Guide to Labiaplasty Surgery
What Is A Labiaplasty
It describes any surgery that is carried out on the exterior female genital region, or the labia. The most common labia surgery consists of:
- labia majora reduction or
- labia minora reduction
As you can guess by the names of these procedures, the surgery involves reducing the amount of tissue in either the labia majora or labia minora. The labia majora are the pair of outer lips, while the labia minora are the inner lips.
Other types of labial surgery include augmenting the size of either the labia minora or labia majora, modifying pigmentation, or removing folds and bulges.
Why do women request labia surgery?
The most common reason women give for requesting the procedure is that they are unhappy with the appearance of their vulva. In this sense, the procedure is almost always for cosmetic reasons.
Women with enlarged or elongated labia may feel very conscious when wearing tight clothing or swimwear, as the outline of the labia may be visible through the clothing. Enlarged labia may also cause women to feel self-conscious during intimate contact.
Labia majora is the Latin, medical name for the outer lips, while doctors refer to the inner lips as the labia minora. Unfortunately, the English language version of the names as commonly used is a rather loose translation, and gives rise to a common misconception. The English translation refers to the position of the pairs of labia relative to the vaginal entrance, and not to each other.
Many women believe that there is something wrong with them if their inner lips protrude beyond the outer lips, because they wrongly believe that inner labia should be inside outer labia. In fact, there is no medical definition of which of the pairs of the labia should overlap the other.
Some women find that enlarged labia make it more difficult to maintain personal hygiene, and this can lead to constant irritation, and they request labial reduction surgery to deal with this issue.
A small percentage of women may request the procedure because they experience discomfort in the area, and their doctor has suggested that the discomfort could be due to enlarged labia majora or enlarged labia minora. The discomfort may be experienced when undertaking specific activities such as:
- walking for prolonged periods
- horse riding
- during sexual intercourse
Some women with thick labia may also feel physically uncomfortable when wearing certain types of clothing, such as thongs, bikinis, or tight pants.
What causes large labia or long labia?
The primary cause is simply down to genetics. Some women will naturally have enlarged or elongated labia. As a woman ages, she will lose muscle and skin tone, and some women may notice that their labia become elongated as a result.
A woman may also undergo physical changes to the labia during pregnancy and/or childbirth. Less frequently, the labia may undergo changes in size or shape due to trauma related to some type of accident. Find out more about labia size.
How do I choose the best labia reduction surgeon or clinic?
The best possible way to ensure you are dealing with a good labia plastic surgeon is to ask for references. Your surgeon will be pleased to provide these for you, and you should then take the time to personally check out those references.
When you speak to women who have had the surgery done, ask them how happy they are with the results, and with the service they received. Good service includes paying attention to the patient’s needs at all times, making the patient feel as comfortable and relaxed as possible, and being ready and willing to deal with any questions or anxieties a patient has.
If possible, choose a surgery or clinic that is located reasonably close to you. It is best if you do not have too far to travel home after the procedure.
How do I arrange labia surgery?
The first step is to arrange a consultation with a plastic surgeon or gynecologist. The physician will examine your vulva, and will discuss your reasons for wanting the procedure. He or she will be able to advise you on what can be done. Many surgeons will offer this initial consultation free of charge.
The physician will normally carry out some tests to examine your overall state of health, although some surgeons will do this only after you have decided to go ahead with the surgery. Your vital signs will be checked and recorded, as well as information about any allergies or other current medical conditions. Your medical history will be taken.
An important part of this process is discussing your expectations of what your genital area will look like following the surgery. If your expectations are unrealistic, your doctor will point this out to you.
Your doctor will also give you a full description of the procedure, how it will be performed, and what you need to do to prepare for the surgery. He or she will usually use diagrams to explain exactly how the procedure will be carried out, and whether laser tools will be used during the procedure. He or she will also inform you of the risks associated with the procedure.
The physician will show you before and after photos of previous patients who have had similar procedures done, and this will give you a much clearer idea of what you can expect if you go ahead with the procedure.
You will usually be given literature or an information pack to help you decide if this is the best option for you. When you decide to go ahead with the procedure, you will need to make a new appointment. Most clinics will require you to pay the full fee before surgery commences.
Before and After Labiaplasty
Here is a small selection of images showing before and after labia cosmetic surgeries.
As this is an informational site we do not perform procedures ourselves and as such would be grateful of any images sent by patients that have been through the procedure. If you feel this is something you could help with please email firstname.lastname@example.org to discuss further.
