Do I need a labiaplasty? (Photo)

If desired, your labia minora and clitoral hood can be reduced to improve the appearance. A labiaplasty with a clitoral hood reduction can reduce your hood size. However, it must be performed by a surgeon with experience. One of the two most common labiaplasty techniques is the central wedge technique, which I invented in 1995 and published in the plastic surgery textbooks. It is also known as the "V" or wedge technique. 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. In contrast, the central wedge removes 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. There is rarely a sign that the woman has had surgery.

Since you have extra tissue on your clitoral hood, it can be reduced at the same time. Your clitoral hood is long and protuberant. It can be decreased somewhat by reducing the sides. I pioneered a clitoropexy with clitoral hood reduction in which the clitoris is pushed closer to the pubic bone and the width, thickness, length, and protuberance of the clitoral hood can be decreased. 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, and protuberance of the clitoral hood, so that the hood is now 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.​

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.​​ Approximately 40% of the female genital surgeries that I perform are reconstructions of other women's botched labiaplasties and hood reductions.

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NYC

There is almost zero risk to labiaplasty surgery. Nerve pain or damage is zero in my practice and scarring is almost invisible. The key is finding an expert surgeon with great before and after photos, videos and reviews. If long labia is bothersome, a labiaplasty and hood reduction is liberating for many women.

The decision to have a labiaplasty is a personal decision. There is no normal appearance of labia. They vary from woman to woman. Reasons for having a labiaplasty are pain, pulling or discomfort with intercourse or exercise. Irritation with sitting or walking. Unhappiness with the appearance of the labia due to pigmentation, length or different sizes. Sometime the appearance inhibits women from sexual activity because of being self-conscious or embarrassed due to extra tissue. If you decide to have a labiaplasty, consult an experienced cosmetic gynecologist or urogynecologist and discuss your desired results of the labiaplasty.