Is it possible to reduce the labia and hood without affecting sensation? (Photo)

Question

I'm 19, 5'8'', 171 lb. My labia minora have always bothered me, especially the hood. It all sort of puffs out and it's uncomfortable. I feel like its gotten bigger overtime and "buried" my clitoris. My gyno says it has always looked normal to him since i started getting the checkups, and that if i got surgery it could affect my sensation. Is it possible to reduce the labia and the hood and still have normal feeling during sex?

Marco A. Pelosi III, MD, FACOG, FACS · Answer

Yes. When performed properly by an experienced surgeon, labiaplasty and clitoral hood reduction can usually be done without affecting sexual sensation.

Your gynecologist is correct that changes in sensation are a possible risk of any surgery in this area, but significant sensation loss is uncommon when the anatomy is respected and the procedure is performed carefully.

Many women choose these procedures because excess labial or hood tissue causes discomfort, irritation, self-consciousness, or the feeling that the clitoris is partially covered or "buried."

Based on your description, you may be a candidate for labiaplasty, clitoral hood reduction, or a combination of both. A consultation with a surgeon who performs these procedures regularly can help determine which option is most appropriate for your anatomy and goals.

Best wishes!

Gary J. Alter, MD · Answer

Your labia minora and clitoral hood are vey enlarged with some coverage of your clitoris. Yes! You can have the reduction without loss of sensation.

I am the inventor of the central wedge technique, in which I remove triangles of tissue and bring the normal edges together.  It is also known as the "V" or wedge technique. Thus, the normal labial edges, normal color, and normal anatomy are preserved, but the darkest labial tissue is usually removed.  Since you have extra tissue on your clitoral hood, I can reduce it at the same time using various techniques.  I have been featured performing this operation on Dr. 90210 on the E! Channel as well as on multiple other television shows.   I travel and lecture all over the world on my techniques and am published in most plastic surgical textbooks.  I invented the surgery in 1995 and reported the seminal article in the plastic surgery literature.

FYI:  Gynecologists and most plastic surgeons perform a labiaplasty 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 technique often results in scallops, asymmetry, an unnatural edge, hanging frenula, and over-resection. In contrast, I remove 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.   My technique is performed with magnification to ensure an accurate approximation of the normal labial edges, whereas the other technique often takes 15-30 minutes and results in a linear scar as the labial edge.  That scar can cause chronic discomfort and aesthetic disfigurement.

The clitoral hood is the skin above the labia minora and the skin that overlies the head of the clitoris. The type of hood reduction depends on the patients anatomy and desires. I routinely remove the sides of the clitoral hood with a labia minora reduction if there is excess tissue. However, this would not be adequate for you to achieve your desired result as you need a more aggressive reduction of the hood to enable access to your clitoris.  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, width, and protuberance of the clitoral hood, so that the hood is now more more within the labia majora when the woman stands. I have performed this procedure over 400 times with outstanding results.  I have not published this technique so no one does it like me.

I doubt any procedure would completely result in your clitoral hood and labia being completely within the labia majora when standing. However, a skilled wedge reduction and clitoropexy with hood reduction would give you the most natural and aggressive result without creating a deformity or visible scars.

About half of the labia surgeries I perform are reconstructions of botched labiaplasties done by other surgeons. Do your research and make sure you choose an experienced surgery.  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.

Sincerely,

Gary J. Alter, M.D.

Beverly Hills, CA  -  Manhattan, New York City

Yasemin Aydinli, MD · Answer

This is one of the most common concerns I hear from patients considering labiaplasty, and the reassuring answer is: yes, it is absolutely possible to reduce both the labia minora and the clitoral hood while preserving &mdash; and in many cases even improving &mdash; sensation. Your gynecologist is right that anatomical variation is common and often "normal," but that doesn't mean you have to live with discomfort if it's affecting your quality of life.
The key is surgeon technique. Using a wedge resection or conservative trim approach, a skilled surgeon can remove excess tissue while carefully protecting the sensory nerve branches. Clitoral hoodectomy can actually improve clitoral exposure and enhance sensitivity for some patients. The vast majority of women who undergo labiaplasty report preserved or improved sensation after recovery.
The most important step is choosing a board-certified plastic surgeon or urogynecologist who performs this procedure regularly and in high volume &mdash; experience matters enormously here. If this is causing you physical discomfort, it is a legitimate reason to consider surgery.

Is it possible to reduce the labia and hood without affecting sensation? (Photo)

Answers (3)

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