What would I need done, and roughly what would it cost?

I'm so very self concious about my vagina, and even more so since giving birth four years ago. My lips I feel are large and fat. My labium minus is loose and saggy, one side is larger than the other and hangs out which can be uncomfortable at times. I'd also like to tighten the opening around my vagina because I noticed its wider and looser since giving birth. I hope that was enough detail.

Doctor Answers 10

Vaginoplasty and Labiaplasty

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Thank you for your question.  Answering this question is more challenging without photographs.  However, based on your description, you may benefit from a vaginoplasty and labiaplasty to address your concerns. These are typically outpatient procedures, which could be performed on the same day.  

I would recommend a consultation with a experienced cosmetic genital surgeon for an evaluation even if this requires traveling.   

Best of luck.     

Jeffrey S. Palmer, MD, FACS, FAAP (Cosmetic Urologist -- Cleveland, Ohio)

What procedure do I need?

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Vaginoplasty is a procedure to tighten the vagina. This should be accompanied by a perineoplasty or tightening of the opening. "Saggy" lips can be corrected with labiaplasty.  The surgeries would be performed at the same time and tailored to your specific needs.  Photos would help.  This is a common common problem.  Its painful because it effects how women feel about their bodies.   Motherhood is a big sacrifice and women have more difficult lives because of this.  But you can be helped for certain. 

Vaginal rejuvenation

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Based on your description it sounds like you would be a good candidate for vaginal rejuvenation or labiaplasty surgery. Vaginal rejuvenation will tighten and improve the appearance of your labia so you are more comfortable. The procedure can also make the two sides of your labia much more symmetrical. Your next step should be to consult in person with a board certified plastic surgeon to learn more about the procedure. 

Jimmy S. Firouz, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 18 reviews

Photos are more important then words when discussing aesthetic issues online

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Post some photos. There are many options for effectively dealing with all of your issues, but without seeing the area, there's no way to give specific advice.


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It sounds like you would be a good candidate for a labiaplasty with a vaginal rejuvenation procedure. There are several options available for you and you can see more information on this on my website; click on the link below to see.


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A labiaplasty is a good idea, but it must be performed by a surgeon with experience. One of the two most common 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 vaginal opening can also be closed at the same time.  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

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

Vaginal Changes after childbirth-Solutions?

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Hello tnicknick,

Thank you for sharing your question. It appears many of the changes you are describing are quite common post pregnancy/vaginal delivery. In order to assess the crux of your question I would recommend an in person consultation with a cosmetic gynecologist (pelvic surgeon), urogynecologist or plastic surgeon who offer both the surgical and non-surgical (laser) remedies for the changes you have described. This is the only means to know what "needs to be done" and only then can you have an idea as to what the cost, extent of procedure(s) needed/desired and down time. Be well. 

Paul Pietro, MD
Greenville Physician

Vaginoplasty/Vaginal Rejuvenation

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I appreciate your question.

Cost varies by geographic location, surgeon expertise, OR time, anesthesia, length of procedure etc.  I would recommend that you see a board certified plastic surgeon in your area who specializes in aesthetic and restorative plastic surgery and who is also a member of The American Society of Plastic Surgery.  You can call their offices in advance and ask for quotes prior to scheduling consultations.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon



"Saggy" labia, loose and open vagina: What TO DO?!

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Not that you "NEED" surgery, but your goals are very understandable and CAN be achieved. My recommendation would be a Perineoplasty (aesthetically repair and "bulk up" the opening,) Vaginoplasty (tighten and approximate the muscles up into the "vaginal barrel,) and a Labiaplasty, to minimize the size and contour the lips to your specifications.

The only person to do ALL of this is a "cosmetic gynecologist" or "cosmetic urogynecologist." Look carefully at websites (Google "perineoplasty" and "cosmetic vaginoplasty" ) Seek EXPERIENCE and look for many photos and patient experiences. Be prepared to travel to fine the right person. Very experienced surgeons like myself and several others on RealSelf have patients coming in from all states & foreign countries: the ones who have seriously researched & want the best for this very personal, intimate surgery. Don't be lad astray- the so-called "minimally invasive" radiofrequency (ThermiVa) and laser (FemiLift) may be good in some situations, but are NOT the answer you your situation.

Our total "Out-the-door" price for perineoplasty + vagionoplasty+ labiaplasty done in our office under local anesthesia is ~ $9500. It would be ~ $2500 more if done in hospitaql under general anesthesia.

Best wishes. The weblink below gives you additional information...

Michael P Goodman, MD

Davis, CA, USA

What would I need done, and roughly what would it cost?

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Thank you for sharing your questions.  Some women may have, or develop, enlarged or asymmetrical labia that can make exercise, sexual intercourse, or wearing certain types of clothing difficult. In these instances, a labiaplasty allows for a reduction in the size of the labia, while also making a more symmetrical pairing.  If your vaginal opening was elongated during pregnancy and delivery you may be a candidate for a perineoplasty procedure to help tighten the tissues.  A consultation with a board certified plastic surgeon, who could perform a physical exam, would be able to give you a more definitive opinion.  Prices will vary based on geography and the exact procedures needed, so an in-person consultation will afford you the best idea on pricing.  Best wishes. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 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.