Is my large inner labia and excess skin underneath vaginal opening normal? (photos)

I have very large inner labia. In addition, I have what appears to be excess skin directly underneath the vagina opening. I would describe it as two "pouches" of very loose skin on both sides. It almost looks like two clusters of warts but my GP has confirmed that it is simply excess skin. Combined with my very large inner labia, is this normal? What options are available to get this fixed?

Doctor Answers 17

Your genitals are normal

but certainly on the redundant side and a combination procedure would most likely be needed to produce the results you may desire.  This includes combining the trim and wedge methods and also extending the excision to the hood (hoodectomy/reduction).  Also make sure whomever you see has a reasonable revision policy as its likely you may want some additional touch ups when done.  Avoid surgeons who only have one way to do this procedure... you will not like your results if you use them.


Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Labiaplasty

Female genitalia ranges greatly in appearance, and yours appears to be normal. If you are bothered by this excess tissue, then you can have it removed with labiaplasty.

There is no need to "fix" anything with your labia

Your labia are completely normal. Your choice of words suggests that you think there is something wrong. There is nothing wrong. However, if  you wish to have a cosmetic procedure to reduce the loose excess skin, then you will need to address the entire length of the labia and the central area between them posteriorly. This is an expert level procedure so choose your surgeon wisely. Check out a lecture I gave to gynecologists and plastic surgeons on the link below:

Large labia minora

I reviewed your photos. Your labia minora and clitoral hood are very enlarged. A labiaplasty with a clitoral hood reduction can reduce your 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 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 at the same time. Your clitoral hood is thick, wide, 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. 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.

Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 20 reviews

Are large inner labia normal?

From your photos it appears your labia are perfectly normal. Labia come in a wide variety of shapes and sizes. However, if the appearance bothers you or if you experience physical symptoms due to the length, you could consult with a board-certified plastic surgeon or gynecologist who performs labiaplasties. It's important to choose an excellent surgeon well-versed in the procedure, even it means traveling out of your area.

For more information on labiaplasty, click on the link below.

All the best.

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 29 reviews

Large inner labia with excess skin

Hi there,
Inner labia of all shapes and sizes are normal. Just as all breast shapes and nose sizes vary from person to person, the labia are unique to their owners. That being said, if your labia are bothering you, and you decide to follow through with a labiaplasty procedure, do your research. It will be one of the most important decisions you make. Look at before and after pictures and find a surgeon whose expertise is in doing labiaplasties. Some surgeons are advertising these procedures with very little real experience and they are simply adding this to the list of what they are already doing. It's opened up an entire new field of "revisions". Partner with someone you feel comfortable with and confident in.  I hope this is helpful for you.

Enlarged labia minora and clitoral hood

What you have is on the spectrum of "normal" but your labia minora and clitoral hood are enlarged, as are the tissues of the perineum or posterior fourchette.
This can all be reduced with a labiaplasty and clitoral hood reduction.
Just be careful which doctor you choose for this. There are lots of docs who just use a scissors and baseball stitch technique for this... Basically an amputation procedure. 
The extended wedge approach is much more elegant and thoughtful and has less injury, faster recovery, better results. Hard to find the right doctor to do this. Be very selective and don't be afraid to travel to have this done!

Labiaplasty indication

Your story and concerns are in good company with almost ever other patient that undergoes labiaplasty and/or clitoral hood reduction (aka hoodectomy). Based upon your photos, your anatomy is very typical of someone who seriously considers having these procedures and experiences a major boost in (sexual) self-confidence and pleasure thereafter.
Labiaplasty, which most commonly involves surgical reduction of the labia minora (inner/thinner lips) but not infrequently trimming or tucking of the labia majora (outer/thicker lips), has become a relatively common procedure over the last ten and even more so last five years. Most commonly it is done under light sedation (aka twighlight sleep) with local anesthesia, in which case the patient should feel no pain during the operation. 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 ~10 mm or so of the dry part of the labia. 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.

Ryan Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 103 reviews

Are my large labia and extra skin normal?

Dear A3456,

Thank you for writing in with your great question. Every body is different, so the most important thing is how does your body work for you and are you happy with its appearance. It is not up to anyone else but you to decide if labia reduction surgery is right for you.

Labial issues often start during puberty when estrogen stimulates the breasts and labial tissue to develop and grow. The labia can become longer, thicker, darker and uneven. They can cause comfort, function and appearance concerns. Having performed more than 750 labiaplasties, I have identified over 20 reasons women and teenagers seek labiaplasty including hygiene issues, discomfort, pain and/or irritation with clothing, activities and sex, embarrassment and feeling self-conscious about one's body among others.  The skin around the vaginal opening varies in its appearance as well. This can easily be reduced with the labiaplasty, but make sure to discuss that not too much be taken off or there can be scarring and pain or pulling with sex.

The majority of Ob/Gyns do not have labiaplasty training, so I highly encourage you to research cosmetic-plastic gynecologists, urogynecologists and plastic surgeons who are skilled in several labiaplasty techniques (there are many but they fall into two categories: those that remove the edges (traditional trim method) and those that preserve the edges (the various wedges). There is a slightly higher risk of complications with the wedges but either type of procedure, if performed by someone with expertise should produce satisfactory results. With your anatomy, you will require a reduction of the skin around the clitoral hood as well to achieve a satisfactory aesthetic result. Please make sure to see lots of before and after pictures, discuss risks and complications and how the surgeon has addressed them when they come up.

You can read more about labiaplasty and hood reduction at the link below.

I hope this information is helpful and would be happy to answer any more of your questions.

Sincerely,

Dr. Troy Robbin Hailparn

Troy Hailparn, MD
San Antonio OB/GYN
5.0 out of 5 stars 26 reviews

Labia hypertrophy may be normal but it doesn't mean we like it!

There is absolutely nothing wrong with you, but if it bothers you it can be easily fixed!  There has been a lot in the recent press about women undergoing labiaplasty for normal labia, like its a bad thing.  A great big hook nose or H cup breasts are also normal but we don't criticize people who want to change those things. Large labia can be bothersome for a whole host of reasons, not the least of which may be you just don't like the way they look (like with a hook nose) and they can be changed with what is typically out patient surgery under local anesthetic. 

Please see see a board certified surgeon with a special
interest in labiaplasty who can show you before and after pictures.  I hope this helps. 

Melinda Haws, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 42 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.