Surgical or nonsurgical rejuvenation for loose & extra skin on major & minora? (Photos)

Thank you for reaching out! There are multiple nonsurgical options for tightening majora and minora tissue and each will work slightly differently depending on the method. An important thing to note with nonsurgical treatment methods is that they are typically not permanent and require treatments be performed once or twice a year.

If you are seeking definitive management of the loose tissue then surgical excision of the excess tissue would be recommended. This would be in the form of a labiaplasty and/or labia majora reduction. Typically, the excess tissue at the perineum could also be addressed as well. Depending on your surgeon, these procedures are typically offered in an outpatient setting. If addressing both, it may be recommended to do so in a staged manner, meaning you perform one at a time.

If you are planning on surgical options, be sure to seek expert opinion from a board certified specialist. Also, ensure that they are able to show you multiple before and after photos as this is a good indication of volume as well as outcomes. Hope this helps!

Thank you for asking about surgical versus non-surgical rejuvenation for loose and extra skin on the labia majora and the labia minora. Based on your description, a surgical reduction of your labia minora and labia majora, which removes excess skin and some mild soft tissue, might be a good fit for you. Recent studies have shown that vaginal rejuvenation lasers do not effectively tighten the vagina. You might find prescription and over-the-counter skin bleaching creams helpful for lightening darker areas. Thank you for your question, and I wish you the best of luck.
Sincerely,
Dr. Katzen

Vaginal rejuvenation with laser is mostly used for vaginal tightening. It is necessary to surgically remove and correct the excess and wrinkled tissues at the labia majora, minora and vaginal entrance. The dark appearances that you are uncomfortable with will also be gone when surgically removed. Apart from this, only the laser procedure can be applied for lightening and skin wrinkles.

There are a couple of non surgical treatments to tighten the skin of the labia Majora and minors namely laser and radio frequency. They came be combined for a better effect. Chemical peeling helps to reduce skin pigmentation

Hello, thank you for your question. To reduce the minora we could potentially do a labiaplasty to help reduce some of the excess skin. Regarding the majora, I would not recommend a surgical approach. We could discuss vaginal rejuvenation in the form of skin tightening that may help you get closer to your goals. To make a more direct plan I would need to do an exam in the office and have a discussion to make sure that the treatment plan aligns with your goals. Hope that helps!

Q: Can corrective surgery be done on the labia minora and majora?

A: Yes, it can be done successfully. In your note, you did not mention that you underwent labia minora labioreduction and that the original surgeon left behind the labia minora tissue in the lower segment of the labia minora and the posterior perineum (the crotch). In my clinical practice, I do not do corrective surgery on the labia majora, which is presented in the pictures, which both are off-focus, and is difficult to provide you with a more detailed answer.

With regards,
Prof. Dr. Adam Ostrzenski
USA

Hello "...Gregarious."

In my opinion, there are two answers to your question: one in general, and one specifically for your anatomy. They are different answers. IN GENERAL, for women with saggy, robust sized labia minora, plus redundant, saggy, "folded" labia majora, my new combined procedure ("Angel Wing Labiaplasty") combines, in one single incision line, a wedge-type labia minoraplasty, extending onto the majora to both reduce size and "lift" both the reduced minora and majora with the incision line hid in the inter-labial fold. It is a nifty procedure for selected women with large and "loose" labia that they feel "sag." This is NOT what would work for you. In looking closely at your anatomy, I do notice hypertrophy and redundancy in the posterior commissure and posterior fourchette (the "bottom" of the labia; the area between the vaginal opening and the anus). Your labia minora are beautifully shaped, and if care is not taken, could easily be "amputated" and would look horrible. Your majora are "full" but not wrinkled or redundant. Surgically (really, the only way to produce permanent change), I might recommend a very conservative curvilnear "edge trim" but only if the darkened color bothers you, "flowing down" to incorporate the lower part in a "U-shaped" incision line at the bottom, hiding the line within the vaginal opening. If you wish to permanently minimize/flatten your majora, a "Classical" vertical majoraplasty could be performed, being very conservative so as to mostly hide the incision line within your interlabial fold. Or, you could leave well-enough alone, and just have the lower part reduced, a much more affordable option.

There is no "non-invasive" procedure to rid yourself of the dark wrinkled skin at the bottom. As far as "vaginal rejuvenation" and lasers are concerned, there are many practitioners out there who, untrained in the fineries of masters-level surgical work, hype non-invasive methods such as RF or lasers under the heading of "Vaginal Rejuvenation. They have been sold $125,000 machines (and need to make the lease payments!), and charge upwards of $3000 for "shrinking" procedures on the majora that never do the job as well, and in any case last only 8-10 months. Do you want to spend 3 doctor's visits, pay $3000 every 8-10 months, and 10 years later, having made over 40 trips to the clinic, spent over $40,000, and come out just as you started, or pay maybe ~ $10,000 to a master surgeon to have a tight trim + posterior commisure work + perhaps a conservative majoraplasty, have only one recovery, and never have to do it again..? While there definitely is a place for "machines" in Cosmetic Gynecology, "...this ain't it..!

Cheers, and best wishes for a successful outcome. Find a Master to do your work. Anatomy such as yours (not huge, not terribly saggy) is the hardest to get right; I have seen many amputations, poorly done work, and inadequate results with "Energy-Based Devices" in my over 25 years as a Cosmetic Gynecologist and Plaintiff's Expert in Professional Liability ("Malpractice") cases. Don't be a statistic...

Michael P Goodman, MD, FACOG, IF, AAACS
Cosmetic Gynecologist and Revision Specialist
Davis, CA, USA