Women have discovered that their concerns over the length of their labia minora are much more common than previously thought. Long labia minora can get tangled in underwear, can be painful and can get twisted during intercourse. Labiaplasty has emerged as a procedure that has a high satisfaction rate and delivers results that are permanent. Each woman’s anatomy is different. Labia minora that protrude beyond the labia majora can show through clothing or bathing suits, can cause discomfort, become chafed and interfere with exercise. Labiaplasty aims at reducing the size of the labia minora with a procedure that takes only about an hour and is relatively painless during the recovery. There are two basic types of labiaplasty for labia minora: a trim labiaplasty and a wedge labiaplasty. It is important that your surgeon be familiar with both techniques as each woman’s anatomy is different and may benefit from one technique over the other.
For many patients the excess tissue extends onto the clitoral hood. If that is the case an extended labiaplasty with reduction of the clitoral hood is performed. The procedure does not add any time to the recuperation and is commonly performed at the same time as a simple labiaplasty. If the aesthetics of the clitoral hood are not analyzed ahead of surgery, reduction of the labia minora a lone can lead to a disproportionately large clitoral hood area. Make sure your surgeon can show you before and after photos of a clitoral hood reduction as well as a labiaplatsy, as many problems occur when surgeons do not feel comfortable operating around the clitoris.
If the labia majora are protruberant, the size can be reduced with a labia majoraplasty. Patients who have large labia majora come in complaining of visibility through their underwear or bathing suits. Some patients refer to the problem as camel toe. Conservative reduction of the labia majora can restore the aesthetics of the vulva, and it can be performed at the same time as a labiaplasty.
One additional concern that many labiaplasty patients have is the appearance of the vaginal opening (introitus). The vaginal opening may be gaping due to damage incurred at birth and from a poorly repaired episiotomy. A procedure to repair the perimenum and vaginal opening is called a perineoplasty and it can be safely performed at the same time as a labiaplasty.
If a patient feels “loose” during intercourse, she may have separation of her levator musculature as a result of childbirth. In addition to the previously mentioned perineoplasty, the rectovaginal fascia and levator musculature can be repaired in a complete vaginoplasty.
A comprehensive consultation with a surgeon skilled in cosmetic genital plastic surgery is most important. Be sure to ask many questions, ask to see many before and after photos of each procedure you are considering. Patients who have labiaplasty, labia majoraplasty, perineoplasty and vaginoplasty are some of the most grateful patients we have. Their anatomy can be vastly improved and the confidence in having a reconstructed perineal area can lead to improved sexual function also.