I want my inner vaginal lips made smaller & to have my clitoris extended into a functional penis. What are the costs? (photo)

I'm 18, live in SoCal, and have wanted this for a long time. My vaginal lips are kinda big and I don't think it looks very pretty. I want the inner vaginal lips made smaller so that they aren't as pronounced and noticeable. Then I want my clit extended into a functional penis. And no less than 5in in length when erect. I don't want a full sex change because I still want a fully functioning womb to have babies. Essentially, I want both parts down there. How much money am I looking at?

Doctor Answers 5

Costs of labiaplasty

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vary widely from region to region and surgeon to surgeon.  A straightforward procedure done in the office under local will not exceed $2000.  If more areas need attention such as the majora or hood, costs will increase.  Unfortunately, you cannot achieve what you desire with your clitoris so focus on other ways to satisfy the needs that you have.

Lips smaller and clitoris larger

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It is not possible to make your clitoris 5 inches in length even if you are on male hormones for a long time. If you wish a penis, you need to undergo a much more involved procedure. Your labia minora can be reduced. One of the two most common 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 labioplasty 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. If you have extra tissue on your clitoral hood, it can be reduced it at the same time. 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.

Genital surgery

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Unfortunately it is not possible to "extend the clitoris into a 5 inch penis" even with testosterone hormone therapy. This requires a formal "sex change" operation to create a penis. On the other hand, reducing the inner vaginal lips (labia minors) via labiaplasty surgery is very possible and not uncommon. 
Labiaplasty, which most commonly involves surgical reduction of the labia minora (inner/thinner lips), has become a relatively common procedure over the last ten and even more so last five years. Whether the surgery is done using a laser, scalpel, or scissors does not really matter but what does matter is "symmetry". Symmetry is the most important aspect to the final aesthetic result. Most women, just like yourself, prefer to have as much of the darker pigmented edges removed as possible. Also, it's not how much tissue is removed but how much is left remaining because a certain amount is necessary to maintain proper form and function - typically 7-8 mm actually. To achieve these three most important elements, I have found that the "Trim Method" satisfies best. It is extremely important to consult with a board certified plastic surgeon that specializes in this operation (does at least 1 - 2 per week). It may cost you a bit more but it is this type of result you will want to live with for the rest of your life. Typical (all inclusive) fee at my office/surgery center is $4500.

Although there is no guarantee, women frequently do seek clitoral hood reduction (Hoodectomy) to improve exposure of the clitoris and hence better stimulation during sexual activity. By removing some of the excess &/or redundant skin concealing the clitoris, it becomes more readily exposed to sexual stimulation and hence a heightened sexual experience/orgasm is possible. Sometimes I recommend adding hoodectomy to labiaplasty to better harmonize the aesthetic outcome. Again, the key is seek consultation with a board certified plastic surgeon or gynecologist who performs this procedure regularly (>2-3 x/month) so that just the right amount of tissue is removed and just the right amount remains such that the clitoris is not constantly exposed and rubbing on clothing, etc... Typical fee for a hoodectomy is ~$3000 but reduced to about half that price if done along with a labiaplasty.

Now for recovery, because the labia tissue is so robust with blood supply it has an amazing ability to heal relatively quickly. Most patients are sore for 4-5 days before things start to get a lot better from there. Some patients can resume work before this time depending upon their occupation. No exercise for two weeks, no baths/jacuzzi or swimming for 3 weeks, and no sexual activity for typically 4 weeks. My patients are given an oral pain medication such as Vicodin or Percocet but icing the area for the first 48 hours and applying some custom made take-home topical local anesthetic cream seems to work the best. Glad to help.

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Neophalloplasty: Maintain Female Genitalia

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Thank you for your question.  Yes, it is possible to perform a phalloplasty to create a neophallus (penis) without affecting the female genitalia.  There are different techniques.  One technique involves creating the penis from forearm skin, which can be disfiguring.  The other technique uses abdominal skin, which typical leaves one with a more appealing abdominal scar, is less invasive, and the cost is typically much less.  The abdominal skin technique is the one offered at our practice.   I was personally trained on this technique of neophallus creation by the creator of this technique.  The new penis would not have a urethra and would not be able to obtain an erection without the insertion of an artificial device, if one chooses.  Please refer to our website for additional information. Prior to surgery, all patients require evaluation by an appropriate psychologist and receive the appropriate counseling.  I wish you the best of luck.     Jeffrey S. Palmer, MD, FACS, FAAP (Cosmetic Urologist -- Cleveland, Ohio)

Labiaplasty and clitoral surgery

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It would be possible to reduce the size of the inner labia.  However, it would not be possible to transform the clitoris into a penis that is 5 in or more in length.  In order to create a penis of that size, a much more extensive operation would be necessary.  

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.