Labiaplasty performed without clitoral hood reduction

I received a labiaplasty without a clitoral hood reduction out of province this week under general anesthesia. However a couple of days before my surgery when I asked my surgeon if he can give me a hood reduction he told me it's against the surgery board and considered "abusive" and I didn't need it. I am not satisfied with my results as of now. Should I go elsewhere for the additional surgery?

Doctor Answers 9

Clitoral Hood Reduction

Thank you for your question.  I am sorry to hear about your experience.  Every country has a medical board with their own rules and regulations.  However, clitoral hood reduction at the time of labiaplasty is commonly performed in the United States  It is difficult to judge whether a clitoral hood reduction is recommended in your situation without photographs and physical examination.  I would recommended an evaluation by an experienced cosmetic genital surgeon.  Our practice provides assistance in making travel and hotel arrangements for international patients.   Best of luck.     Jeffrey S. Palmer, MD, FACS, FAAP (Cosmetic Urologist - Cleveland, Ohio)


Cleveland Urologist
5.0 out of 5 stars 4 reviews

Clitoral hood reduction and labiaplasty

Hello, unfortunately you were given a personal opinion or sentiment, not a legitimate answer to your request. Clitoral hood reduction is not "abusive" and our board (The American Board of Plastic Surgery) has not dictated any rule like that. However, not everyone is a candidate for it. It you have excess clitoral hood tissue you may be a candidate for it. Oftentimes, women with large and redundant labia minora also have excess clitoral hood tissue and these women are good candidates for the procedure. Every operation requires balance and sometimes only reshaping the labia results in disproportion, making the clitoral area appear oddly enlarged. I advise you to wait until you are completely healed, meaning at least 3 months after your surgery, and then go see a board-certified plastic surgeon that does labiaplasties often. 

Orna Fisher, MD
Las Vegas Plastic Surgeon
4.4 out of 5 stars 13 reviews

Addition of clitoral hood reduction

Not sure why your surgeon referred to this procedure as "abusive" (Integrity of clitoris is maintained. As a matter of fact, you want to stay as far as you can from the clitoris during this procedure). It is very common to perform clitoral hood reduction with labiaplasty at the same time. This is usually done if redundant skin covering the clitoris may potentially affect final aesthetic results. But very unique and individual. In your situation, since you had your procedure several days ago, I would suggest to waiting until you completely healed and reassess. Hope this helps.

Armen Kirakosyan, MD, FACOG, FACS
East Aurora Urogynecologist
5.0 out of 5 stars 1 review

Labiaplasty performed without clitoral hood reduction

Thank you for sharing your question and I am sorry that your results have not been what you anticipated.  In the United States most labiaplasty patients benefit from clitoral hood reduction a the same time to leave a pleasing, tapered appearance to the tissues.  If you are unable to find a surgeon willing to perform a revision you may have to travel abroad for treatment.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Clitoral Hood reduction

This is very unfortunate.  While I don't proclaim to understand the rules and regulations of every country, this is hard to believe.  a clitoral hood reduction simply removes excessive prepuce allowing better access to the clitoris.  This provides improved stimulation and improves the sexual response.  This procedure is performed regularly in the USA.

Melvin Ashford, MD
Saint Paul Urogynecologist
5.0 out of 5 stars 1 review

Nonexperts in clitoral hood reduction are experts in making excuses for why you don't need it

Stay away from surgeons who give silly excuses for not performing clitoral hood reduction. Rather than admitting that they lack experience, they prefer to dupe you with misinformation. As you can easily see on this site and others, clitoral hood reduction is performed by labiaplasty experts worldwide. Don't limit yourself to the local quack.

Should a clitoral hood reduction been performed at Labiaplasty?

It does not make sense that a labiaplasty is considered OK but a clitoral hood reduction is considered abusive. I consider labiaplasty and clitoral hood reduction to be the "same operation" because this surgery addresses symptomatic redundant skin of a woman's external genitalia.  To achieve a successful cosmetic result requires attention to the entire area, not just the labia minora.  I suspect a more honest explanation is that your surgeon was not comfortable with the clitoral hood aspect of your procedure.  A surgeon should not do something he or she is not comfortable performing without the appropriate supervision.  But that does not mean he or she can't be honest with you.   You can show photos to the doctors on Real Self.   Wait six months before you receive revision surgery so all the tissue heals and the swelling goes down and you can decide for yourself if you want anything else done.

YES - you need to go elsewhere for your surgery

Sorry to hear about your experience. This is the first time I've heard this as an excuse for not performing a clitoral hood reduction as part of your overall cosmetic vulvar surgery. What's "abusive" is him not being honest with you regarding his lack of understanding or knowledge of this surgical specialty.You obviously will need to travel for your clitoral hood reduction and likely Labiaplasty revision. See link below to see hundreds of before and after photos representing complex aesthetic vulvar surgery. I perform labia reductions in the office under local anesthesia. Every woman is shaped differently and requires her own unique cosmetic correction.  What is often overlooked by most surgeons is the prepuce, or clitoral hood, which may require reduction and even lifting to achieve the optimal youthful appearance and enhanced sensation for ultimate pleasure.We offer a travel credit to cover expenses for women who come from abroad for their surgery.

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 23 reviews

A Surgeon's Philosophy

Hello,
Sorry to hear of your troubles. A surgeon's philosophy can vary substantially, but hood reduction only leads to significant improvement in the occasional case. I do them in about 1/3 to 1/2 of cases now. The issue now is why your surgical result is not to your satisfaction. This may or may not be due to the hood surgery or its omission. You need to be examined by an expert labiaplasty surgeon to work this out before having any more surgery.

Best Regards,
John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 26 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.