Is my vaginal area (labia or vulva) irregular or do I just require cosmetic surgery? (Photos)

My lips are awfully big around and below my clitorus . The right side is longer than the left. Do I need a vulvaplasty? Also my lips are really dark too

Doctor Answers 11

Labiaplasty candidate

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You are definitely a candidate for a labiaplasty. Most women want the most aesthetically beautiful genital area they can have, thus I created my technique of doing labiaplasty called the True Labiaplasty. I recently presented my technique at the American Academy of Cosmetic Surgery.
There are many type of labiaplasty procedures. I personally prefer my method of doing labiaplasty procedures using a modified posterior wedge technique. It can give you very good symmetry of the labia, it looks the best aesthetically, and postoperatively they experience less pain in my experience. In addition, many patients have more satisfying sex since the sensitive thin delicate labial edges are left intact. You can learn more on the link below.  Details are on my website on the link below. Your concerns are exactly the reason why I developed my technique. Good luck.

Is my vaginal area irregular or do I just require cosmetic surgery?

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Thank you for sharing your question and photographs.  There is a very wide variation in the size and appearance of a woman's anatomy and yours is well within normal.  Some women can develop functional or cosmetic concerns about their labia, and in these cases aesthetic surgery can be performed to reduce their size and improve upon any asymmetries.  In your pictures you appear to have an enlargement of the upper third of your labia minora as well as excess tissue along your clitoral hood.  Both of these areas can be addressed with surgery to leave you with a smaller overall appearance.  Be sure to see a board certified plastic surgeon with extensive experience in labiaplasty techniques.  Best wishes!

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Candidate for Labiaplasty

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#Labialplasty is probably the most common of the Vaginal Enhancement procedures. A candidate for a Labiaplasty procedure is concerned about the appearance of her labia or she may experience pain and discomfort from large, long or uneven labia; usually of the inner lips or labia minora. Women have a wide range of normal color, texture, size and asymmetries of their genitilia, so that is likely not anything for you to worry about. This is true of the Vulva and all of its parts, the same as other parts of the body.Surgery is the most common treatment and this problem can usually be corrected in under one hour with a local anaesthetic. Many women feel more comfortable and relaxed with a quick twilight or general anaesthetic. Each procedure is customized to the physical findings as well as the desired goals of the patient. Some procedures may include treatment of the clitoris or clitoral hood to further enhance this region.  The “trim procedure” is a straight incision along the edge of the labia to reduce excess tissue.  A “wedge” is the removal of a triangular shaped part of the labia with the remaining parts placed together to look completely normal. 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Cosmetic surgery is a want, not a need. It appears that you want a labiaplasty.

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Your labia are normal. They protrude beyond the labia minora and this entire area can be reduced with labiaplasty and clitoral hood contouring. This is expert level work and should be conducted by someone with extensive experience in these procedures.

Possible Labiaplasty

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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 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 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, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 25 reviews

It is what you want and not what you need

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Labiaplasty is getting more and more common in our society as more women take a critical look at their labia. There are lots of variations in labial size among women. However, many women want them to be less prominent. This now can be safely and relatively easily achieved with a labiaplasty. I do most of these just in my office with local anesthetic, supplemented by oral sedation. You can return to work after 48 hours.make sure you see a board certified Plastic Surgeon  or board certified gynecologist.
david berman md

Do I "NEED" cosmetic labiaplasty!?

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I agree with my colleagues: No you don't "need;" but it is quite reasonable to "want" cosmetic "rearrangement. That said, the MOST IMPORTANT DECISION you will make is WHO will perform your surgery. What we "experts" have been writing for years here on RealSelf is now supported by evidence-based research!! In an article in the July, 2016 issue of the American Journal of Obstetrics and Gynecology," (one of the top 3 gynecological journals in the WORLD) entitled "Surgical outcomes for low-volume vs. high-volume surgeons in gynecology: a systematic review and meta-analysis," what is "intuitive" is now PROVEN. Gynecologists performing procedures approximately once a month or less were found to have much higher rates of adverse outcomes in gynecologic surgery than more experienced, higher-volume surgeons...
The "take-home message?" ASK your surgeon how many procedures (labiaplasty, vaginoplasty, etc.) she or he does monthly, and ask them to prove it by "before and after photos. If that number is less than one/month AVOID that surgeon! 3 to 5 procedures or more, and excellent quality B&A photos, along with 4-5 star reviews usually guarantees you a decent outcome!
The weblink below is a good starting place. Look also at the Blogs, and the "Genital Cosmetic Procedures" drop-down menu for additional educational material. Very best wishes,
Michael P Goodman, MDDavis, CA, USA

You might want it

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While no woman needs labiaplasty, some women want it. I would focus the issues of importance to you and see a qualified surgeon about possibly having it done.
Best Regards,
John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon

Personal choice - labiaplasty

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Dear Problem 333:
As stated below: no one really needs a labiaplasty, this is a personal choice.  Patients choose a labia reduction surgery if they are having functional problems ( pain or discomfort)  or then do not like the appearance ( aesthetics).  If you choose to have a labiaplasty choose your surgeon wisely.
Though it is possible to end up with a botched surgery and complete amputation of the labia after a linear resection, it is also possible to end up with a wedge resection surgery which falls apart and you are left with a V -cut or a wedge of labia removed from your labia (just like a slice of pizza removed from whole pizza).  I see this often after plastic surgeons perform labiaplasty and have revised one patient from Miami in the last 2 weeks and have another from Atlanta only this past week.  You see contrary to what others on this board might say it is not the technique nor board certification or type of surgeon but the surgeon performing the surgery which increases success or failure.
I would recommend labia minora reduction and a lateral prepuce reduction.  My partner and I have performed more than 2000 cosmetic vaginal surgeries.  Choose a surgeon wisely and base it on experience, expertise, reputation and foremost results ( before and after photos).  I wish you the very best
John R Miklos MD
Urogynecologist  & Cosmetic Vaginal Surgeon
Atlanta ~ Beverly Hills ~ Dubai

Labiaplasty candidate

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nobody needs a labiaplasty but many patients will benefit from one. In this way it's kinda like an upper eyelid surgery. You would be a perfect candidate for an extended wedge labiaplasty with hood reduction. If you get a trim you will be left with a "small penis" as some revision patients have told me who were treated by their local GYN with an amputation. Make sure you're super selective and find an expert. 

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.