Labiaplasty w/ fat transfer needed ASAP. Want to make sure I'm a good candidate & I want extremely noticeable results? (Photos)

I have been very depressed for as long as I can remember with the way my "lady parts" look. I am uncomfortable with sex, I hate to be naked in front of my s/o, and feel "different". I am (for lack of better words) desperate for a Confidence boost. I already have my financing in order, I just need the perfect surgeon. I have attached my pictures and my wish pics. I'm having a hard time finding a surgeon that has availability soon and good reviews. Is there any hope that I can get good results?

Doctor Answers 12

Labiaplasty results depend on where you start

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Looking at your pictures, I think you can get dramatic improvement with the fat injection, labia minora reduction and clitoral hood reduction. You will not be able to achieve your wish pictures simply because your anatomy is different to start with. If you look at the base of your clitoral hood you will see that even without the excess tissue, your labia majora are separated significantly. And while fat injection and the clitoral hood reduction will help reduce that separation, it will never be as tight as on the wish pictures.  You can get a great result, but much like no amount of surgery will ever make me look like Angelina Jolie, we are all limited by our basic anatomical structure.   The other thing to remember is your anatomy is normal. And yes it can be improved to not be so bulky and make you more comfortable in clothes as well as when you are intimate, there is nothing awful, deformed or weird about it. You are normal, but as plastic surgeons we improve normal all the time   So take a deep breath and take your time researching board certified surgeons in your area with experience in advanced labiaplasty techniques.  Do not choose your surgeon based on who can get you in the quickest.  This is not an emergency. It is your body and unlike hair, your tissues won't grow back.   Take your time.   Get more than one consult and best of luck

Labiaplasty with fat transfer

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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 it 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. With this procedure, I lift up the clitoral hood skin, move the clitoris closer to the pubic bone, thin the tissues under the clitoral hood skin, and then remove a large amount of excess skin. This results in a dramatic decrease in the length, thickness, and protuberance of the clitoral hood, so that the hood is now within the labia majora when the woman stands. I have performed this procedure over 250 times with outstanding results.

Your labia majora have stretched which resulted in excess skin. In addition, they probably have lost some fullness.  I suggest reducing the excess skin and maybe increasing the fullness with fat injections if there is a fat deficiency. The technique I use leaves a scar on the inside of the majora in the fold between the majora and the minor and clitoral hood.  

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, M.D.
Beverly Hills, CA - Manhattan, NY

Find the right surgeon(see link below)

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There is a trend to have less prominent labia, but this is a matter of choice and there are no medical reasons to do so other than improving your appearance down there. Candidates for a Labiaplasty procedure are women who are concerned about the appearance of their labia or experience discomfort due to exceptionally large or long labia of either the inner our outer lips. Labia unevenness can result in discomfort with intimate contact, chronic rubbing, as well as psychological discomfort, which leads to the inability to wear certain types of tight clothing. Most women live with these symptoms, and actually are not even aware that a certain surgical procedure exists to help to correct this problem and restore their femininity.

Suggestions for you to reach your dream goals

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would require fat grafting as you have mentioned... the labia majora will need a huge boost to hide your minora.  As for the minora, if you believe that the minora has a function as I do, a cm height should be left behind but if you want an amputation, you could certainly find a surgeon out there to do that for you.  You have to be educated about what the differences a wedge and trim will produce and you must pick.  And yes a hood reduction would also help.


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After reviewing your photos I believe your labia and clitoral hood are enlarged.  You are a good candidate for a labia minora reduction as well as a clitoral hood reduction. You don't need a fate transfer however if you prefer to have one this can be done during your procedure. Be sure to choose a board certified plastic surgeon who specializes in labiaplasty procedures. 

Labiaplasty explained

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This is a very common procedure and can easily be combined with a fat transfer to fill the labia majora. I have attached a video explanation of the procedure.

Dr Scott Ennis

MACIE labiaplasty with fat grafting for beautiful natural appearing results

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You are absolutely correct in realizing what you need to achieve your goals.  You desire a labia minora labiaplasty that will result in smooth nonredundant result and a labia majora labiaplasty that restores volume and a closed or "kissing" appearance.  This is typically what I do with labiaplasty I call it MACIE labiaplasty.  by fat grafting the labia majora, a "kissing" appearance is achieved and by rotating pink muscosa and avoiding deep dissection a youthful smooth and pink labia minora is created.  You should have a great result.   Avoid any surgeon that suggests an "edge trim" or deep dissection and ensure that they have experience with successful fat grafting to the area.  I hope this helps!  

All the best,

Rian A. Maercks M.D.

Labiaplasty ASAP

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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 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.

Cosmetic surgery and ASAP do not belong in the same sentence EVER

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Creating time pressure for yourself is foolish when seeking cosmetic procedures. You're setting yourself up for an impulsive and poorly thought out decision. Take a breath, slow down, do your research and be patient.

Your photos are normal. Your wish pics are also normal. The differences I see are that you have a wider clitoral base which originates more superiorly than that of the wish pics and a more vertical orientation of the underlying bone structure (the pubic bone and symphysis). Regardless of what you want, you can't change the orientation of your bones nor the width of your clitoral base. Neither labiaplasty with hood reduction nor fat injections to the labia majora will be able to create the wish pic appearance. They can change the appearance moderately, but anything more is unrealistic.

Choose a surgeon with experience

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Thank you for sharing your story and photos.  Let me start off by saying choose a surgeon wisely and choose a surgeon with experience, expertise, reputation and results.  Judging from your photos and your post operative expectation you would benefit from:   labia minora reduction, clitoral hood reduction, cltioral lift and autologous fat transfer to the labia majora.  When choosing a surgeon make sure they offer each of these surgeries.   Though no surgeon can guarantee the exact results you want choose a surgeon who is has experience in each procedure.  Most surgeons who perform cosmetic vaginal surgery only perform a labia minor reduction and will not even operate around the cltioris as they are not comfortable.  Please review my website and see if we meet your criteria for a qualified surgeon.  I am the first urogynecologist in the country to offer cosmetic vagina surgery starting in 2001 and my partner and I have operated on patients from 50 states and from 54 countries.   Contact our office for a consult.  

John R Miklos MD

Atlanta ~ Beverly Hills ~ Dubai

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.