I have a lot of concerns with my vagina. Can you give me reassurance/treatment options?

1 Are my labia abnormal? Can this be altered? 2 I gape since childbirth and I find it embarrassing. Normal penetration no longer satisfies and we have to use either a few extra digits or sexaids to make me feel full. 3 I now get eczema when I shave. I feel (is this possible?) that I have become hairier since childbirth - thicker and up onto my thighs. This embarrasses me, I don't know if it is normal and I'm unsure if there cosmetic treatment options for this? 4 Can my stretchmarks be treated?

Doctor Answers 8

Childbirth has not been kind to you

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but you can pursue things that can help restore you to what you were.  Your photos show that your hair pattern has not really changed as you had some hair growing on your thighs pre-birth.  If shaving sets of eczema, consider attempting laser hair removal to create a more manageable hair pattern.  Stretch marks cannot be helped but if removing the color form them would beneficial, you could find laser centers that could address that for you.  You could find a Thermi owner in your area and consider attempting Thermi to diminish the size of the stretch marks.  The most predictable procedure would be labiaplasty to remove the redundancies of your minora.  It will not improve what you feel with sex and if you feel you are 'too loose', please see your GYN about it for an evaluation.  Otherwise, your labia look completely normal.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Vaginal laxity and hirsutism issues after childbirth

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Hirsutism, aka excess hair growth, is frequently a side effect of hormone problems and requires a medical evaluation. Vaginal laxity is common after childbirth and if it bothers your sex life, vaginoplasty and pelvic floor reconstruction are commonly required to achieve correction. You need to have a gynecologic evaluation to determine how much damage you have sustained from childbirth.

Labia and vaginal changes after childbirth

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I reviewed your photos. Your labia minora and clitoral hood are 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.

You also need vaginal tightening and a perineal repair as you have lost sensation during intercourse.  This is commonly done at the same time as the labiaplasty.

Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 25 reviews

Your labia appear normal to me.

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Your description of the changes you have noted in your genital area after childbirth are common; most women do not spring back to a pre-pregnant, "everything's rosy" appearance and function. You have been burdened by multiple annoyances, though, and I hope that you can someday realize that you are pretty normal.

Stretch marks: Will continue to fade over time (how long since childbirth?). As elsewhere stated, some of the redness can be pulled out of the stretch marks, while time will reduce the color to a slightly silvery flesh color over time.

Gaping/loose feel to vagina during sex: Again, how old is your baby? The vagina tightens back up considerably during the first year. It does take time. Kegels work if you do them properly. If looseness continues past one year, a vaginal tightening (vaginoplasty) would be a definitive game-changer for you (best considered if your family is completed).

Labial size: Your labia are not abnormal. Mild asymmetry is the rule and, while a labiaplasty can be applied to any woman with any degree of dissatisfaction, having examined many thousands of women, I can state that you are normal. 

Hair: The pattern is probably the same, though the thickness may increase due to hormonal influences. Permanent hair reduction can go a long way to giving you back your confidence.

Please do not jump right into a labiaplasty without giving time to think on all of the suggestions you have received here. Take your time, tone your body with exercise, eat well and enjoy life. 

Best of luck.

Treatment options for vaginal laxity and labial enlargement

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It's not so much about "abnormality" (you certainly are very "normal!") as it is about your aesthetic desires.  Others in this thread have answered your questions about your stretch marks; I will focus on your labial perceptions, your feelings of being "...open..." and your vaginal/pelvic floor laxity, and WHO-- which surgeon- can best help you in a skilled way with your issues.

It reallly revolves around your vaginal laxity issues.  The ONLY person who can help you in all of your vagino-vulvar issues (labial size, gaping vaginal opening, widened vagina) is either a COSMETIC GYNECOLOGIST, or plastic surgeon who also is skilled in SURGICALLY tightening the vagina.  Do not let anyone use either ThermiVa or FemiLift as a vaginal tightening procedure if they also do not do intra-vaginal surgical tightening, so that they fairly can counsel you as to the proper procedure for YOU, since although ThermiVa and FemiLift will gently tighten the vagina, it is not permanent, and in no way do these procedures tighten the MUSCLES and fascia, which is the key to successful vaginal tightening.

Yes! you can accomplissh what you desire with a combination internal Vaginoplasty, Perineoplasty, Labiaplasty and possible clitoral hood reduction.  In our office we can do all of these procedures at the same time under local anesthesia, so you don't need to be "put to sleep" , have the difficulty of recovering from a general anesthetic, and the extra expense of an anesthesiologist and surgicenter facility.  The stretch marks may be dealt with at a separate time by a good laser specialist with the equiment to treat the marks as noted in other answers. For more cogent information, please click on the link below.

Best wishes!

Michael P Goodman MD

Vaginal concerns after childbirth

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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 thereafter.
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. 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. 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 A. Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 128 reviews

Labiaplasty options in Los Angeles

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Labiaplasty is a wonderful procedure that can improve the cosmetic appearance of protuberant labia minora. In our office, we offer labiaplasty to adult women who have functional and cosmetic problems with large labia. 

Dr. Karamanoukian 
Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Am I normal?

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Hello.  Thank you for your question.  Please understand that "normal" is a subjective word. Having labia is normal and they come in various sizes shapes and colors.  However, many women feel uncomfortable  and/or embarrassed when their labia extend further down than their outer lips.  When looking at your picture this is what I see.  I can also see that your perineum does gape open which is common after delivering babies.  I would recommend labiaplasty and perineoplasty as surgical procedures to help you achieve the look you are wanting as well as to help you with sensation.  As far as the change in hair after childbirth, yes this can happen and does.  I would recommend laser hair removal.  Unfortunately there is truly no good treatment for stretch marks but they do lighten over time. I hope this answer is helpful to you.
~Dr. Poucher

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.