Best type of labiaplasty and hood reduction?

Question

I’m wondering what type of labiaplasty would be best for me? Also whether hood reduction is appropriate? I am worried about over doing it and looking unnatural but I do want to reduce the inner labia and possibly hood area, without loss of sensation or function.

Gary J. Alter, MD · Answer

Your labia minora and clitoral hood are enlarged.  I am the inventor of the central wedge technique, in which I remove triangles of tissue and bring the normal edges together.  It is also known as the "V" or wedge technique. Thus, the normal labial edges, normal color, and normal anatomy are preserved, but the darkest labial tissue is usually removed.  Since you have extra tissue on your clitoral hood, I can reduce it at the same time using various techniques.  I have been featured performing this operation on Dr. 90210 on the E! Channel as well as on multiple other television shows.   I travel and lecture all over the world on my techniques and am published in most plastic surgical textbooks.  I invented the surgery in 1995 and reported the seminal article in the plastic surgery literature.

FYI:  Gynecologists and most plastic surgeons perform a labiaplasty very differently. They essentially trim the labia minora (inner vaginal lips) and leave a long suture line instead of the normal labial edge.  Their technique is the same whether a scalpel or a laser is used.  This technique often results in scallops, asymmetry, an unnatural edge, hanging frenula, and over-resection. In contrast, I remove triangles of tissue and bring the normal edges together. Thus, the normal labial edges, normal color, and normal anatomy are preserved, but the darkest labial tissue is usually removed.   My technique is performed with magnification to ensure an accurate approximation of the normal labial edges, whereas the other technique often takes 15-30 minutes and results in a linear scar as the labial edge.  That scar can cause chronic discomfort and aesthetic disfigurement.

The clitoral hood is the skin above the labia minora and the skin that overlies the head of the clitoris. The type of hood reduction depends on the patients anatomy and desires. I routinely remove the sides of the clitoral hood with a labia minora reduction if there is excess tissue. However, this would not be adequate for you to achieve your desired result.  You have a large, protuberant, long, wide clitoral hood. I invented a procedure called a clitoropexy with a clitoral hood reduction.  With this procedure, I lift up the clitoral hood skin, move the clitoris closer to the pubic bone, thin the tissues under the clitoral hood skin, and then remove a large amount of excess skin. This results in a dramatic decrease in the length, thickness, width, and protuberance of the clitoral hood, so that the hood is now more more within the labia majora when the woman stands. I have performed this procedure over 400 times with outstanding results.   I have not published this technique so no one does it like me.

A skilled wedge reduction and clitoropexy with hood reduction would give you the most natural and aggressive result without creating a deformity or visible scars.

About half of the labia surgeries I perform are reconstructions of botched labiaplasties done by other surgeons. Do your research and make sure you choose an experienced surgery.  No matter the technique, an inexperienced or unskilled surgeon can lead to a high rate of complications, chronic scar discomfort, labial deformities, and further surgery.

Sincerely,

Gary J. Alter, M.D.

Beverly Hills, CA  -  Manhattan, New York City

George Marosan, MD · Answer

Thank you for your question and photos. What would be best for you is choosing a board certified plastic surgeon or gynecologist who specialize in female genital cosmetic surgery. Base on your photos, without the benefit of a physical examination, you seem to be a good candidate for labiaplasty and clitoral hood reduction. I personally prefer the wedge resection technique since it leaves a natural labial edge and the clitoral excess skin removal is important to leave a harmonious non-operated look. Loss of sensation and/or function is extremely rare. I have done several hundred of these procedures with no woman complaining of sensation loss. See a board certified plastic surgeon or gynecologist who specialize in these types of surgeries, since not all of them do. Good luck.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

The real question is: What would you like it to look like afterward?

What is “best” depends primarily on the result you want and secondarily on what achieving that result would entail. Your concerns about looking unnatural or losing sensation and function are understandable. An unnatural result is avoided by not removing too much tissue, and loss of function is avoided by seeking out an expert who knows the anatomy well.

Clitoral hood reduction is appropriate only if the hood itself bothers you or would appear out of balance after labiaplasty. It should not be performed automatically. Your goals and an examination—not photographs alone—would determine the appropriate plan. A virtual consultation is an excellent first step.

Best type of labiaplasty and hood reduction?

Answers (3)

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