Time period prior to the procedure
Your surgery will issue you with prescriptions for anesthetic cream to be used prior to the labia surgery, cream to be used afterwards to aid recovery, and prescriptions for painkillers and antibiotics. You should purchase these and have them in your medicine cabinet before you come in for your operation.
You will have been told how to apply the anesthetic cream, and will probably be advised to get a Saran wrap to cover the area once you have applied the cream. As with any surgical procedure, your recovery time will be shorter if you are in good physical condition.
In addition, the results of a procedure can be improved when the recipient’s muscles are well toned. You could use the period leading up to the procedure to improve your physical condition by taking regular exercise. Likewise, if you are overweight, you might want to try to lose some of the excess.
The day of the procedure
You will have been informed of the time at which you need to be at the clinic or surgery. You may have been prescribed some anesthetic cream to apply to your genital area after you have taken your morning shower.
Apply this as instructed, and then apply a Saran wrap to keep the cream in place.
Make sure you set off in plenty of time, allowing for things like distance, traffic and possible breakdowns. You want to be as relaxed as possible when you arrive at the clinic or surgery. Being pressed for time is one way to ensure that your anxiety levels will be raised.
Be aware that you will not be able to drive yourself home after the surgery, so you will have to arrange some other form of transport, or have another person with you who can drive you home.
If you do bring another driver, you should let that driver do the driving on the way to the clinic or surgery, as this will keep you more relaxed.
You must not eat any food or drink any liquids for at least 8 hours prior to your scheduled procedure time, and it is important to adhere to this restriction.
When you arrive at your clinic or surgery, you will be taken to a private room.
Members of the clinic’s staff will do their best to put you at ease, and to answer any questions you may have. They will ask you to confirm that you have not eaten, they will do a pregnancy test, and they will check your general health signs, including your pulse and your blood pressure. They will also check that your bladder is empty.
Prior to the commencement of the actual procedure, your surgeon will have another chat with you explaining the entire process to you. He or she will advise you once again of the options you have, the benefits you can expect, and the risks involved.
You will be asked to sign a consent form. Some clinics will give you the consent form in advance, while others will present it once you check in for the procedure.
If you have not seen the consent form in advance, take a few minutes to read it. If you have any questions related to the consent form, ask your surgeon.
Most surgeons will want to take photographs of your vulva before the procedure begins. They do this for their own records, but it is also a useful aid to you, as you will be easily able to note the difference to your genital area in the labia surgery before and after photographs.
At some stage prior to the commencement of your operation, you will be given a drug such as Valium to reduce your anxiety level and make you more relaxed. This may be administered orally or, less commonly, via an injection.
When the procedure is about to commence, you will be given medication to reduce the production of saliva, to prevent nausea, to reduce the risk of cramps, and to reduce pain.
Some of these drugs are administered by injections. Some surgeons may want to use an intravenous drip, while others are happy to proceed without one. Your surgeon will tell you if he or she will be inserting a drip.
The procedure room
You will then be taken to the room where the procedure is to be performed and will be connected up to various monitors. The medical staff will check to see the effectiveness of the various medications you have been given. You should be feeling a little woozy, like you would after a drink or two.
If you are still completely alert, you may be given a further injection of narcotic painkiller. Once your doctor is satisfied that the drugs have taken effect, he or she will be ready to begin.
The first step is for the surgeon to use colored markers to sketch out the surgical plan on your vulva. The initial sketch marks will be based on your previous discussions with your surgeon.
In those discussions, you will have agreed on the amount of reduction required. Before the surgery commences, your surgeon will let you see the colored marks, either via a handheld mirror or a closed circuit TV screen.
You can then finalize how much work will be done. Do not be afraid to request changes.
You will be encouraged to relax, and to take your mind off what is happening. Your surgery may have live TV, or you may be encouraged to bring your own entertainment, such as your own music player. You can also bring a book or a magazine.
Once you have agreed on the final surgical sketch, your surgeon will place a covering screen over your abdominal area to improve sterility in the region. He or she will then sterilize the genital area with a sterilizing fluid such as betidine.
Commencement of the procedure
Your doctor will now deliver local anesthetic to the areas to be worked on.
This is often the most uncomfortable part of the operation.
