Vaginal rejuvenation - What would reduce the skin at the bottom? (Photos)

Question

I want the skin at the bottom to be inside my labia majora, would laser fix this? What are my options

Anna Chacon, MD, FAAD · Answer

I understand what you mean—you’re looking for the tissue at the lower part of the labia to sit more inside/within the labia majora rather than extending outward. Based on the photo, what you’re describing appears to be excess or prominent vulvar tissue, but a photograph alone cannot determine exactly which anatomical structure is contributing to it.

Would laser fix this?

Probably not if your main goal is to physically reduce or reposition the tissue.

Vaginal/vulvar lasers are sometimes marketed for "rejuvenation," but they don't actually remove a defined amount of excess labial skin or surgically reposition the labia. They may be used for certain concerns involving tissue quality, but they would not be my first choice when the primary concern is the shape or amount of tissue.

What are the options?

If the tissue is truly excess labial tissue and you want it to sit more within the labia majora, the procedure that most directly addresses that concern is labiaplasty. Depending on the exact anatomy, a surgeon can remove a carefully planned amount of tissue and reshape the labia while trying to preserve normal sensation, blood supply, and the natural edge of the labia.

There are several surgical approaches, including trim and wedge techniques, and the best choice depends on whether the excess is primarily along the length of the labia, concentrated toward the lower/posterior portion, or involves the labia majora as well.

If the issue is actually that the labia majora themselves lack volume or projection, rather than simply having too much inner labial tissue, the approach can be different. In selected cases, fat grafting or other techniques to improve the relationship between the labia minora and majora may be considered rather than simply removing more tissue.

One important consideration

I would be careful about trying to make the labia completely "hidden." There is an enormous range of normal vulvar anatomy, and some labial tissue naturally extends beyond the majora. The goal of surgery should be proportion and comfort while preserving normal anatomy, rather than removing as much tissue as possible.

Over-resection can create its own problems, including tightness, scarring, asymmetry, altered sensation, dryness or irritation, and discomfort with sexual activity.

So, if what bothers you is specifically the visible tissue at the bottom that you want positioned more inside the labia majora, I would think of this primarily as an anatomical/contouring issue rather than a laser-rejuvenation issue. A carefully planned labiaplasty or, depending on the anatomy, a combination of labial reshaping and treatment of the majora would generally be more directly suited to that goal.

Helen Otteno, MD, FACOG · Answer

Hello smoky_q! To address the excess skin at the perineum, I recommend a mini-perineoplasty. This procedure removes and tightens the extra tissue to create a smoother, more comfortable contour. Please consult a board certified gynecologist with additional training in cosmetic gynecology procedures. Best,

Vaginal rejuvenation - What would reduce the skin at the bottom? (Photos)

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