What is the Most Effective Method for Labiaplasty. DLV Laser Reduction or Surgical Excision?

In researching labiaplasty online I am reading a lot about a procedure called DLV laser reduction. I don't know anything about lasers but I wonder how precise they are in targeting such a small area and whether the result is better, worse or the same as having a surgical excision done. Any and all information on this topic would be helpful. Additionally, is this something that should be only performed by a plastic surgeon or would a gynecologic surgeon be similarly qualified? Thank you, kd

Doctor Answers 8

Laser labiaplasty? Plastic surgeon vs. Ob/Gyn?

I am an American Board of Plastic Surgery-certified plastic surgeon, and partly because of my undergraduate degrees in Mathematics and Physics and my awareness and understanding about lasers since before medical school, I have taught laser surgery for over 25 years. I have also done labiaplasty for most of my 26 years in private practice.

Lasers are great (I own 5 and utilize many more on an as-needed basis), but they are tools, not procedures unto themselves. Incisions can be made with lasers, and the resultant skin edge burns can  heal with increased scarring. Yet in other situations, use of lasers allows more precise hemostasis, leading to less bleeding, bruising, and scar formation. But it's a tool. The tool OPERATOR is much more critical!

For instance, I could hand you a hammer, chisel, and a block of marble and you could undoubtedly put some marble chips on the floor, but how many of us can leave a statue like Michelangelo's Pieta behind? Even if I handed you a power chisel and mechanical stone finisher, would that make you as capable as DaVinci? And will a laser make a certain surgeon capable of better results that s/he can obtain with "regular" tools?

Of course, the answer is NO, but there is the marketing benefit of getting patients in their front door. WOW! DLV (Designer Laser Vaginoplasty) must be something! And those doctors using it must be true "Leonardos" of the female genitalia!

Seek the most experienced surgeon, whether plastic or Ob/Gyn. Of course, plastic surgeons have more surgical training and have (perhaps) a more aesthetic or artistic "eye" than our gynecologic colleagues (I have to be careful here--I have a daughter and son-in-law who are both Ob/Gyn surgeons), but it really comes down to experience.

And frankly, laser is simply a marketing gimmick here; there are no specific inherent advantages for using a laser to make labia minora incisions. Laser vaginoplasty is another thing entirely, even though DLV is a trademarked name that seems to be applied to many types of cosmetic genitalia surgery.

Seek a qualified, experienced surgeon who does lots of labia minora (labiaplasty) surgery, regardless of specialty. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Labiaplasty vs. Laser Vaginal Rejuvenation

With the availability of recent technology, there are few nonsurgical vaginal rejuvenation options available for our patients. CO2 fractionated lasers include the #FemiLift, #MonaLisa Touch and #IntimaLase. The #ThermiVa as radiofrequency energy that can also treat the outer Labia to reduce and tighten this area. It can increase blood flow, sensitivity , and orgasm. It can increase moisture and decrease stress urinary incontinence for many women.
#PRP ( Platelet Rich Plasma ) can be added to these procedures which may make a difference in the outcome. It can be injected into the vaginal mucosa to increase circulation and vaginal health, O-shot.PRP can also be used for a “G” Shot which is injected into the G-spot. Twice yearly or yearly follow up treatments are recommended to maintain vaginal health.If PRP is being added there is an additional $1000-1200 per treatment session.

However, surgery is the most common treatment. I perform a variety of treatments and surgeries to enhance, restore and rejuvenate the female genital region. This includes procedures to improve moisture, sensitivity and tighten the vaginal canal; which can enhance orgasm and restore or improve the appearance of the vulva. This includes the labia minora, labia majora, the clitoral region and the vestibule of the vagina. When necessary and capable, a vaginoplasty may be combined with a #Labiaplasty. Or, if the outer labia or labia majora may also be excessively large, uneven, or may be too small, the size may be increased with fat injections.

