Friday, November 6, 2009

All About Labiaplasty - Labia Minora Reduction


Labiaplasty is a surgical procedure which corrects excessively long, enlarged or redundant labia minora. Women who seek this surgical procedure may be self-conscious about hanging labial tissue, they may have asymmetric labias, or they may have pain or discomfort during sex, with exercise or sometimes just walking!

The purpose of labiaplasty is to surgically reduce excessive large labia minorae, to create symmetry when it is lacking, and to make the labia appear more cosmetically appealing. Occasionally excess tissue around the clitoral hood is also carefully trimmed, without any injury to the nerves that provide sexual stimulation.

Labiaplasty only addresses the labia minora (inner lips of the external genitalia of women). It does not generally affect the labia majora (outer lips), nor does it alter the vagina.


In order to ensure complete comfort and relaxation, we perform labiaplasty in the operating room, under a short and safe general anesthesia. Surgical loupes (microscope glasses) are always used to ensure the most meticulous possible repair.

The area to be trimmed is marked, and local anesthetic containing epinephrine (adrenaline) is injected to prevent bleeding and bruising during surgery, and to keep the area numb for many hours after surgery. Next, excess tissue is trimmed. A multiple-layer closure is then done (usually 2-3 layers of stitches) using all dissolving (absorbable) sutures. Antibiotic ointment is applied, and mesh panties with an absorbable pad are placed.

On average, surgery takes around an hour and a half to two hours. It is outpatient surgery - women can go home in a couple of hours, when they are awake and alert, without nausea and when they are eating and drinking well.


You can expect some mild discomfort requiring oral pain medication such as Tylenol or occasionally something stronger (Vicodin or Percocet) for a few days. Aspirin or Ibuprofen (Advil, Motrin) should be avoided as these can increase bruising or bleeding.

There will be some swelling and possibly bruising of the genital region. You can shower the next day, and will be advised to apply antibiotic ointment daily and wear a thin pad in your underwear in case of any spotting or bleeding.

If you have your period, use a pad instead of a tampon for your first 1-2 menstrual cycles to avoid irritation of the incisions while they are healing.

Most women take at least a few days off of work, or work from home during the first few days after surgery, when they are swollen and tender.

Sexual intercourse should be avoided for 3-6 weeks, or until the area is no longer swollen and tender. Aggressive physical activity should also be avoided for at least a week, as increasing your heart rate and blood pressure will bring more blood flow to the area and create more discomfort or swelling.

Some women describe intense itching (due to histamine release during healing), while others have very little discomfort at all after surgery. Keeping a small pillow in your purse can cushion the area if you are sitting on a hard surface during healing.

Like any incision, it takes at least 3-4 weeks for initial healing, and 6 months up to a year for the results to be absolutely final. Incisions are hidden in the natural crease. The area of surgery will eventually be very difficult to see, and there is usually very little scarring, as it involves a mucosal membrane (think about cuts to the inside of your mouth or gums, and how they have healed).

You will be seen back at your surgeon's office within a few days of surgery for an initial checkup, and then usually at 2-3 weeks, 6 weeks, 6 months and one year. All follow-up visits are covered by your surgery fees.

Most women find this operation liberating and are very satisfied with the results.


Any surgical procedure carries with it potential risks of anesthesia (nausea, headache, etc), the potential for bleeding, infection and wound healing problems. There will be temporary pain or tenderness, swelling, bruising, and numbness of the area.

Bleeding is controlled during surgery by a cautery pen that coagulates any blood vessels that are encountered. You likely be given a few days of prophylactic (preventative) antibiotics to help prevent infection. You should shower daily and ensure the area is kept clean after surgery.

Your labia may not be completely symmetric - this is the norm for most women. You can have temporary change in pigmentation (lighter or darker) while you are healing.


Women of all backgrounds, shapes and sizes, professions (including stay-at-home moms) and cultures seek labiaplasty! Many women are born with asymmetric or redundant labial tissue, which is normal for them! Sometimes after childbearing, labial tissue can become stretched, and following menopause, the area can droop more.

Labiaplasty is a private procedure that should not be viewed with embarrassment or shame! It is often an empowering experience that can improve a woman's body image and self-esteem.


Any surgical procedure includes a surgical fee, operating room or facility fee, and anesthesia-related fees. On average, the total cost can range between $4000 and $8000, depending on the complexity of the surgery, time needed for surgery, and other details specific to your unique anatomy.

Insurance does not usually cover labiaplasty. You can inquire with your insurance carrier about this benefit, but labiaplasty is usually viewed as cosmetic.


Smoking should be stopped for at least 6 weeks before any operation. Other health problems such as diabetes, heart disease, high blood pressure, or autoimmune disorders should be well-controlled before considering any surgery.

You should be cleared by your primary care physician for surgery, and have had routine preoperative tests (bloodwork, EKG), as appropriate based on your age and medical history. You should not be pregnant, and should not undergo surgery immediately before a major life event (give yourself at least 4-6 weeks to heal before a vacation, etc).

Avoid medications and herbs or nutritional supplements that can increase the risk of bleeding or bruising with surgery (aspirin, anti-inflammatories, vitamin E, fish oil, etc) - your surgeon will give you a comprehensive list of what types of things to avoid and for how long before and after surgery.