A routine labiaplasty. Labiaplasty before and after photo courtesy of Dr. Gary J. Alter, board-certified plastic surgeon in Beverly Hills and New York City. Results may vary.
A reconstruction labiaplasty with clitoral hood flaps. Photo courtesy of Dr. Gary J. Alter, board-certified plastic surgeon in Beverly Hills and New York City. Results may vary.
A labiaplasty with a clitoropexy and hood reduction. Photo courtesy of Dr. Gary J. Alter, board-certified plastic surgeon in Beverly Hills and New York City. Results may vary.
A routine labiaplasty. Labiaplasty before and after photo courtesy of Dr. Gary J. Alter, board-certified plastic surgeon in Beverly Hills and New York City. Results may vary.
A reconstruction labiaplasty with clitoral hood flaps. Photo courtesy of Dr. Gary J. Alter, board-certified plastic surgeon in Beverly Hills and New York City. Results may vary.
A labiaplasty with a clitoropexy and hood reduction. Photo courtesy of Dr. Gary J. Alter, board-certified plastic surgeon in Beverly Hills and New York City. Results may vary.
Labiaplasty surgery reduces the size of the labia minora, the inner vaginal lips, by removing excess tissue. (Cosmetic surgery to reduce the larger, hair-bearing labia majora is called majoraplasty.)Â Â
The goal is to reduce the size of the inner labia so they sit neatly tucked in between the labia majora. âThis creates a nice, feminine shape to the female genitalia and reduces pinching and pulling and issues with intercourse,â says Dr. Adam Oppenheimer, a board-certified plastic surgeon in Orlando, Florida.Â
To create a cosmetically desirable result, your surgeon should evaluate the entire region in a pre-op exam and create a comprehensive treatment plan. This may include reducing the prepuce, the fold of skin that sheathes the clitoris, connects to the labia minora, and forms the clitoral hood.Â
âThe prepuce commonly extends into the labia minora, sometimes overwhelming them,â explains Dr. Mark Scheinberg, a cosmetic gynecologist in Deerfield Beach, Florida. âProper reduction of this excess prepuce tissue is frequently necessary before addressing the lower pair of labia, to get a natural, symmetrical appearance.âÂ
Dr. Gary Alter, a board-certified plastic surgeon with practices in New York City and Beverly Hills, agrees. âItâs not always just about the labia minora,â he says. Dr. Alter is the inventor of the central wedge labiaplasty surgical technique. âWomen come to see me and their labia may be big, but their clitoral hood may be too. If you just do the labia, their hood looks gigantic.â Correcting this imbalance may require clitoral hood reduction.
This comprehensive approach to genital surgery can alleviate a common post-op concern: the size of the clitoris and prepuce compared to the rest of the vulva, once the inner labial edges are reduced.
The mons pubis (the hair-bearing mound of fatty tissue that covers the pubic bone) can also be reduced via pubic liposuction or a pubic lift (monsplasty).
RealSelf Tip: Labiaplasty doesnât make you tighter because it only involves the external genitalia. But the procedure can be combined with a vaginoplasty, to tighten the vaginal canal, and/or a perineoplasty, to tighten the vaginal opening. These vaginal rejuvenation procedures can also reduce urinary incontinence.
This surgery is safest when performed by a board-certified plastic surgeon, cosmetic gynecologist, or cosmetic urologist who has extensive training and experience operating in this sensitive, nerve-rich area.
In fact, some surgeons suggest only consulting surgeons whoâve performed at least 100 labiaplasties, since it can take that many to become truly proficient.Â
A 2018 study found that many providers offering the procedure may not have sufficient experience: while nearly 11,000 labiaplasties were performed by members of The Aesthetic Society in 2017, 66% of these surgeons only performed between 1 and 10 of these procedures each year.Â
Dr. Michael Goodman, an OB-GYN in Davis, California, who specializes in female genital aesthetic surgery, says that "thousands of labiaplasties are performed annually by 'general gynecologists,' for mostly functional reasons. In order to be covered by insurance, these procedures are not considered cosmetic." He cautions that because general gynecologists do not receive plastic surgery training, "mutilations may result."
Related: Botched Labiaplasty Is Common. Doctors Explain Why.
Women consider labiaplasty surgery for several different reasons.
âPatients in my practice fall into one of three groups. Some have functional issues as a result of enlarged or asymmetrical labia,â explains Dr. Nelson Castillo, a board-certified plastic surgeon in Atlanta. âOthers desire improved aesthetics and self-esteem, and some have a combination of functional and aesthetic concerns,â he explains.
Pros
Cons
During your initial consultation, ask whatâs included in the cost they quote you. It could be just the surgeonâs fee, or it might include the anesthesia, facility fees, lab work, and any follow-up appointments. Make sure that you ask about the total âout-the-doorâ fee.