The local anesthetic has to be injected, and despite the narcotic pain killer previously administered, and the anesthetic cream previously applied, there will be some pain as the needle penetrates. Fortunately, the administration of the local anesthetic is over very quickly.
Your surgeon will make sure that the areas to be worked on are completely numb before commencing the actual surgery. Your surgeon may decide to use laser tools, or may use traditional tools (he or she will have told you beforehand what method is to be used) to remove the excess tissue.
He or she will excise the tissue based on the colored markings placed before the procedure begins. When the surgery is completed, your doctor will stitch up the wounds.
Your doctor will then clean up the surgical area before removing the sterile drape and letting you see the results. Most doctors will request your permission to take more photos of the completed surgery.
Immediately after the surgery, you can return to your private room and get dressed. The medical staff will take you through the post-operative care procedures and recommendations again, and you are free to go.
Because your procedure required the administration of narcotic and anti-anxiety drugs, you cannot drive until the following day. If you drive on the same day you have the procedure, you run the risk of being arrested on a DUI charge.
In the hours immediately after the surgery, you should not feel any pain or discomfort. As the anesthetic begins to wear off, and as your body breaks down the administered drugs, you will begin to feel some pain and discomfort.
The amount of pain and discomfort felt varies from individual to individual and on the extent of the surgery.
You will have been given a plan for post-operative pain management, and you should stick with that, including taking painkillers as prescribed. You will probably be given a 24-hour telephone number to call if you experience excessive pain or other problems, such as wounds reopening.
Every form of surgery is prone to complications arising, and labia surgery is no exception, although serious complications are extremely rare. Your surgeon will talk you through the risks during the consultation process. Complications that can arise include:
- excessive bleeding during or after the surgery
- development of hematoma (clotting) that needs to be removed
- asymmetry (where one of the labia is a different size to its partner)
- chronic pain
- reopening of the wounds
It can take several months for complete recovery from labial surgery. The actual length of time for labia surgery recovery will depend on the individual, on how extensive the labial procedure was, and on how well the patient follows post-operative care instructions.
Your surgeon will give you a detailed list of instructions to ensure your recovery is as quick and comfortable as possible. You should follow these instructions precisely, and not be tempted to skip some measures, or introduce your own strategies.
You may find your recovery instructions include some or all of the following advice:
- Immediately after the surgery, prolonged rest is recommended. You should definitely avoid any physical strain.
- Your surgeon may instruct you on how to use ice to help reduce swelling and pain.
- You will need to attend to the wounds, and clean them according to your doctor’s instructions.
- Finish any antibiotic course you have been put on.
- Do not try to avoid taking the amount of painkillers your doctor has recommended. Stick to the recommended dosage. Do not worry about becoming dependant on painkillers.
- When traveling away from home, bring a small cushion with you so you can always sit comfortably.
- Wear loose and comfortable clothing, including loose underwear. Avoid wearing bikini or thong style underwear, as these can irritate the wounds.
- Use sanitary napkins instead of tampons when menstruating.
- Take a daily sitz bath. This helps keep the wounds clean, and is often helpful in reducing pain and discomfort.
- Do not take hot baths, and avoid excessive heat.
- It is normal to have discharges after labia reduction surgery, and you should follow instructions for cleaning these up.
- If you feel uncomfortable while excreting, take a stool softener to ease the strain.
Average recovery time
The actual recovery time will vary from one individual to the next, but most people will go through the recovery stages in pretty much the same time frames as referenced in this list.
- Your pain should start to ease off after the first week, and should be gone completely within four weeks.
- Bruising and swelling will be most pronounced in the first two weeks, after which it will begin to disappear. It may take three months to completely disappear.
- You should avoid strenuous work or strenuous physical activities for the first four weeks. Follow your doctor’s advice after that period.
- You should not engage in penetrative sex or use tampons in the eight weeks following surgery.
1. How much does labiaplasty cost?
The cost of labia surgery will depend on several factors. These include:
- geographical location
- extent of surgery
- type of anesthetic used
For example, if you have labia reduction surgery carried out in the center of a major city, it is normally going to cost more than getting it down in a smaller town. This is simply because the surgery or clinic in a major city center will have higher overheads than a rural one.
Essentially the cost is comprised of three factors:
- surgeon’s fees
- anesthetic fees
- facility fees
If you get both labia minora surgery and labia majora surgery done at the same time, the total labiaplasty cost will be less that having labia reduction surgery done separately on the labia majora and minora, since you will only pay once for the anesthetic and facility.
