What procedures would help me? Do I need clitoral hood reduction and labiaplasty? (Photo)

Question

I have always struggled with my lady parts. I play lots of sports and ride mountain bikes. It seems the older I get the bigger my labia gets. Also, I have an autoimmune disease which causes issue with my hormone regulation so I've been on BHRT for a few years. I have noticed quite a bit of growth from that as well. What procedures would help me? Do I need clitoral hood reduction and labiaplasty? I would like to be quite trim. Thanks in advance!

Lori Warren, MD · Answer

First, I would like to tell you that you are completely normal. Lady parts, as you call them, come in all different shapes and sizes. What’s normal and fine for some, is uncomfortable for others. The good news is that you have options. If you are uncomfortable or experiencing pain from your labia a qualified cosmetic gynecologist can give you a consultation of your options. Based on what I’m seeing here, it does look like you would be happy with the results of a labiaplasty and a small clitoral hood reduction if you experience discomfort during activities. I hope this helps.

Randal Haworth, MD, FACS · Answer

It's important to note that labia size can vary greatly among women, and having larger labia is actually quite common. However, if you are experiencing discomfort or pain during activities like sports or biking, you may want to consider labiaplasty or clitoral hood reduction. These procedures can help reduce the size of the labia and clitoral hood, which can improve both appearance and function.

Labiaplasty involves reducing the size or reshaping the labia minora, while clitoral hood reduction involves reducing excess tissue around the clitoris. Both procedures can be performed together or separately, depending on your individual needs and goals. It's important to choose a skilled and experienced plastic surgeon who has experience performing these procedures.

Before undergoing any surgery, it's important to have a consultation with your surgeon to discuss your goals, concerns, and expectations. Your surgeon can evaluate your individual case and recommend the best course of action for achieving your desired results.

Additionally, if you have an autoimmune disease and are on hormone replacement therapy, it's important to discuss any potential risks or complications with your surgeon and primary care physician. They can help ensure that the procedure is safe and appropriate for you.

Overall, labiaplasty and clitoral hood reduction can be effective solutions for women who experience discomfort or self-consciousness due to the size or shape of their labia. With proper consultation and care, these procedures can improve both physical and emotional well-being.

Best of luck !

Gary J. Alter, MD · Answer

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. This often causes asymmetry, scallops, and a wide suture line. 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 drastically decreased. I have done it over 350 times with excellent results.  I have not published this technique, so no one does it like me.

However, you definitely have clitoral enlargement. A clitoral hood reduction will not resolve your issue, but will make you worse if a clitoris reduction is not also done. A clitoropexy will not work, because your enlarged clitoris will pull out the sutures.

Very few surgeons perform a clitoris reduction, since it is technically challenging and is rarely taught. It is an intricate procedure, since the sensory nerves have to be carefully preserved.  I have done over 40 reductions without any loss of sensation or orgasmic ability. The clitoral reduction reduces the glans or head and also removes the erectile tissue in the shaft. After surgery, the clitoris will not stick out much or increase with arousal. The surgery is not very uncomfortable.  It takes up to 3 1/2 hours and includes clitoral hood reduction.

No matter the techniques, an inexperienced or unskilled surgeon can lead to a high rate of complications, chronic scar discomfort, labial deformities, and further surgery.  About 40% of my labia cases are reconstructions of other surgeons' labiaplasties.

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NY

Mehmet Bekir Sen, MD · Answer

Clitoris aesthetics must be performed simultaneously with labiaplasty. Otherwise, a micropenis image is seen in the clitoris area. I also recommend a fat injection to the outer lips (labio majoras) taken from the inner thigh.Beauty always comes from within you
Thank you
Dr. Mehmet Bekir SENGenital Aesthetic Expert

Michelle Jones Singer, MD · Answer

If you are unhappy with the appearance of you labia minor and clitoral hood and uncomfortable or experiencing pain from your labia. I suggest you consult and experienced cosmetic gynecologist or urogynecolgist regarding having a labiaplasty with clitoral hood contouring. I think you would be very pleased with the results of a labiaplasty with clitoral hood contouring.

Michal Brichacek, MD · Answer

It appears that you have significant excess of the labia minora as well as hooding over the clitoris.

There are various techniques for performing labiaplasty, and which one is best largely depends on your anatomy. In this case my perference would be to perform a labiaplasty using a posterior wedge technique to maintain the natural edge of the labia minora, along with a clitoral hood reduction and reduction of the prepuce superiorly. You have too much fullness of the labia minora superiorly for an edge trim to provide a natural result.

Your labia majora also appears to be deflated. Fat grafting to this area can help restore fullness and further hide the labia minora.

Mark N. Scheinberg, MD · Answer

Thank you for your question There are two pair of inner labia : a lower pair that inserts into the clitoris and an upper pair, called prepuce, that forms the hood and often inserts into and can overwhelm the lower pair. If you online reduce the lower pair it can leave a bulky appearance. As to method, see the video below to become better informed

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

Yes, the protrusion of the labia minora and clitoral hood can be aggravated by bike riding and other activities that have a tendency to pull on the protruding tissues. Reducing the protrusion with labiaplasty and clitoral hood reduction would improve this issue and also give a smoother appearance. Recovery from bike riding would be 6-8 weeks for most.

Burcak Tok, MD · Answer

hello, you may also have enlarged clitoris due to the hormones you use. I think labia and clitoral hood reduction surgery is suitable for you.

Oscar A. Aguirre, MD, FPMRS · Answer

Hello Kate,
Thanks for including your photos with your question. You would benefit greatly form reducing the size of your hood at the time of your labiaplasty. A good deal of work involves expertly reducing the hood and from there begin to sculpt your labia for both structures to look as youthful and aesthetically pleasing as possible. 
Go to the link below to see hundreds of before and after photos where you will find many examples that are similar to you. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. Women from all over the world travel to my Center for their Intimate Makeover.
Best of luck,

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