Can I get the results I want from a Labiaplasty without a clitoral unhooding? (photos)

Hi there. I'm 24 with no kids and I recently had a consultation with a local Board Certified plastic surgeon who does not perform hoodectomys. I believe my clitoris pokes out a good bit and my vulva seems naturally long and "open". Would I benefit and get the results I want from a labiaplasty without a clitoral unhooding? I would like my labia minora to be smaller, smoother, and neatly tucked away while standing. Is this possible with my anatomy and without the unhooding? Thank you!

Doctor Answers 12

Discussion with Surgeon

Probably but I wouldn't tell you one way or the other without examining you. Not all clients want hood reduction.
Looking at Pre and Post procedure images of actual patients in your prospective surgeon's book can show you what he or she can do for you as well as what surgery seems best for you. :)

Best Regards,
John Di Saia MD

Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

Labiaplasty needed

A labiaplasty would help achieve the desired result.  The unhooding of the clitoris would most likely be needed. Your surgeon may be hesitant to have incisions or scars around the clitoris that could affect sensation or sexual pleasure.  If you would like, I'd recommend a second opinion to see if a different surgeon could offer you the procedure you seek.  Best wishes!

Levi J. Young, MD
Overland Park Plastic Surgeon
4.8 out of 5 stars 57 reviews

Labiaplasty with clitoral hood width reduction i.e. lateral prepuce reduction

Thanks for sharing.  What you want to accomplish most likely can be achieved through both a labia minora reduction and lateral clitoral hood reduction.  If your surgeon can not perform this procedure then you should choose a new surgeon.  A board certified plastic surgeon does not guarantee success. Choose a surgeon wisely based upon:  skill, expertise, experience, reputation and results.  Results can best be determined by looking at their before and after photos on their website.   Their website should display multiple types of cosmetic vulvar and vaginal procedures.  Remember choosing the wrong surgeon can leave one with devastating results.  John R Miklos MD
Urogyencologist & Cosmetic Vaginal Surgeon
Atlanta ~ Beverly Hills ~ Dubai

John R. Miklos, MD, FPMRS, FACS
Atlanta Urogynecologist
5.0 out of 5 stars 19 reviews

To Do or NOT to do a hood reduction (not "unhooding") with labiaplasty.

Yes it is possible, although the very tip of your hood may slightly "peek out" between your majora... You would do well with either a V-Wedge or a curvilineal revision. If the size or your hood does not bother you there is no reason to resect hood epithelium.  HOWEVER-- it is imperative that your surgeon understand the natural "flow" of the labia from their beginnings on your hood, and that he or she design and operate (whether Wedge or Trim) so as to continue this "flow" from your hood and not make the lips so small as to make the hood stick out like a "...small penis..!" By the way, the correct terminology is "hood reduction." "Unhooding" is a much different procedure
The weblink below will explain linear/trim vs. V-wedge differences.

Clitoral unhooding is not the same as clitoral hood contouring and is not a cosmetic procedure

Perhaps you are confused by terminology. Unhooding of the clitoris would completely and permanently expose the head of the clitoris and cause extreme discomfort - it is only done for the treatment of cancer and typically by gynecologists who treat female cancers. Since you are concerned primarily with the appearance of your labia in the standing position, it would be useful to see a photo of the area in the standing position as well. From what I see in the photo, you would benefit from a labia minora reduction and possibly from a conservative clitoral hood contouring (not unhooding), but without a standing photo this cannot be assessed adequately.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.6 out of 5 stars 24 reviews

Labiaplasty without hoodectomy?

First, double check the specialization and reputation of your "board certified plastic surgeon" because, frankly, any labiaplasty specialist also performs hoodectomy...its just part of the deal. Nonetheless, your photos do indicate the possible need for both labiaplasty and hoodectomy in order to obtain the best balanced result. Glad to help.

