Labiaplasty
Each vagina is different, and therefore, each labiaplasty is different. Just like there is no "normal penis," there's a wide range of normal appearing vaginas. Some labia are long and narrow. Some labia have one side enlarged and one side short. Some labia are very rough and dark, while some are thin and smooth. Just like a fingerprint or a snowflake, no two labia are alike, even on the same person.
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Labiaplasty Videos
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The PostOPP Podcast
Do I need a labiaplasty?
I'd like to take a moment here to pause and state the following: Plastic Surgery is only ONE way to achieve empowerment. It is not THE way and it is certainly not the ONLY way. Whenever we are bothered by our appearance we have a choice: To accept how we are, or to change it with plastic surgery. Each option is empowered and each option is equally valid.
Most women seek labiaplasty for appearance reasons. Specifically because of labia minora "show," where the inner labia (the labia minora) protrude beyond the outer labia (the labia majora). The labia minora are reduced--not removed--so that there is a more "tucked in" look to the vagina, especially when standing.
Large labia minora can also be symptomatic, in that they can get in the way of activities, clothing, and intercourse. A labiaplasty reduces the labia minora to alleviate these symptoms.
Most women seek labiaplasty for appearance reasons. Specifically because of labia minora "show," where the inner labia (the labia minora) protrude beyond the outer labia (the labia majora). The labia minora are reduced--not removed--so that there is a more "tucked in" look to the vagina, especially when standing.
Large labia minora can also be symptomatic, in that they can get in the way of activities, clothing, and intercourse. A labiaplasty reduces the labia minora to alleviate these symptoms.
There is no such thing as a "normal" vagina. Each vagina is different. Each of these patients presented to my clinic for a labiaplasty.
Labiaplasty is Liberating
We wear nice clothes, we exercise, and we present our best selves to the world. When intimate, in our own private world, we endeavor to feel that same degree of confidence. A labiaplasty is a freeing and empowering procedure for many women, providing confidence, alleviating self-consciousness, and aiding in body positivity.
A Labiaplasty Reduces the Labia Minora
In simplest terms, a labiaplasty is a procedure for reduction of the inner labia, the labia minora. Of course, expert plastic surgery is never simple. There are an amazing number of nuances involved in making the labia minora reduced in the most aesthetic--and safest--way possible. Much like an upper eyelid surgery isn't just removing eyelid skin, there are nerves, vessels, lymphatics and many other critical structures that are involved with performing expert labiaplasty surgery.
Before and after labiaplasty with hood reduction.
The Clitoral Hood or Prepuce should also be reduced at the same time.
The clitoral hood, or prepuce, should always be addressed at the time of a labiaplasty. In fact, a labiaplasty is incomplete in most cases unless a clitoral hood reduction (aka hoodectomy) is also performed. Naturally, sensation is completely preserved with hood reduction, because only the most superficial skin is removed, about the thickness of a skin graft.
If the clitoral hood is not reduced, the upper part of the vagina can stick out or be more prominent. Some women have described this to me as a "small penis". Needless to say, that is not the goal. A labiaplasty should have a balanced look of the top, middle and bottom portions of the vulva (the outward appearing vagina). In the ideal, no single area of the vagina protrudes more than the other. In some cases, a perineoplasty is also performed at the time of a labiaplasty and hood reduction. The perineum is the space between the anus and vagina. In some women, this tissue can also be prominent and protrude. To get a balanced look tissue may also need to be removed from this area. Vaginal tightening can also be performed along with this procedure.
Is my vagina normal? Why do I have long labia?
We’ve all wondered at some point in our lives if our bodies are normal. For most of us, these questions begin at the time of puberty when we rapidly experience changes in our bodies.
For men, breast development (gynecomastia) can be a source of stress: breasts are feminine traits and can be quite distressing. Similarly, enlargement of the genitalia in women, specifically the labia minora, can be perceived as a masculine trait. As such, large inner labia can be distressing to young women and is homologous to breast development in men (gynecomastia).
