Which procedure(s) would help improve the appearance of my labia/clitoral hood and excess perineal skin? (photo)

\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. This often causes asymmetry, scallops, and a wide suture line. 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. You have extra tissue on your clitoral hood, which can be reduced 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 drastically decreased. I have done it over 400 times with excellent results. I have not published this technique, so no one does it like me. In addition, I would remove the excess skin in your perineum.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. About 40% of my labia cases are reconstructions of other surgeons' labiaplasties.

Gary J. Alter, M.D.
Beverly Hills, CA - Manhattan, NY

There are several ways to reduce the excess skin at the perineum that is either connected to the labia minora or simply present nearby. The most common method that I use is called a horseshoe labiaplasty where I simply continue the labiaplasty incisions across the midline to create one smooth line. In other situations, I excise and reconstruct that skin separately. In others still, I conduct a perineoplasty. The exact choice requires a virtual consultation to discuss your goals in more detail.

Hello Catl0ver23,
Thanks for question and photos. You have a large droopy hood that needs both reduction and lifting at the time of a labiaplasty and excision of excess perineal skin. Go to the link below to see hundreds of before and after photos where you will find many examples that are similar to you. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. Women from all over the world travel to my Center for their Intimate Makeover.
Best of luck,