Ryan Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 116 reviews

Every vagina is different, and labiaplasty can be individualized to that

No labia or vagina is "normal", there are so many variations upon what we expect to see or think "normal" in cosmetic genital surgery. I think if what you would like is the labia minora to be smaller without trimming the clitoral hood just let your plastic surgeon know those desires ahead of time when the examination and preparation for surgery takes place. It is totally do-able and given the anatomy of your labia minora, I don't think it would not look disharmonious to simply perform a labial minora reduction without resecting the prepuce/ clitoral hood area above. We have so many more options in noninvasive external and internal tightening of the vagina now too, so if you wanted to for more harmony, you could even tighten/ shrink the prepuce area post-operatively with a noninvasive device such as the SkinTyte/ DiVa laser for the vagina.  Good luck!

Jennifer L. Walden, MD
Austin Plastic Surgeon
4.5 out of 5 stars 34 reviews

One of your options is to do nothing!

My consents disclose the common risks and benefits of a labiaplasty. Also mentioned as an "alternative" to the procedure is the option to NOT do the surgery. It may sound silly but it is an important part of your thought process: will I be substantially improved by the contemplated surgery?
Please realize and be reassured that there is no standard of beauty for the labia. There is huge variation in size, shape, length, pigmentation and so on, so much so that you yourself are, essentially, unique. 

As a gynecologic as well as cosmetic plastic surgeon I would say that your photos do not show any "poking out" of your clitoris. As well, your inner lips can be "tucked away" by reducing the total amount of tissue within the labia by either a wedge or trim technique. But, should they? Your photo shows one natural variant of three possibles: larger minora, smaller minora and minora equal in prominence to the majora. That's it! Throw in an infinite variation in color, texture, length, etc. and you have the female in all of her uniqueness. Getting back to your photo shows quite smooth, symmetrical, minimally-protruding inner labia with no excesses of the labia or the clitoral hood. These facts do not prevent labiaplasty surgeons from recommending labiaplasty in almost every instance. Small wonder!Out of sight when standing? Yes. Smaller? Yes. Smoother? Very unlikely! Spend a few minutes looking at labia photos here  and you will see many dozens of post-op labia results that one could never characterize as "smooth." A perfectly performed labiaplasty with perfect wound healing may result in a perfectly smooth tucked away appearance; what is more likely, however, is that you will end up with smaller, tucked away but irregularly-shaped labia with a "worked on" look. One of the risks you take with labiaplasty is to have a bobbed, irregular and less-than-natural look to your labia.

Hopefully, you can come to be assured that you are normal and do not automatically need to trim your inner lips to conform to what I see as a current "wave" of trying to interiorize your labia to the extent that you would look like every other woman who had done so. The trend to which I refer is the desire to cause your labia to look like a "clam shell;" that's how every little girl appears: dominant, puffy outer labia with as yet undeveloped inner labia. 

Do not be influenced by the current trend to "nip/tuck" every little variant of your unique anatomy. If you are comfortable with this advice you now have about $4,000-$5,000 to spend on something more worthwhile.

William E. Shuell, MD
Phoenix OB/GYN
5.0 out of 5 stars 3 reviews

Labiaplasty With And Without Clitoral Hood Reduction

Labiaplasty by an experienced cosmetic genital surgeon should be able to smooth, reduce the size and improve the overall appearance of the labia.  The excess hooding of the clitoral area can also be reduced at the time of the labiaplasty in order to reduce the amount of protuberance.

Labiaplasty with and without clitoral hood reduction is a personal decision after being well educated on the benefits and risks.  In my practice, I discuss this with my patients in order to educate them on their cosmetic issue, the surgical options and possible outcomes so that they can make an educated decision.  Assessing your specific needs in order to attempt to meet your goals is challenging with a single photograph without a thorough examination.  Best of luck.

Jeffrey S. Palmer, MD, FACS, FAAP
Cleveland Urologist
5.0 out of 5 stars 7 reviews

Can I get the results I want from a labiaplasty without a clitoral unhooking?

Thank you for your question and for sharing your photograph.  Based on your picture alone I would recommend a labiaplasty to help reduce the overall size of your labia minora combined with a clitoral hood reduction to diminish some of its width.  Unhooding, or shortening the clitoral hood, will depend on an in-person examination as the benefits of reduction need to justify any potential exposure of the clitoris which should be avoided.  See a labiaplasty specialist to have the best treatment recommendations made.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.