Cosmetic surgery procedures arenât covered by insurance. If your procedure isnât considered medically necessary, your provider may offer payment plans or accept third-party financing options, such as CareCredit.
See our complete guide to labiaplasty costs and insurance coverage
As you're choosing your surgeon, look for labiaplasty pictures with symmetrical, natural-looking results and no visible scars. The labia should look well-balanced with the clitoral hood.
It can be difficult to see whether too much tissue has been left, or too much has been removed, so itâs still important to ask your prospective surgeon about their training and technique, to avoid a poor outcome that may require reconstructive surgery.
The labiaplasty photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.
Adult women who are physically uncomfortable or self-conscious due to the size or appearance of their labia minora can be good candidates. Generally speaking, most healthy nonsmokers and non-diabetics can have this surgery.Â
If you want to reduce an enlarged labia, remove skin with pigmentation issues, or fix asymmetry, this procedure might be a good choice for you.Â
Labia naturally have a lot of variation in size, shape, and pigmentation. While adult films have normalized very small, pink labia minora, keep in mind that your anatomy can look very different and still be well within the range of whatâs ânormal.âÂ
In some cases, a patient may benefit from mental health support before making a decision to have surgery. One study found that 18% of women pursuing labiaplasties met the criteria for body dysmorphic disorder (BDD), a type of obsessive-compulsive disorder in which you canât stop thinking about one or more perceived flaws in your appearance. If your surgeon has concerns that you may be showing symptoms of BDD, they may refuse to operate on you.
The type of anesthesia you have will depend on the complexity of your procedure and the preference of you and your provider.
They may recommend:
âThe choice of local with mild sedation or general anesthesia is determined by the surgeon and patient,â says Dr. Alter. âI perform the central wedge technique, often with extensive clitoral hood surgery. This procedure can take up to two hours which can be difficult for patients with local anesthesia in stirrups, so I usually use general anesthesia or sedation.â
Dr. Goodman utilizes local anesthesia with mild sedation for all procedures up to 3.5 hours.
Whichever option you have, you should experience no pain during the procedure itself.
This outpatient procedure usually takes one to two hours, though it will take longer if itâs combined with other procedures.
There are more than a dozen variations on the two main labiaplasty techniques: the trim and wedge methods. Find a board-certified surgeon who is skilled in more than one technique, so they can recommend the most appropriate one for your situation and desired result.
Hereâs how some of the primary techniques work.
Once your procedure is complete, your surgeon will suture the incisions closed with dissolvable stitches. Scars typically blend into the labial tissueâs wrinkles and folds.Â
Youâre able to return home shortly after your surgery. You may be groggy from the anesthesia or sedatives, so make sure you have someone you trust there to get you home safely.
"If your surgeon uses a long-acting anesthetic, which lasts 4-5 hours, you can return to home or your hotel, have a meal, and begin taking pain medication before your anesthetic wears off," says Dr. Goodman.
Unlike the trim method or the central wedge method, which removes or alters the free edge of the labia minora, the natural edge technique maintains the natural aesthetics of the tissueâthe color, contour, and texture.Â
There are several ways to perform a natural edge labiaplasty procedure, but Dr. Scheinberg prefers the technique known as posterior wedge delamination because it helps avoid these potential drawbacks of the trim and wedge techniques:
Posterior wedge delamination involves the layer-by-layer removal of the central portion of the labia. âThe labia can be viewed as lamina (layers), with flat inner and outer surfaces,â explains Dr. Scheinberg. âBy delaminating, instead of excising [cutting out] these enlarged surfaces, the blood supply can be preserved, leaving a solid, natural-looking, petite labia with hidden suture lines.â
During the posterior wedge delamination procedure:
Posterior wedge delamination is a more technically challenging technique than other labia reduction options, so itâs not yet widely offered. âItâs not just cut and sew,â says Dr. Scheinberg. âIt takes a better surgeon to do it.âÂ
When consulting with providers about this technique, be sure to see plenty of before and after photos of their patients to get a good sense of their aesthetic sensibility and what they consider an ideal post-op outcome.
This aggressive trim labiaplasty procedure involves cutting away the entire labia minora, leaving minimal to no tissue at its base and allowing the labia majora to completely close. It replicates the smooth look of a Barbie doll, hence the name.Â
Providers on RealSelf caution women about the dangers of removing too much tissue. A certain amountâtypically 10 millimeters, around .4 inchesâis necessary to maintain proper form, function, and comfort.Â
A fully removed inner labia creates a compromised vaginal opening, which means that bacteria and fluids can enter and leave the vagina freelyâsetting up the patient for yeast infections, UTIs, difficulty with lubrication, and painful scarring, says Dr. Oppenheimer.Â
âThereâs a thin line between safely performing the Barbie method and removing entirely too much and ending up with an awful appearance, sexual pain, and ânothing there,ââ Dr. Goodman cautions.Â
If the goal is to have no visible inner labia, labiaplasty with clitoral hood reduction surgery can be combined with outer labia augmentation (labia puffing), using dermal fillers or fat grafting.
