Question 1

What is clitoral hood reduction surgery?

Accepted Answer

Clitoral hood reduction is a surgical procedure that reduces the length, width, or protrusion of the folds of skin around the clitoris, called the clitoral hood. Removing excess skin can increase clitoral stimulation and sexual pleasure, while improving the aesthetics of the vulva.

Also known as a clitoral hoodectomy, hoodoplasty, or unhooding, the procedure can also reduce discomfort, since a large clitoral hood can rub against clothing and cause irritation. In some women, it can also trigger yeast infections and urinary tract infections.

Clitoral hood reduction surgery is commonly paired with a labiaplasty, which removes excess tissue from the labia minora, the inner lips that surround your vaginal opening. “The clitoral hood is connected to the labia minora, and frequently when you have to reshape the labia minora, you also have to reshape the hood,” says Dr. Marco Pelosi, III, an OB-GYN in Bayonne, New Jersey. Clitoral hood reduction can also be done as part of a full vaginal rejuvenation.

Question 2

What is a clitoral hood?

Accepted Answer

The clitoral hood is a fold of skin (aka prepuce) that protects your clitoris (aka the glans), which is the small nub that’s just above your urethral opening, the tiny hole that you pee out of.

The clitoris is filled with nerve endings—about 8,000, according to the Cleveland Clinic—that make it very sensitive to touch and play a critical role in achieving orgasm. Without any clitoral hood, your clitoris would be overly sensitive to touch and irritants, like friction from clothing rubbing against it. Your clitoral hood makes a lubricant called sebum that helps it glide smoothly over your clitoris.

“The clitoral hood is there to protect the glans when you’re not sexually aroused, but elevates out of the way during sexual stimulation,” says Dr. Mark Scheinberg, an OB-GYN in Deerfield Beach, Florida, who specializes in vaginal rejuvenation.

Though it plays an important function, the clitoral hood can sometimes be too large or lengthy, or not retract during intimacy. Excess clitoral hood tissue is usually genetic and, contrary to what you might have heard, not caused by masturbation, explains Dr. Leila Kasrai, a plastic surgeon in Toronto.

Some women are just fine with a significantly hooded clitoris, but others struggle with the physical, cosmetic, or emotional symptoms related to this excess skin. “Sometimes women complain about the excess tissue,” says Dr. Gary Alter, a plastic surgeon in Beverly Hills, California, who helped pioneer clitoral hood reduction surgery. “It makes it look like a little penis.”

Question 3

What are the pros and cons of clitoral hood reduction?

Accepted Answer

Pros

The surgery is relatively quick (around an hour), with a speedy recovery back to work and normal activities.
It typically doesn’t require general anesthesia.
Removing excess skin can make your clitoris look more proportional with your labia and vulva contours. It can also reduce irritation, pain, and embarrassment that may result from having an overly prominent clitoral hood.
To improve symmetry, the procedure can be performed on just one side if—like many women—your anatomy isn’t completely even.
There is some evidence that clitoral hood reduction can enhance or improve orgasm, but “this is quite difficult to guarantee,” says London-based plastic surgeon Dr. Amir Nakhdjevani, who notes that orgasm is dependent on more than just physical manipulation. However, the procedure will expose the clitoris, making it easier to access for stimulation—and potentially create stronger, more frequent orgasms.
Scars from a hoodectomy are concealed and practically invisible. “Because this tissue typically heals so well, scarring should be minimal enough to be imperceptible in the majority of patients,” according to Dr. Ryan Stanton, a plastic surgeon in Beverly Hills, California, who specializes in genital surgery.
Most people who have the surgery are satisfied. “I can’t stop looking at my vagina,” says RealSelf member Makemebeautiful, who is “really pleased with my results.” Clitoral hood reduction has a type: embedded-entry-inline id: Ks6V6ARYAktTMUTOEu3el Worth It Rating from RealSelf members, who report increased self-esteem and sexual pleasure.

Cons

Like any surgery, it comes with risks, including excess bleeding, hematoma, infection, asymmetry, and an unsatisfactory outcome. However, when performed by a specialist on an appropriate candidate, these risks are quite rare, according to Dr. Stanton.
Removing too much or too little skin can lead to not enough—or too much—sensitivity. This may lead to sexual dysfunction, though it may be corrected with revisional or reconstructive surgery.
You’ll need to wait six weeks before returning to heavy workouts and sexual intercourse. If it feels comfortable, gentle oral sex (aggressive suckling can irritate healing tissue) may be okay sooner than that—just check with your surgeon first.
The surgery is expensive (especially when performed in tandem with a labiaplasty) and, because it’s considered cosmetic, is not covered by insurance.

Question 4

Who performs clitoral hood reductions?

Accepted Answer

The clitoral hood is very delicate tissue and requires careful surgical technique to avoid complications, such as scarring and removing too little or too much skin, and create the best results.

It’s essential to choose a board-certified expert in female genital surgery. This procedure is highly specialized and delicate and should only be performed by someone who performs clitoral hood contouring on a regular basis “and can prove this to you with at least dozens of before-and-after pics,” advises Dr. Michael Goodman, an OB-GYN in Davis, California. “Getting the procedure correct the first time is critical, since revising imprecise surgeries can lead to a loss in sensation and irreparable outcomes,” says Dr. Stanton.

Clitoral hood reductions are typically performed by surgical specialists:

Gynecologic or urogynecologic surgeons, medical doctors who performs surgery on the female reproductive system
Plastic surgeons, medical doctors who specialize in cosmetic and reconstructive procedures

Question 5

How much does clitoral hood reduction cost?

