LABIAPLASTY: Popular, Low Risk and High Reward


Over the past couple of years, we are seeing a lot more women in Albany, NY requesting labiaplasty and other cosmetic enhancements of their genital area. Our patients range in age from teens to late middle age and their motivation to seek out these procedures is varied. While just a few years ago this topic of conversation never came up, today we think it is time to clear up the facts and myths regarding these popular procedures.

It turns out that labiaplasty is one of the fastest growing plastic surgery procedures in the western world. The American Society for Aesthetic Plastic Surgery reported that labiaplasty procedures had increased by 44% in 2013. Many factors are playing into this trend, including the commonplace practice of genital hair removal and the availability of explicit photographs of female genitalia on the internet seems to be particularly influential. Women can now easily ‘compare’ their own anatomy to what is projected as ‘ideal’, even though they may fall well within the normal range.

Our patients’ complaints include dissatisfaction with the appearance of their vaginal area, as well as discomfort associated with excessively large, protruding labia minora (inner labia). These symptoms may occur during exercise or sexual intercourse. Remarkably, many of our patients are teens who are not yet sexually active but have difficulty with chafing during sports, as well as being self-conscious about their appearance. Middle aged women have often experienced enlargement of the labia with childbearing, while other see volume loss in the outer labia and mons pubis.

Female genital cosmetic surgery (FGCS) can include removal of excess tissue of the labia minora, clitoral hood remodeling, ‘filling’ of deflated labia majora, reduction of enlarged or drooping labia majora (common after massive weight loss) as well as liposuction or ‘filling’ of the mons pubis. While I have performed all of these procedures, by far the most commonly requested one is labia minora reduction, or labiaplasty.

I note with interest that quite a few women come to me already having detailed information about the various techniques used in labial reduction. This is where confusion often occurs. While there are several ways to surgically reduce the labia minora, as yet there is no scientific proof that one technique is clearly superior to another. Like most ‘good’ plastic surgery, the selection of the best technique is customized to each patient’s unique anatomy and goals by an expert surgeon. And every approach has its advantages and disadvantages.

The most common approach is a ‘trim’ or edge amputation procedure which removes the prominent edge of the labia. It is simple, removes the often dark edge of the labia minora which many women don’t like, and even if stitches fall out too early (dehiscence), the wound usually heals without any problems. A recently published study of over 100 labiaplasties performed using this technique showed minimal complications and high patient satisfaction.

A wedge excision procedure takes a large pie-shaped wedge out of the labia minora and the wound is then stitched, creating a shorter, smaller labium. The dark edge seen in some women is then preserved, which may be preferable to some. It has been proposed that the sensitivity in the labial edge may be better preserved using this technique. This has not yet been scientifically proven or compared to ‘trim’ procedure results. Healing from a wedge excision has a risk of creating ‘notching’ in the labial edge, and if dehiscence occurs, the would must be re-stitched.

Composite labiaplasty includes modification of the clitoral hood, which may be prominent or have excessive tissue in some women. This adds complexity to the surgery and may have a higher risk of complications. Fortunately, it is not needed in many patients requesting labiaplasty. Again, this procedure is elective and can be fully customized to YOUR desires and goals.

If you are interested in labiaplasty surgery, it is important to choose a board-certified plastic surgeon with knowledge and experience in this area. I would be happy to openly discuss your goals with you.

For more information on labiaplasty surgery, or to schedule a consultation, contact us today at 518-765-8405.