Everyone heals differently, but this is a typical recovery timeline, according to the doctors we consulted.
Plan for a week of initial recovery timeâpossibly longer, depending on which technique was used (the wedge requires a longer recovery) and if you had multiple procedures done at one time.
During this week, you can expect:
Your surgeon should provide specific instructions about what to do during recovery and healing. Itâs important to follow their recommendations. âIn my experience, the women who have less swelling and have everything stay intact, are those whoâespecially in the first week to 10 daysâtake it easy and donât overdo it,â says Dr. Goodman.
That said, it's important to not be too sedentary after the first day. For a smooth recovery:
Dr. Castillo also stresses the importance of elevating your pelvis, cold compresses, pain relievers, and anti-inflammatories, including arnica and bromelain.Â
Pain and discomfort should resolve within 3 weeks. If you experience discomfort for longer than a month, reach out to your provider.
Most patients are fully healed within 6 weeks.
Sutures should fully dissolve within 8 weeks. "Some surgeons use slowly dissolving sutures hidden underneath the skin, using rapid-dissolving sutures for the skin edges only," says Dr. Goodman.
At this point, you can resume sexual intercourse and inserting tampons.
Most of the swelling should have resolved at this point, so you can see your final results.
Youâll see your final labiaplasty results within three to four months, once all the swelling has resolved.
âIt generally takes three months for the majority of the swelling to go down,â says Dr. Mathew Plant, a board-certified plastic surgeon in Toronto. âThere may be some continued improvement in the appearance for up to one year.â
Donât be surprised if you have an âOMG momentâ in the first week after your surgery, says Dr. Goodman. âThe first week or two is the âFrankenstein phase,â where you look down and it looks positively awfulâirregular, bumpy, and swollen.â
Labiaplasty results are considered permanent, though your body will continue to change as you age. For example, many women lose volume in the labia majora. If this bothers you, labia puffing can restore it.
You can have a baby after labia reduction, though childbirth can stretch the labial tissues or change their appearance. There is no evidence of increased labial tears, nor is there evidence that one technique withstands childbirth better than another.
Youâll need to heal for up to 6 months after labia surgery, to allow time for all the swelling to go down and blood flow to return to the tissues, before considering labiaplasty revision or reconstruction, sometimes called âcorrective labiaplasty.âÂ
After youâve completely healed, your plastic surgeon will set up a plan to reconstruct any parts of the clitoral hood or labial tissue that were excessively removed or deformed.
Skilled surgeons can often correct gaps, create new labia tissue out of a remaining clitoral hood, correct scars or scalloped cuts, inject fat to restore volume, or reattach hanging skin.Â
However, labia reconstruction or revision surgery is more complex and delicate, so it's even more essential to find a skilled surgeon you can trust. "You only get one good chance for reconstruction, so be patient and ask a lot of questions,â says Dr. Alter.
Labiaplasties are considered safe when performed by an experienced surgeon, but itâs still important to be aware of the risks.Â
An inexperienced or unskilled provider can create a poor result that leads to complications, including:
Infection, excessive bleeding, hematoma, and extreme swelling are also possible during the recovery period. Post-operative care may include a round of antibiotics to prevent infections, including both oral medication and ointments.
The risk of incision separation is greater with the wedge technique than the trim technique, if itâs not performed exactly right and if post-op instructions arenât followed.
Temporary numbness of the labia (and sometimes the surrounding tissue) is common after this surgery. The nerves that provide sensation take several daysâsometimes weeksâto return to normal.Â
As sensation returns, itâs common to experience the type of âpins and needlesâ you may feel after your foot falls asleep and starts to âwake up.â
Long-term sensory changes after a routine procedure are said to be very rare, but this complication may happen more often than is widely known. According to Dr. Alter, he and other physicians frequently see women with significant sexual and orgasmic dysfunctions after labial reduction.Â
âThese women presenting for labial reconstruction are usually devastated from poor appearance, but often have discomfort and orgasmic and sexual disorders from pain, lack of stimulation, loss of self-esteem, or damage to sexual structures,â Dr. Alter wrote in an Aesthetic Surgery Journal article.
A recent study of the nerves of the clitoris, which are large and near the surface of the skin, may help explain sensory loss or chronic pain. The long body of the clitoris lies under the clitoral hood and mons pubis, two areas that can be affected by labiaplasties and related surgeries. âKnowledge of this anatomy is critical prior to performing surgery near the clitoris,â the studyâs authors concluded.
The labia minora are also nerve-rich and play a role in arousal.Â
âItâs critical that women do their homework and investigate their surgeon well,â says Dr. Scheinberg. "An experienced surgeon with a good reputation should avoid any problems."
Updated December 21, 2023