Accepted Answer

Your clitoral hood reduction cost will depend on your surgeon’s level of experience, expertise, and/or their practice location. Choosing an experienced, board-certified plastic surgeon may be more expensive, but it can help you avoid complications that may cost more to correct.

If you’re getting a clitoral hood reduction along with labiaplasty, you can expect to pay more.

Very rarely, health insurance plans will cover this procedure, if it’s deemed medically necessary by your doctor. In most cases it’s considered elective plastic surgery.

Question 6

How does clitoral hood reduction surgery work?

Accepted Answer

Clitoral hood reduction is an outpatient procedure that takes about an hour. It can be performed under local anesthesia, conscious sedation, or general anesthesia, depending on whether it’s being performed as a standalone procedure or in combination with another procedure.

Reducing excess clitoral hood tissue can be addressed with several different incision patterns. Your surgeon’s technique will depend, in part, on your unique anatomy and goals. Some surgeons use an electrosurgical knife, while others use a laser, to seal the blood vessels as the tissue is removed, resulting in quicker healing and less scarring.

When done as a standalone procedure, clitoral hood reduction may be performed via simple skin excision:

Incisions are made on either side of the hood, and excess skin is surgically removed.
The sides are compared for symmetry and evened out.
The remaining skin is sutured into place between the hood and the labia majora, the outer vaginal lips.

Another technique to achieve a clitoral hood lift is to remove excess length of skin where the clitoral hood meets the pubic area. “Essentially I do a double-inverted ‘V’ incision, or an upside down ‘V’ incision times two, and the hood is elevated upwards,” says Dr. John Miklos, a urogynecologist in Atlanta.

Special caution should be taken not to remove too much tissue, which can put tension on the clitoral hood and result in poor healing.

If your procedure is being performed with a wedge labiaplasty, a V-Y wedge technique can be used. During this procedure, the upper portion of the V-shaped wedge of tissue that’s removed during a labiaplasty can be extended to encompass any redundant hood tissue into a single incision line.

If you’re having a trim labiaplasty, during which one continuous incision is made along the edge of the labia minora to remove excess tissue, the incision can be extended up to the clitoral hood.

Whatever technique is performed, most surgeons close the wound using dissolvable sutures that the body breaks down and absorbs over four to five weeks.

Question 7

What should you expect during clitoral hood reduction recovery?

Accepted Answer

Your surgeon will send you home with post-op instructions, but here’s what a typical recovery process involves.

You’ll need three to five days of downtime after the procedure.
During this time, you can expect to be very swollen (“freakishly so,” according to Dr. Pelosi, due to the nature of the hood anatomy).
You’ll also have some discomfort. Makemebeautiful123, who described the initial pain as “really uncomfortable, almost like a burning sensation,” only needed to take pain medication for the first day. After that, over-the-counter pain relievers should be enough.
Most patients are able to walk more comfortably within a day or two.
Make sure that you have loose-fitting clothing to wear during your recovery.
To help reduce swelling, the Cleveland Clinic advises applying a cold pack over your underwear to the area on and off in 20-minute increments. Anti-inflammatory medication and elevating your pelvis can also help.
Your surgeon may say that you can shower with soap and water and remove your bandage as early as 24 hours post-op, then apply an antibiotic cream to the incisions afterwards for the first three to five days.
“Within five days, most patients are able to go back to work with minimal discomfort,” says Dr. Stanton. “Just don’t lift more than 20 pounds for at least two weeks after the procedure, unless your surgeon says otherwise.”
Avoid baths, saunas, steam rooms, and swimming for at least three weeks, unless your surgeon says otherwise.
It’s quite common to experience spot bleeding after the procedure. Mild to moderate pressure with a gauze pad or ice wrapped in a thin cloth can help stop the bleeding. If it gets worse or doesn’t stop, contact your surgeon.
Avoid vigorous exercise and sexual activity for six weeks post-op, to give the incision time to fully heal and let the swelling go down.

Question 8

How soon will you see results?

Accepted Answer

“This area of the body has a robust blood supply, so it heals relatively fast,” explains Dr. Stanton. “Initial results can frequently be appreciated within 2–3 months, but final results cannot be judged until 4–6 months post-op,” once all swelling has resolved.

If you have your hoodectomy along with a labiaplasty or vaginoplasty, a procedure that tightens the vaginal canal,it may take up to a full year for the swelling to fully resolve.

Question 9

Clitoral hood reduction before and after pictures

Accepted Answer

The clitoral hood reduction photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 10

What are the risks of clitoral hood reduction?

Accepted Answer

Every surgery carries inherent risks. The most common risks of clitoral hood reduction include:

Scarring
Asymmetry
Under-reduction (not taking enough skin)

More rare occurrences include bleeding, infection, wound separation, and nerve injury that could lead to numbness or changes in sensitivity—something most RealSelf members say they didn’t experience after the procedure.

Unfortunately, that wasn’t the case with RealSelf member, SeaGoddess, who lost all sensation in her clitoris after the procedure and is unable to achieve orgasm.

To minimize the risk of complications, choose your surgeon carefully and follow all of their pre- and post-surgical instructions, including to stop smoking at least two weeks prior to your procedure.

CLITORAL HOOD REDUCTION

Ryan A. Stanton, MD

Colleen Williams

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Ryan A. Stanton, MD

Colleen Williams

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