Labiaplasty surgery has been described online and in the media in fantastic terms both positive and negative. Many women’s sites warn of poor outcomes, pain and problems. On plastic surgery practice sites, it is described in glowing terms. Both of these extremes are not realistic. The problem is that the operation varies substantially with the technique used and its implementation. Done properly and in the right patient labiaplasty can be a rewarding endeavor.
The most common (and lowest risk) procedure in the group of operations called “labiaplasty” is the Labia minora reduction. This amounts to reduction of the size of the inner lips of the vagina. The very mention of the operation frequently sends liberal female types into a rage with cries of misogynist! Despite the fact that these women would have you believe that the operation is some manifestation of male subjugation of women, women looking into the surgery in practice are much more often motivated by internal concerns.
Amongst the common complaints of prospective surgical candidates are:
(1) The size of their Labia minorae is the cause of embarrassment and/or discomfort.
(2) The lips themselves interfere with sexual activity.
(3) The lips are misshapen or uneven.
These are relative designations of course. The truth is that the variation in the size and shape of the normal Labia minorae vary substantially. Women with larger labiaae are not abnormal although in comparing the size of their vaginal lips with those of other women (made painfully easy on the internet these days) some may feel so.
Surgery to improve these issues can be performed many ways but the two most common have been named the “Trim” and the “Wedge.” Each of these operations varies a bit by the surgeon performing it, but some generalizations can be made.
Trim surgery is simple. It involves simply cutting away the excess lip tissue and stitching the wounds closed. While this seems “direct and to the point,” there are some distinct disadvantages to doing things this way. The pain experienced by patients who have this form of surgery is more intense and longstanding than those done by other techniques. This pain can interfere with the return to sexual activity. This fact might tempt you to give credence to the cries of the anti-labiaplasty crowd; that is if this was the only way to accomplish the operation. It isn’t.
The Wedge technique offers a variation on the theme that does not come with the same pain problems as the Trim procedure. The basic technique involves removal of a portion of the labia minora at a different angle. The closure leaves the majority of the lip that remains looking natural and untouched. The operation is a bit harder to learn and is much easier to perform under more than local anesthesia, but is in my experience a better procedure with fewer risks. Patients operated in this fashion have had much improved outcomes relative to those operated using the Trim in years gone by.
Labiaplasty surgery may include other specific operations. As these procedures are not standard it makes sense to ask your prospective surgeon exactly what he or she has in mind and his or her experience with it. Investigate here before you proceed.
John Di Saia MD is a board certified plastic surgeon practicing in Orange County California. His blog CosmeticSurgeryTruth.com features more editorial on procedures like labiaplasty and his practice site OcBody.com provides information for potential patients.