That said, all of these changes are actually normal. And by "normal" I mean that an estimated 20% of young adults of both sexes experience these types of changes with puberty. But the question isn’t really a question of "normal." We know that we are all different! The question is really this: do my labia minora bother me? Do they bother me in a physical way? Do they bother me in an emotional way? Or is it a combination of both?
For men, breast development (gynecomastia) can be a source of stress: breasts are feminine traits and can be quite distressing. Similarly, enlargement of the genitalia in women, specifically the labia minora, can be perceived as a masculine trait. As such, large inner labia can be distressing to young women and is homologous to breast development in men (gynecomastia).
That said, all of these changes are actually normal. And by "normal" I mean that an estimated 20% of young adults of both sexes experience these types of changes with puberty. But the question isn’t really a question of "normal." We know that we are all different! The question is really this: do my labia minora bother me? Do they bother me in a physical way? Do they bother me in an emotional way? Or is it a combination of both?
Why women seek labiaplasty
Women seek labiaplasty--reduction of the inner labia, the labia minora--for two main reasons:
- They don't like the way the labia look.
- They don't like the way the labia feel.
In reality, women seek labiaplasty because of both self-consciousness AND discomfort. Click HERE for an in-depth discussion on changes in labia appearance over time.
Let's look more closely at these two reasons for pursuing a labiaplasty in more detail.
Reason 1: To Change the appearance of the inner "lips"
Labiaplasty can reduce long hanging labia
While large inner "lips" or inner labia can be seen as attractive by some, most women want a "tucked in" look to the labia minora; where they are mostly or completely hidden by the outer labia, the labia majora. A labiaplasty reduces the inner labia so that the outer labia cover them when standing.
Standing view with labia minora "show" beyond the outer labia.
Large labia can cause a large number of functional issues. For example:
- Long inner labia get in the way of clothing, exercise and intercourse. Yoga pants, tight jeans, bikini bottoms and thong underwear can be a problem for women with large labia. Not only do the labia pinch and pull in certain clothes, but they can become visible in certain clothing. This leads women with large labia to avoid certain clothing.
- Large labia can interfere with exercise. Women often will tell me that they have to adjust themselves while running or doing yoga, which is a source of distress and discomfort.
- Long labia can get physically in the way of sex. Sometimes the inner labia will get pulled into the vagina during intercourse, leading to injury, tearing, and pain.
- Large labia can actually cause yeast infections. Because of infolding of the labia, fungal infections can become more common, resulting in chronic yeast infections.
- Long inner lips can cause challenges with hygiene. Urination can be a problem because the urine stream can be affected by labia. In addition, toilet paper can get caught in larger labia, making cleanliness a challenge.
Large labia before and after showing toilet paper getting caught in the folds before treatment.
Labiaplasty can smooth out the Rough labia edge that doesn't look "neat" to some women
Not only can folds on the labia minora edge look rough, but as mentioned above they can cause hygiene issues. Beyond that, many women want a smooth look to the outer labia. The best way to achieve this is with an edge labiaplasty to remove the rough edge, and replace it with a more smooth contour.
Before and after labiaplasty with prominent rough edges or rugae in the before picture. While normal, they can be a source of distress. The after picture shows the results after labiaplasty with a smoother edge to the labia minora.
Labiaplasty can remove Dark Pigment on the edge of the labia minora
A dark edge of the inner labia is the result of hormones, particularly estrogen. The more time that estrogen circulates in the body, the darker the labia minora can get. This is why the inner labia can become darker and darker over time. There is no safe way to lighten the inner labia. The best treatment is to remove the dark edge if this is bothersome to you. A wedge labiaplasty, discussed further below, does not remove the dark pigment or rough edge as well as my modified edge technique. (Of note, the outer labia anal area can be lightened with bleaching cream and pads, which can be found HERE.)
Labiaplasty can remove the dark edge of the inner labia.
Labiaplasty can make the inner labia more symmetrical
Asymmetry, where one labia is larger than the other, is very common. Just like one testes hanging lower than the other in men, one labia is often longer than the other in women. While this is normal, the long labia can become folded and can pinch and pull, becoming irritated. Moreover, we all would love to think that we are a mirror image, and if surgery can bring us closer to that goal, then it can be a welcome solution.
