Am I a candidate for labiaplasty minora revision, labia majora reduction and clitoral hood reduction? (Photo)

I had labia minoraplasty in March. My labia are not as small as I wanted, & overall appears sloppy. I'm upset over my clitoral hood, it bulges out & there is extra skin that prevents it from being tucked in. I asked for a tucked in appearance with no labia visible while standing up. My labiamajora cause a buldge make it hard to wear tight clothing. I want a petite slit barbie appearance while standing and while spreading my legs I want a smaller tight slit. Is this look possible to obtain?

Doctor Answers 12

Are you a candidate for a Labiaplasty?

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.

You can have whatever you want

because there are always surgeons who can be convinced that they can 'help' you.  Your photos show excessive hood but the rest of you is not really that bad at all... so this creates a situation where do you do what the patient wants, even if it creates abnormal results, or do you help the patient realize that anatomy is normal as is?  I'm not into amputating the minora because I believe it serves a function to sealing your vaginal vault so if you have less than a cm height of your labia minora, I would not do anything else to that.  Your hood can be reduced and produce a less bulky look.  And your majora, at your age, would consider augmenting rather than reducing.  So be careful with what you desire as you will find surgeons who will do almost anything you ask without concern for what may be best for the patient.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Labiaplasty

I think your previous surgeon has been a bit too conservative.  You can have a secondary labiaplasty and clitoral hood reduction where more skin is removed making it less bulky.  You are a good candidate for this.  Be sure to choose a board certified plastic surgeon who specializes in labiaplasty and has extensive experience with performing this procedure.


Labiaplasty

Thank you for your question and sharing your photographs. Labiaplasty is a cosmetic procedure that may improve one's confidence and resolve physical issues that one may have with enlarged labia minora and labia majora.  Clitoral hood reduction may also be indicated depending on the findings on physical examination. Labiaplasty with and without clitoral hood reduction is a personal decision after being well educated on the benefits and risks. There are several techniques, which should be discussed with you by the surgeon.   In my practice, I discuss this with my patients in order to educate them on their cosmetic issue, the surgical options and possible outcomes so that they can make an educated decision. I would recommend finding an experienced genital surgeon, which include Cosmetic Urologists, even if it involves traveling.  

Best of luck.

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

Jeffrey S. Palmer, MD, FACS, FAAP
Cleveland Urologist
5.0 out of 5 stars 4 reviews

Labia minora, Majora, and Clitoral hood reductions

Your goals are achievable.  As the inventor and innovator of the wedge technique in 1994, I reconstruct many women who have had labia reductions by other surgeons, both wedge and trimming techniques. Your present labia dissatisfaction are due to  the specifics of the trim technique used by your surgeon. I would reduce your labia minora with a wedge reduction which will eliminate most of your scalloping. 

I routinely remove the sides of the clitoral hood with a labia minora reduction if there is excess tissue. You have a  large, protuberant, long, wide clitoral hood, I invented a procedure called a clitoropexy with a clitoral hood reduction.  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.

I have also published on labia majora reduction In which I remove the inner portion of the labia majora, placing the incision in the concavity between the majora and minora. 

I often perform all three of these procedures at the same time.

Gary J. Alter, M.D. 

Beverly Hills, CA - Manhattan, NYC


Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 20 reviews

Candidate for labiaplasty revision etc?

Keep in mind that a physical exam is first always necessary before recommending any surgery. Nonetheless, 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.  In a multi-center peer reviewed study I was involved in back in 2009, 98% of labiaplasty patients were satisfied with their results and had an improved sexual experience post-operatively.  

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.

Ryan Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 102 reviews

Can I achieve the look I want with revision labiaplasty/hood reduction and labia majoraplasty?

Y'know, it depends on what you wish to accomplish. First, your genital appearance is entirely normal, and my personal observation is "...If it ain't broke, don't fix it." That said, it really is all about "bother..." If it BOTHERS you (appearance, function...) then -YES- you would be considered "...a good candidate." A skilled, experienced SPECIALIST in genital plastic plastic & cosmetic surgery could perform a further reduction of your labia (careful, careful!), clitoral hood and labia majora. Many of my patients ask about the "flattened smooth, tight slit-like appearance. The very important thing is to share your wishes clerly with your surgeon.


I'd counsel you in 2 ways: 1. Make sure you retain a specialist who is also an "Artiste" and can design an operation specifically to suit YOUR needs rather than just what they know how to do, and 2. Please understand that no female genital plastic/cosmetic surgeon, no matter how skilled, can guarantee you an exact outcome experience. That said, both your revision, hood reduction, and labia majoraplasty can be performed at a single sitting under local anesthesia. The weblink below has many photos of outcomes of both minora- and majoraplasty.


Best wishes,


Michael P Goodman, MD


Davis, CA, USA

Revision

Hello. Thank you for your question and photos. You can achieve the appearance you desire. You need further reduction of your clitoral hood and a revision for your labiaplasty. An exam in office would serve to determine what can be done for your labia majora. I recommend you seek out experts in revision and try to have 2-3 consultations before making your decision as revision requires expertise. Best wishes

Dr Poucher

Am I a candidate for labiaplasty revision, labia majora reduction and clitoral hood reduction?

Thank you for sharing your question and photographs.  I do see your areas of concern and feel that you can have a revision performed to better approximate your desired appearance.  Your clitoral hood shows continued excess skin in both width and length that can be refined to leave a smaller appearance and a more natural taper into your labia minora.  It also appears that you have some asymmetry in size to your labia minora which can be surgically addressed.  As for your labia majora either fat grafting to the tissues or a reduction in the amount of skin can be performed which will depen on your desired goal appearance.  Hope this helps.

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

Not happy with labiaplasty...

Yes, you can undergo revision Labiaplasty of the subtle asymmetry between the labia. You would benefit most from a Clitoral Hood Reduction with Clitoropexy. Personally, I DO NOT like the term Barbie appearance, primarily because it sets an unrealistic expectation of what is actually possible in the majority of women. This signifies an amputation of the labia and clitoris/hood (not possible), which is not natural.

In the 3rd to last photo where you are pulling up on your hood you can clearly see the redundant lateral prepuce, bilaterally, that can be reduce and the improved appearance that can be achieved with a clitoropexy. You also see that your left labia is too small, almost absent. To achieve a natural, aesthetically pleasing result I would reduce your right labia to match the left, but not amputate them.

You have 4 options for you labia majora (#2 is a favorite with my patients):

1) Tighten them with lasers such as Radiofrequency or SkinTyte. These are temporary, but may give you the look you are looking for.

2) CO2 resurfacing of the labia majora to lighten the color and tighten the looseness followed by injection of Platelet Rich Plasma (PRP) to give you more fullness.

3) Fat transfer - not a good option for your slim build since it may give you worse camel toe, but will help hide your hood/clitoris.

4) Labia majora reduction - a great permanent option which can be performed at the time of your labia and hood work. This may, however, expose your labia/hood more.

Do your research. Look at link below for an extensive photo gallery, many reviews, and personally contact us for a consult.

Best of luck,

Oscar A. Aguirre, MD
Aguirre Specialty Care - Pelvic Surgery & Intimate Aesthetics®

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