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Labiaplasty

Reviewed by Jean M. Loftus, MD, FACS

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In the U.S. medical community, a small number of doctors have specialized in refining a plastic surgery procedure that helps women who experience difficulties with their vaginal labia area. These doctors have dedicated many years to refining a variety of techniques to accommodate individual needs.

Labiaplasty can relieve the emotional and physical discomfort associated with labia majora (outer lips) and labia minora (inner lips) conditions. The goal of the surgery is to provide a balanced, comfortable appearance of the labia area. Labia appearance issues typically result from sexual intercourse, childbirth, genetics, or aging. There may also be asymmetry between the inner and outer labia lips, which may cause discomfort.

Is Labiaplasty Right for Me?

The labia area is a sensitive issue for women. Enlarged inner or outer labia lips of the vagina may cause discomfort, embarrassment, or adversely affect sexual intimacy. Candidates may have a poorly defined labia anatomy, which can make everyday activities difficult. Close-fitting pants and bathing suits may be uncomfortable. Sporting activities may be difficult. All of these factors can be distressing. Labiaplasty can restore the contour of the labia minora or labia majora, and alleviate these distressing conditions.

Fully developed young women and adult women who are in good health are the best candidates. However, patients with certain medical conditions may not be appropriate for this treatment. The procedure does not result in perfection, so be sure to discuss your expectations with a board-certified plastic surgeon.

A Long-Distance Procedure

Because there are so few qualified labiaplasty surgeons, many people travel to receive the procedure. These doctors often have special accommodations available for traveling patients. Initial consultations may be conducted by phone. Patients can also send photos of the area that needs treatment. This helps the doctor determine whether the patient is a suitable candidate for labiaplasty before traveling, and if so, the most appropriate technique.

The Labiaplasty Procedure

The doctor will review your medical history and explain the risks associated with the procedure. A treatment plan will be developed, then the precise technique for your procedure can be determined. Your procedure may include the surgical reduction of the labia major (outer lips) or labia minor (inner lips) or both. The procedure is often performed by a board-certified plastic surgeon. The location of the procedure is usually the doctor's office or an outpatient surgery center. Time in surgery is typically two hours. The procedure is performed under local anesthesia, while you are numbed and awake. Sedation or general anesthesia is not necessary.

The instrument used in labiaplasty varies among doctors. The doctor may use Iris Scissors which are also used in the facelift and blepharoplasty procedures. Other doctors may prefer to use a scalpel. The doctor may use both instruments. You can discuss the type of equipment to be used with your doctor.

Labia Minora or Labia Majora Reduction

For patients with enlarged inner and outer vaginal lips, surgically reducing the enlarged labia minora or labia majora may be appropriate. During this procedure, the doctor will use Iris scissors or scalpel to sculpt the tissue on the labia. The appropriate incision location depends on many individual factors, including the configuration and texture of the labia. The doctor will then suture the incision closed with dissolvable stitches.

Recovery

The labia and surrounding area may be slightly bruised. Patients can expect swelling for several weeks. Oral medications can be administered to reduce pain. Oral antibiotics may be prescribed to reduce the risk of infection. Severe pain or abnormal symptoms should be reported to the doctor immediately. The patients will receive a list of postoperative instructions that may include the restriction of heavy exercise for three or more weeks, restriction of sexual relations for six to eight weeks, and no tampon use for ten days.

Since many patients travel for the procedure, a follow-up view of the labia can be made by sending a picture to the doctor within six weeks of the procedure. Some patients may notice an increased sensation in their clitoris as a result of the removed tissue; however, this is not the purpose of the procedure. The final appearance will be evident in three to six months.

Complications and Risk

Complications are a possibility with any medical procedure. The risk can be reduced by selecting the right doctor and carefully following preoperative and postoperative instructions.

One of the most common, but infrequent complications is temporary numbness or infection. Other risks include excess scar tissue buildup (appearing as lumps on the treated area), a hematoma (break in blood vessel causing localized blood filled area or blood clot), puckering or creases of the skin, or sensitivity loss in the treated area. However, the treated area does not play a part in sexual sensation. Some patients may experience asymmetry between the inner and outer labia lips. There may also be variances in pigmentation, thickness, and uneven edges of the labia.

Consult a Qualified Surgeon

The evaluation of surgical skills specifically relating to labiaplasty is not required for certification with the American Board of Plastic Surgery. There are no specific licensing requirements or required educational courses to perform labiaplasty. So you need to do two things:

Using a board-certified plastic surgeon does not guarantee the best results; however, board certification does require specific and rigorous surgical education and training, which increases your odds of a successful, individualized outcome.

Here are some tips to consider when consulting a plastic surgeon:

  • Check references. References may be obtained through the doctor, friends, and online chat rooms.
  • Review credentials and make certain that the credentials are current. Ask about the doctor's type and extent of training.
  • Ask how many times the procedure has been performed by the doctor.
  • Review before-and-after photos of individuals who received labiaplasty to help set reasonable expectations. You can also bring a photo of the desired result you would like to see.
  • Inquire about the type of equipment to be used, where the procedure will be performed, and the extent of the procedure.
  • Ask the doctor about the possible side effects of the procedure.
  • Review preoperative and postoperative instructions and follow them carefully.
  • The technique used in the procedure depends on factors related to your personal anatomy.

Check with these resources to verify credentials:

  • The American Board of Medical Specialties (ABMS) at 1-800-776-2378 to determine whether a physician is board-certified.
  • State Medical Boards to investigate physician credentials, pending malpractice judgments, and disciplinary actions.
  • The Joint Commission on Accreditation of Healthcare Organizations to determine if the facility where the procedure will be performed is fully accredited.

Labiaplasty Costs

The procedure includes three costs: local anesthesia fees, facility fees, and surgeon's fees. Patients may have a labia majora reduction or labia minora reduction, or both, to produce a fully satisfactory outcome. Both procedures may be performed at the same time, which reduces overall cost, since you pay only once for anesthesia and for the facility.

Labia minora or majora reduction fees can range from $5,000 to $10,000.

If the cost of the procedure is difficult for you, ask the facility about payment plans and medical finance options. For financing options and tips, continue reading about Patient Financing.

About the Reviewer of This Article

Jean M. Loftus, MD, FACS, is a member of the American Society of Plastic Surgeons and a Fellow of the American College of Surgeons. Dr. Loftus is certified by the American Board of Plastic Surgery and the American Board of Otolaryngology and currently practices in Cincinnati, Ohio.

[page updated June 2008]