An example of a young woman with uneven labia. The left inner labia is longer than the right. A labiaplasty was performed on both sides, with more tissue removed from the patient's left side to achieve symmetry.
Labiaplasty can repair Trauma and Injury to the labia from Childbirth
While less common, women can experience tearing of the inner labia during childbirth. Much like a perineal tear occurs very characteristically at the bottom of the vagina, a labia minora tear during childbirth occurs right where the clitoris and labia meet. This is called the clitoral frenulum.
A labia minora tear from vaginal delivery showing on the left, and after repair on the right. Also performed was a labiaplasty on the unaffected side.
My patient above demonstrates a typical tear at the clitoral frenulum which is a very thin and sensitive structure of the vagina. Many other related birth injuries can be repaired at the time of labiaplasty.
Reason 2: Large labia can make women self-conscious
Large labia can make some women feel self-conscious. The reasons for this are complex and deeply embedded in our biology. For example, why are large male genitalia sought after and seen as masculine in most cultures? The answers lie deep within our anthropology. Regardless, large genitalia is universally seen as a masculine trait. On the opposite side of masculinity is femininity. This is a simple truth: the Yin-and-Yang of our species.
Because of these internalized, deep-seeded sentiments, large hanging genitalia in women can be seen as undesirable and masculine. This is not a hard and fast rule, and it is certainly not my rule, it is just my experience as a physician and labiaplasty specialist.
Because of these internalized, deep-seeded sentiments, large hanging genitalia in women can be seen as undesirable and masculine. This is not a hard and fast rule, and it is certainly not my rule, it is just my experience as a physician and labiaplasty specialist.
This young woman complained that her large labia were not feminine to her. Before and after labiaplasty is shown.
Feelings of self-consciousness are a major reason why women pursue labiaplasty. Not only do some women feel that the appearance of the labia are not feminine, but they also are concerned about what their partners may think about their large labia. There are many misconceptions about the causes of large labia, and one of my missions is to dispel these myths about large labia minora. That said, if you are ever made to feel bad about the way your labia look, FIND A DIFFERENT PARTNER. NO one should ever make someone else feel bad about their appearance, not the appearance of their vagina, nor any other part of their body.
The Labia Minora grow during puberty and pregnancy
The labia minora grow during puberty and pregnancy in response to estrogen. That's the most important sentence on this page so I will happily write it again in bold.
The labia minora grow during puberty in response to estrogen.
This answers the most common question women have about labiaplasty: What causes large inner labia? Why does this happen to some women? Why did it happen to me?
Since labia minora grow during puberty and pregnancy, it is worth noting what does NOT cause large labia:
- Large inner labia are NOT caused by intercourse
- Large inner labia are NOT caused by masturbation
- Large inner labia are NOT caused by promiscuity
These are unfortunate misconceptions about the labia minora that have no basis in reality. My goal is to dispel these notions and to provide a safe place for women to discuss the issues they are having with their genital anatomy.
The difference between Wedge and Edge labiaplasty
When I first started my practice I performed the wedge labiaplasty. I no longer do so. There are three main reasons why the edge labiaplasty, or as I call it, the modified edge labiaplasty, is superior to the wedge.
- The wedge labiaplasty can split causing a gap in the labia minora,
- The wedge labiaplasty does not remove the dark pigment or rough edge of the labia minora, and
- The wedge labiaplasty does not remove enough tissue in many cases.
For these reasons, the best technique in my experience is the modified edge labiaplasty. Compared to the wedge, the modified edge labiaplasty:
- Allows removal of the rough edge and dark pigmentation
- Allows a more even removal of the labia minora
- Heals beautifully!
How the Consultation Works
Let's face it: Vaginal examinations are awkward. That's the facts. Doctors visits aren't really fun, and GYN visits--as I am told--are not exactly a picnic. Here are the ways I make a labiaplasty exam NOT AS AWKWARD AS YOU THINK:
- I perform 2-4 labiaplasty exams every day and I'm a professional. Always.
