35 y/o unhappy with labiaplasty results - which type of revision procedure is best for me?

THANK YOU FOR YPOUR QUESTIONThe "sloppy and loose" appearance in Your photo shows is predominately the outer labia called majora.There is also excess skin on the hood and prepuce( the skin above and to the sides of the clitoris) and the inner labia are irregular. If you want to optimally improve the appearance you could get a labia majoraplasty, reduction of prepuce with hoodoplasty and revision of labia minora.You really need to find someone who is well trained as well as experienced. Look at several before and after photos to see quality of work and look at their reviews. Do your homework to avoid problems.

I wonder if you had significant weight loss as it appears that your pubic area may have descended and drooped, which may be causing you genitalia to be redundant and excessive. You may need a pubic lift to elevate your pubic skin which would elevate your genitalia and make it look more youthful.

Your labia have been reduced, but they are still redundant. That can also be reduced by doing a wedge labiaplasty, which I invented in 1995 and published in the plastic surgery textbooks. Another trim would not help the tortuous folding of your labia. It is also known as the "V" or wedge technique. Your clitoral hood is also long, wide, thick, and protuberant. Since you have extra tissue on your clitoral hood, it can be reduced at the same time. 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. 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 300 times with outstanding results. I have not published this technique, so no one does it like me.​

​Your labia majora are stretched, redundant, and folded. I suggest reducing the excess skin and possibly increasing the fullness with fat injections. The technique I popularized and published in the medical literature leaves a scar on the inside of the majora in the fold between the majora and the minora and clitoral hood. If closed with sutures under the skin and performed meticulously, the scars are difficult to see.

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.​​ Approximately 40% of the female genital surgeries that I perform are reconstructions of other women's botched labiaplasties and hood reductions.


Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NYC