#VaginalRejuvenation or #Vaginoplasty involves reducing the lining of the vagina , removing excess and redundant mucosa decreasing the diameter of the canal. Additionally, the muscle ring, pubococcygeus, at the entrance or introitus can be tightened.These procedures along with exercises such as Kegles can help keep the muscle tone in this area. Aesthetic Vaginoplasty, in many cases, can increase friction during intercourse, giving women more control of vaginal muscles, increasing sexual satisfaction, while also creating a more attractive and appealing appearance to the vaginal area. Vaginoplasty can also be carried down to the area below the vulva and above the anus, the perineum.This area may be irregular from childbirth or previous trauma. It can be corrected with excision and closure to further enhance the region.
If necessary, this may be combined with a #Labiaplasty which is a surgical procedure that will reduce and/or reshape the #labia. Labia minora are the inner lips of the vagina that cover the female clitoris and vaginal opening. Women with excessively large labia may experience pain during sexual relations, feel discomfort during normal activities or while wearing tight clothing. Or, the labia may be asymmetric or may #hang below the labia majora (the outer lips of the vagina) which some women find this unattractive. At times the outer labia or labia majora may also be excessively large, uneven, or may be too small. The size may be increased with fat injections.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Labiaplasty techniques to reduce labia minora

Labiaplasty techniques vary depending on the type of excision pattern used to remove excess labia minora skin.  In my practice, I use a modified wedge labiaplasty to contour the inner labia and improve aesthetic and medical outcome.  I have seen longterm success with this procedure. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Laser versus surgical excision

A laser is only a cutting tool like a scalpel.  It does not make a difference in the result. The result depends on the choice of procedure (central wedge invented by me versus a trimming technique which is a form of DLV), the skill of the surgeon, and the choice of suture.  Any trimming technique including the laser labiaplasty will result in a scar along the entire labial edge and some irregularity as opposed to the wedge technique.


Dr. Gary Alter


Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 21 reviews

Laser versus surgical excision for labiaplasty


The use of lasers for labiaplasty is a marketing tool and nothing more. Lasers are essentially hot light. They cut and coagulate. They are only as precise as the person using them and the true art of the labiaplasty is not in which instruments to use, but in what to cut and how to suture the wounds closed. A surgeon with a scalpel and needle tip electrocautery can just as easily cut and coagulate the tissue. Make sure that whoever you choose to perform the surgery has performed many of them and has all the surgical techniques at his command, including wedge excision and flap advancement. The use of many fine sutures rather than larger, thicker sutures for the closure also helps with the final result. I hope this helps.


Daniel A. Medalie, MD

Daniel A. Medalie, MD
Beachwood Plastic Surgeon
4.9 out of 5 stars 35 reviews

Effective labiaplasty

As stated above, a labiaplasty is plastic surgery done on the the labia minora and NOT ehe vagina.  The procedure is done to change the apperance of the labia.  Board Certified Plastic Surgeons are the best trained for safely and effectively treating the skin. 

In my practice, I use CO2 laser to make the inicison in the skin of the labia. In my opinion, this makes for a less bloody procedure and a nicer scar.  To be clear, the laser is ONLY used to make the incision and NOT to treat the vagina.  A labiaplasty is a skin procedure and not a vaginal rejuvenation procedure.

Women who are healthy so VERY WELL with this procedure.


Best of luck and I hope this helps.


Sean Doherty, MD

Sean T. Doherty, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 30 reviews

Labiaplasty choices

Labiaplasty and Laser Vaginal Rejuvenation are two totally different procedures done for completely different reasons on different pieces of anatomy.


Labiaplasty, which most commonly involves surgical reduction of the labia minora (inner/thinner lips), has become a relatively common procedure over the last ten and even more so last five years.  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.  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.  To achieve these two most important elements, 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 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. 


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 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.


On the other hand, Laser Vaginal Rejuvenation is performed to reconstruct (more or less tighten) the vaginal vault most typically following vaginal deliver child birth.  Again, there really is nothing special about the laser but rather the experience of the surgeon is the most important element to achieving a good result...Glad to help...RAS 


Ryan Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 116 reviews

Best method for labiaplasty: surgery vs. laser; plastic surgeon vs. other surgeon

I have been performing labiaplasty for 20 years.  What I can confidently tell you is that the most important factor for achieving a good result is the choice of your surgeon. 


Lasers are somewhat gimmicky and don't offer any significant advantage over old fashion surgical techniques.  For the best results there are a variety of surgical procedures available, from simple trimming to more complex flap construction.  Since each woman is different each procedure must be individualized.


Choose a surgeon with a lot of experience, and be adamant that you want to see a complete portfolio of pre- and post-op pictures.  Showing one or two photos is inadequate.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 45 reviews

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.