- There is NO SPECULUM
- There is NO PAP SMEAR
- It is a LOOKING ONLY exam, guided by you with a mirror
- In fact, the only touching is with a Q-Tip
- The exam takes 5-10 seconds. Yes, seconds.
Your Period and Labiaplasty
There's no good time to have your period, as I am told. This is true in labiaplasty as in life. Many women are embarrassed by the idea of having their period at the time of medical examinations and procedures such as labiaplasty. From a medical perspective, it really doesn't matter. If you review my before and after labiaplasty photos, you will notice more than one woman wearing a tampon in the before OR after photo. It may be uncomfortable to you, but to me it's a regular day and a regular part of examining my female patients. Since you're going to have your period at some point during your care with us, it is best to just schedule your consult, procedure, and follow-ups based on life. This process can be stressful, and there's no need to add to that by working around your period. But of course, whatever makes you feel the most comfortable is the right answer!
Having your period doesn't need to interfere with labiaplasty or follow up visits.
Shaving and Labiaplasty
Similarly, some women feel uncomfortable with the idea of not shaving after their labiaplasty, or of being examined in follow up without having shaved. Again, it is highly irrelevant to me and to my nurse whether or not you have shaved. We don't notice. Promise. That said, in terms of the aftercare, we recommend against shaving for 6 weeks after labiaplasty. Trimming the pubic area, however, is recommend before surgery. Learn more about our pre-operative instructions HERE.
Please don't shave for 6 weeks after labiaplasty surgery to be safe.
Out of Town Patients
Out of town patients are about 1/3 of all of our labiaplasty patients. That means you're in good company, and we know exactly how to guide you through every step of the way. If you'd like to get things started, click HERE to set up a virtual consultation. Here you will get a chance to speak with me by phone and go over your concerns and goals for labiaplasty surgery. I will still meet you the day before your surgery, or the morning of, depending on your preference, where we can discuss things in more detail. We often request that our patients stay in town just one night after surgery to make sure that everything is OK before you travel. For general information on the out of town process, where to stay, and the location of our clinic, check HERE.
The PreOPP Visit
The pre-operative visit is a chance to go over your aftercare instructions, and to have any questions answered that you may have about labiaplasty. My clinical nurse, will also take photographs for our records. Please know that your privacy is hugely important to me and my staff. We don't save your name with your photographs EVER, and we NEVER post or share photos without your direct written and verbal approval. That includes on this very website, and of course on social media.
We use this infographic to go over the details of your care and the timeline of your labiaplasty healing, return to work, and other life highlights, including when you can have sex (6 weeks until intercourse please).
Type of Anesthesia: It's up to you
There are three options for anesthesia with a labiaplasty, and I offer them all:
- Local and topical anesthesia (numbing cream): You are awake
- Local and topical anesthesia with valium: You are a little sleepy
- Local and topical anesthesia with IV sedation ("twilight anesthesia"): You are asleep
This part is entirely up to you. Some women feel that they want to be awake for the entire process, perhaps because they are nervous about anesthesia. Other women want to be asleep for the entire process, perhaps because they are nervous about surgery! It's up to you, but either way, I will make sure you are comfortable. Many of the videos on my website, including the one above and the video HERE were performed wide awake under option 1. I am very gentle with the needle and thread!
The Day of your Labiaplasty
Depending on your choice of anesthesia, you will either drive yourself or take an Uber (option 1), or you will have a family member, friend or spouse accompany you (options 2 and 3). You'll arrive to our private surgery center, the same place where you had your consult, and we will put you in a gown. You'll have topical numbing cream applied, as well as a urine pregnancy test. From there, we'll give you some oral medications or an IV if you're having twilight anesthesia for your labiaplasty. We will handle the rest! The surgery takes about 1.5 hours, and adding another half an hour of recovery, you'll be on your way!
A Step-by-Step Guide to the Labiaplasty Procedure
The most critical aspect of the labiaplasty is being gentle. That's it. Gentleness to tissues. Because I have a very delicate touch, you'll see that there is very little swelling and bruising during the procedure.
