Labiaplasty
…is the surgical procedure to remove the excess skin of your labia minora (the inner labia tissue).
This is usually done to create a more aesthetic appearance as well as address any medical issues.
I see many women who present with concerns about their labia. Most commonly patients present with labia minor that are either perceived to be too large, or labia minor that are asymmetrical, or have been torn as a result of childbirth.
The appearance and shape of labia in women are extremely variable, and although most often, they fall in the range of “ normal labia” that does not mean that women may have significant discomfort or visual concerns about their labia.
While there is a large percentage of women who have a normal sized labia minora, there are still reasons why they would like it reduced and have any excess removed. Usually, some women can get excessive skin because they have inadequate skin of the labia majora (the outer labia tissue), or it can be the result of childbirth. Labiaplasty can also address any unsightliness, irritation of the skin, infections, and other related hygiene problems.
A lot of women I see are young, and do not like the fact that their labia minora protrude past the labia majora, or the outer lips of the vulva. When this occurs, the labia minora are often visible in active wear, are uncomfortable in tight clothing, or uncomfortable with sport or sex. I have seen patients who have told me they need to push their labia minora up into the vagina to make it possible for them to go cycling. Additionally, as we age, the labia minora often seem to enlarge, and the constant friction of the protruding labia on underwear means the edges of the labia become darker, more thickened and hypertrophied.
While you can adopt strategies to alleviate the issues that come with significant discomfort due to a large labia, labiaplasty has become more common. More women are becoming more aware of the possibility of having this discomfort corrected through surgery.
When considering a labioplasty, firstly photos are taken both lying and standing and the images are discussed on a case by case individual basis. Labia are never completely symmetrical. One is usually slightly larger than the other, and there may be additional folds or additional extensions of the labia towards the opening of the vagina. The clitoral hood may be in proportion to larger labia, but will look out of proportion when the labia are reduced in size, and in these cases, a clitoral hood reduction may also be discussed.
There are different surgical approaches used to perform a labiapalsty, and some patients are better suited to one option over another. The labia can be “ trimmed” which removes the excess labial tissues to allow the labia to not be visible when the labia majora are together. A labial trim procedure also removes any thickened or darker labia tissue. The scar in a trim labiaplasty sits along the edge of the new labia. A labial trim procedure is easy to recover from as there is very little tension on the sutures of the newly created labia.
An alternative approach to labiaplasty is to perform a “ wedge “ procedure with or without de-epithlialisation. In a wedge procedure the edges of the new labia are formed from the original labia and the scar is horizontal on the inside and outside of the new labia. There is a lot more tension on the newly formed labia after a wedge procedure and exercise needs to be avoided for longer. It is important the the blood supply to the labia is not reduced during a wedge procedure or the scar may breakdown in the early daily of healing.
Labiaplasty is usually performed under general anaesthetic and can usually take about an hour. The procedure is a simple one that involves the removal of any excess tissue from the labia minora or majora, and some patients are generally comfortable enough to go home after the surgery.
As for recovery, this can take a few weeks. While some pain is common, it usually only takes a few days for it to subside. And a week before you would be able to return to work and another to consider low impact gym exercises. There will be swelling that will take several days to subside before it can become comfortable again with some bruising.Generally a labiaplasty is not a particularly painful procedure to recover from , but post operative care is extremely important. The surgery can be performed under general anaesthetic in theatre, but depending on the surgery required, can also be performed in the rooms using local anaesthetic.
New changes to cosmetic surgical practices came into effect in Australia in July 2023 which require patients to have two consultations with the doctor before booking a date for the labiaplasty procedure, and this date needs to be at least ten days after the second consultation to provide a “ cooling off “ period. I believe these new requirements serve patients well, as they provide plenty to time to research and consider the different surgical options, and to decide if they definitely wish to go ahead with a labiaplasty procedure.
