plastic surgeon may be more expensive, but it can help you avoid complications that may cost more to correct.
If youâre getting a clitoral hood reduction along with labiaplasty, you can expect to pay more.
Very rarely, health insurance plans will cover this procedure, if itâs deemed medically necessary by your doctor. In most cases itâs considered elective plastic surgery.
Clitoral hood reduction is an outpatient procedure that takes about an hour. It can be performed under local anesthesia, conscious sedation, or general anesthesia, depending on whether itâs being performed as a standalone procedure or in combination with another procedure.Â
Reducing excess clitoral hood tissue can be addressed with several different incision patterns. Your surgeonâs technique will depend, in part, on your unique anatomy and goals. Some surgeons use an electrosurgical knife, while others use a laser, to seal the blood vessels as the tissue is removed, resulting in quicker healing and less scarring. Â
When done as a standalone procedure, clitoral hood reduction may be performed via simple skin excision:Â
- Incisions are made on either side of the hood, and excess skin is surgically removed.Â
- The sides are compared for symmetry and evened out.Â
- The remaining skin is sutured into place between the hood and the labia majora, the outer vaginal lips.
Another technique to achieve a clitoral hood lift is to remove excess length of skin where the clitoral hood meets the pubic area. âEssentially I do a double-inverted âVâ incision, or an upside down âVâ incision times two, and the hood is elevated upwards,â says Dr. John Miklos, a urogynecologist in Atlanta.Â
Special caution should be taken not to remove too much tissue, which can put tension on the clitoral hood and result in poor healing. Â
If your procedure is being performed with a wedge labiaplasty, a V-Y wedge technique can be used. During this procedure, the upper portion of the V-shaped wedge of tissue thatâs removed during a labiaplasty can be extended to encompass any redundant hood tissue into a single incision line.Â
If youâre having a trim labiaplasty, during which one continuous incision is made along the edge of the labia minora to remove excess tissue, the incision can be extended up to the clitoral hood.
Whatever technique is performed, most surgeons close the wound using dissolvable sutures that the body breaks down and absorbs over four to five weeks.
Your surgeon will send you home with post-op instructions, but hereâs what a typical recovery process involves.Â
- Youâll need three to five days of downtime after the procedure.Â
- During this time, you can expect to be very swollen (âfreakishly so,â according to Dr. Pelosi, due to the nature of the hood anatomy).
- Youâll also have some discomfort. Makemebeautiful123, who described the initial pain as âreally uncomfortable, almost like a burning sensation,â only needed to take pain medication for the first day. After that, over-the-counter pain relievers should be enough.
- Most patients are able to walk more comfortably within a day or two.
- Make sure that you have loose-fitting clothing to wear during your recovery.Â
- To help reduce swelling, the Cleveland Clinic advises applying a cold pack over your underwear to the area on and off in 20-minute increments. Anti-inflammatory medication and elevating your pelvis can also help.
- Your surgeon may say that you can shower with soap and water and remove your bandage as early as 24 hours post-op, then apply an antibiotic cream to the incisions afterwards for the first three to five days.Â
- âWithin five days, most patients are able to go back to work with minimal discomfort,â says Dr. Stanton. âJust donât lift more than 20 pounds for at least two weeks after the procedure, unless your surgeon says otherwise.â
- Avoid baths, saunas, steam rooms, and swimming for at least three weeks, unless your surgeon says otherwise.
- Itâs quite common to experience spot bleeding after the procedure. Mild to moderate pressure with a gauze pad or ice wrapped in a thin cloth can help stop the bleeding. If it gets worse or doesnât stop, contact your surgeon.
- Avoid vigorous exercise and sexual activity for six weeks post-op, to give the incision time to fully heal and let the swelling go down.
âThis area of the body has a robust blood supply, so it heals relatively fast,â explains Dr. Stanton. âInitial results can frequently be appreciated within 2â3 months, but final results cannot be judged until 4â6 months post-op,â once all swelling has resolved.
If you have your hoodectomy along with a labiaplasty or vaginoplasty, a procedure that tightens the vaginal canal,it may take up to a full year for the swelling to fully resolve.
The clitoral hood reduction photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.
Every surgery carries inherent risks. The most common risks of clitoral hood reduction include:
- Scarring
- Asymmetry
- Under-reduction (not taking enough skin)
More rare occurrences include bleeding, infection, wound separation, and nerve injury that could lead to numbness or changes in sensitivityâsomething most RealSelf members say they didnât experience after the procedure.Â
Unfortunately, that wasnât the case with RealSelf member, SeaGoddess, who lost all sensation in her clitoris after the procedure and is unable to achieve orgasm.Â
To minimize the risk of complications, choose your surgeon carefully and follow all of their pre- and post-surgical instructions, including to stop smoking at least two weeks prior to your procedure.