Step by step in photos
To get a sense of how little bleeding there is during my labiaplasty procedure...
One side complete, including labia and hood reduction. Notice how little bleeding there is in the surgical field, and how delicate the internal suture work is for this labiaplasty.
Before and after labiaplasty, healed at 3 weeks #postOPP
How much tissue should be removed during a labiaplasty? The right amount!
Watch another expert labiaplasty by Dr. Oppenheimer
The Labiaplasty Recovery
While it seems hard to believe, there's really only one tough day in the labiaplasty recovery: the first night. We often hear from patients that once the numbing medicine wears off, approximately 3-6 hours after the surgery, there is a stinging, throbbing or burning pain. Much like a burn on the roof of your mouth, or a bite on the inside of your cheek, this can be a miserable feeling. ICE IS THE KEY. Icing the area with our ice packs is the best way to provide both analgesia (pain relief) as well as swelling reduction (which in turn will also decrease pain).
More transparency from me: the labiaplasty recovery in photos from 2 days to 2 weeks to 2 months #postOPP.
Ice, Ice, Ice.
Each of my patients gets these ice packs after their labiaplasty procedure.
We are on call 24/7 for you
In over 200 labiaplasty surgeries, I've had only one emergency which was a hematoma: that's bleeding into the incision. While stressful for the patient, it was a very quick fix: we went right back into surgery and stopped the bleeding. The patient did great and had no adverse problems whatsoever. I'm along for the journey, not just the surgery. Every one of my patients gets a special "medic-alert" bracelet with our on call hotline number. My nurses will pick up the phone to answer. We are here for you!
Scars are invisible after labiaplasty
I use a 5-0 buried monocryl suture for my labiaplasty procedures. This is totally absorbable suture and there is no "baseball" stitching. This means that the scars are imperceptible. Like the inside of the mouth, the vagina doesn't scar in the same way as skin. The most you will see from your labiaplasty scar is a shiny area, and your partner will never be able to tell you had a labiaplasty performed.
Before and after labiaplasty with no visible scarring at 3 months #postOPP
Another close up view of the labiaplasty scar. Invisible.
Liberation Awaits.
Frequently Asked Questions about Labiaplasty
Is there any changes in sensation after labiaplasty? Will labiaplasty affect my sensation?
There are no changes in sensation after labiaplasty. In over 300 labiaplasty surgeries, I don't have a single patient who has numbness or trouble with orgasm after labiaplasty and clitoral hood reduction.
What causes large labia?
Hormones are responsible for large labia, particularly estrogen at the time of puberty. Pregnancy and childbirth can also cause enlargement and elongation of the labia minora.
Do i need to have anesthesia for a labiaplasty?
The vast majority of my patients have labiaplasty under local anesthesia only. That means they can drive themselves to and from the labiaplasty surgery. For patients who are nervous about being awake for the surgery, IV sedation with my anesthesiologist can be arranged and a driver/chaperone is required.
How long is the labiaplasty recovery?
The labiaplasty recovery takes about 3 days, but there is swelling for a week after labiaplasty. At 3 weeks exercise can resume, and intercourse is allowed 6 weeks after labiaplasty surgery.
Does a labiaplasty hurt?
A labiaplasty hurts only when the local anesthesia is injected at the very very beginning, almost like the feeling of a tattoo but just for an instant. Once the first droplet of local anesthesia is infiltrated, the rest of the injections don't hurt at all.
Which technique is better? edge or wedge labiaplasty?
The edge labiaplasty is superior in every way to the wedge. The edge labiaplasty heals faster, has a smooth edge, and removes the darker pigments of the labia minora. For a deeper discussion of wedge labiaplasty, click HERE.
Are there visible scars after labiaplasty?
There are no visible scars after a labiaplasty. The mucosa of the labia minora heal much like the inside of the mouth: a smooth and slightly shiny surface will be barely visible and there is no scar, so no one will know you had a labiaplasty.
What is the cost of labiaplasty?
All of our surgery prices are published HERE on our pricing page.
