Is there any way to make inner labia smaller without surgery? (photo)

Question

The appearance of my vagina gets in the way of me having an enjoyable sex life. How much does labiaplasty cost on average? I'm disgusted with myself.

Gary J. Alter, MD · Answer

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 at the same time. Your clitoral hood is 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. 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, M.D.Beverly Hills, CA - Manhattan, NY

Ryan A. Stanton, MD · Answer

Surgery is the only way to safely and effectively reduce the labia minora, majora, and/or clitoral hood. 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.

Nikesh K. Patel, MD · Answer

ThermiVA works great at tightening tissues and can be a great option for you if you want a labiaplasty but don't want surgery. It works with radio waves and takes four treatments that are only twenty minutes or so long. No pain, only a warm sensation and best of all no downtime!  Check out my link below for more info

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question and picture.  Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve

The shape and colour of labia vary between individuals and it can grow and change after puberty, childbirth and with age. If the appearance of the labia concerns you and it affects your self-esteem and relationship then labiaplasty can reduce your labia to the desired size and shape to improve your self-confidence.

For some it’s a functional problem where the labia can get caught in clothing and makes it uncomfortable during cycling or horse riding. It can cause excess sweating, irritation and rash. Labiaplasty aims to improve the discomfort and hygiene and allow you to get on with your hobbies and activities.

Some can find intercourse and sexual relationship difficult due to the excessive size of the labia. This tends to not only lower their self-esteem and confidence but also cause intimacy issues due to the discomfort during sex, which can be overcome with a simple labiaplasty procedure.

Labiaplasty (Labia Reduction) is performed under local or general anaesthetic. Our cosmetic surgeons will listen to your concerns and needs and discuss the surgical options which best suit you.

During Labia reduction surgery, the excess tissue is removed to keep the size, shape and colour symmetrical and looking natural with scars hidden within the natural folds of skin, resulting in a defined and neatly shaped labia. For most patients, the surgery takes approximately 60 to 90 mins. The scars are virtually invisible and reduction in the size of the labia not only gives comfort in clothing and during sex but it can also improve the cosmetic appearance of the labia.Labiaplasty surgery cost approximately £2500 under local anaesthetic however under general anaesthetic approximately £4250

All The Best

Oscar A. Aguirre, MD, FPMRS · Answer

I'm sorry the size and appearance of your labia are negatively affecting you to this degree. Thank you for sharing your photo since it lets me tell you with confidence that your only option is surgery. Prices vary across the country, but also depending on the expertise and surgical demand of the expert surgeon you choose. Below is a link with advice in choosing the best surgeon for you and be sure to look at the thousands of before and after photos. This is not a procedure you price shop for.Best of luck,Oscar A. Aguirre, MDAguirre Specialty Care - Pelvic Surgery & Intimate Aesthetics®

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph and I am sorry that your labial appearance has caused you such physical and emotional discomfort.  Unfortunately there is no reliable way of permanently reducing the size of a woman's labia minora outside of surgery.  Surgery costs will range based on the exact procedures performed but you can anticipate 2500-6000.  Hope this helps.

John R. Miklos, MD, FPMRS, FACS · Answer

Only way to permanently reduce your labia minora is through surgery.   I doubt you will respond to radio frequency or laser as your labia are moderately enlarged.  John R Miklos MDAtlanta ~ Beverly Hills ~ Dubai

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

Your labia are moderately enlarged. For very mild enlargement, lasers and radiofrequency (RF) are sometimes effective, but in your case it would be a total waste of your time and money. Anyone who tells you otherwise is being less than truthful or lacks real experience. Email me privately and I'll send you a quote.

Larry S. Nichter, MD, MS, FACS · Answer

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.

George Marosan, MD · Answer

Thank you for your question and photo. It depends on the reduction you want to achieve. A smaller reduction can be achieved with Thermiva, a painless, no downtime treatment done in 3 sessions one month apart. If you want a permanent reduction, you would do best with a labiaplasty surgery. This is done under local anesthesia with minimal oral sedation. See a board certified plastic surgeon or gynecologist experienced in this type of surgery for an in person consultation. Good luck.