If you obtain quotes from more than one clinic or surgery, make sure you are comparing like with like. Some clinics may quote for the surgery itself, and then add additional fees such as facility or drug costs. Others may include all costs in the quote.
While it is almost impossible to come up with an average cost for the procedure because of regional differences, you can normally expect to pay between $5,000 and $10,000 for a labia majora or labia minora reduction.
It is generally not practical to travel a long distance to have your surgery done. The local anesthetic will begin to wear off an hour or two after your surgery, and you will want to be able to rest completely at that stage. It is not advisable to have to make a long trip home immediately after surgery.
2. Will the price come down in the future?
This is quite complex to answer. Inflation pushes costs up, while improvements in technology and procedure, and greater demand reduce overheads. As a result, there has been little change in the cost of this surgery in recent years. Nevertheless, the overall trend is likely to be upward, so it is probably not advisable to delay having the procedure in the hope of saving some money.
3. Do I need to go to a hospital for the procedure?
Many specialist clinics are able to perform the operation in their surgeries, so it is not usually necessary to go to a hospital.
4. Does the procedure require an overnight stay?
Normally, there is no need for an overnight stay.
5. How long does the procedure take?
This generally depends on the amount of work the surgeon needs to carry out. The vast majority of procedures will take from 30 minutes up to two hours.
6. Do I need to have a general anesthetic?
The type of anesthetic used will be a matter for discussion between you and your surgeon. The procedure is normally carried out using only a local anesthetic. Sometimes, it may be carried out under epidural anesthesia, and, very occasionally, under general anesthesia.
7. Will I need to take time off work following the operation?
Although the operation is normally carried out under local anesthetic, you will experience some pain and discomfort in the days following the procedure. Additionally, you will have sutures in the genital region.
Therefore, it is recommended that you take some time off work to give your body the best chance to heal quickly. Recovery time varies from person to person, but most women feel fit enough to return to work after one week. If your work involves heavy lifting or is generally strenuous, we would recommend you take more time off.
8. Do I have to return for removal of stitches?
The stitches used are normally of the dissolving type, so there is no need to come back to have them removed.
9. Can I have penetrative sex immediately after the procedure?
We recommend abstaining from vaginal penetration for at least 6 weeks, and preferably eight weeks, following the procedure.
10. Are there any risks involved?
All surgery involves a certain degree of risk. A very small number of patients can have reactions to anesthetics or other medicines used, and there is always a risk of the surgical wound becoming infected. Your doctor will point out all the risks at your initial consultation and usually immediately before the operation.
11. Are there any after affects?
Most women make a full recovery with no after affects. A small number may experience ongoing pain or discomfort, and some will suffer from chronic pain or discomfort. A small number report a reduction in sensation.
12. Will the procedure affect my fertility?
No, the procedure will have no affect on your ability to have children. However, you should use contraception to avoid pregnancy before and after the procedure. Your surgeon will cancel your procedure if you are pregnant on the appointed day. After surgery, you should avoid giving birth for one year following the procedure.
This does not mean you should avoid pregnancy for just 3 months after having had the operation. That would be fine is you could guarantee a normal term. There is a risk that you could deliver a premature baby, or suffer a miscarriage. Either of these events could damage the work done during the procedure.
13. Will there be scarring?
There is usually evidence of scarring following surgical incisions. Your surgeon will try to make the incisions in the least conspicuous areas so that the scarring may be virtually invisible. Even visible scarring will tend to fade over time.
14. Is labia reduction surgery cost covered by insurance?
In most cases, it is viewed as a non-essential, elective procedure, and will not be covered under the terms of your health insurance. If you are suffering from detrimental health issues that could be fixed by labial surgery, then the procedure could be deemed a medical necessity coverable by insurance, although this is rare.
If you are having the procedure done for medical rather than cosmetic reasons, you can check with your medical insurance providers to see if they will pay some or all of the procedure fees.
15. Is labia surgery available to everybody?
This surgery is available to adult women who are in reasonably good health. Most gynecologists or plastic surgeons will not undertake the surgery on patients who have not yet fully matured. This is because labia that may appear enlarged in young teenagers will appear absolutely normal once the teenagers reach adulthood.
Because the surgery is most often an elective procedure, it is normally available only on a private basis. That means any woman considering the procedure must be able to afford the fees. Many labia surgeries offer financing packages, and you may be able to avail of this option provided your have no credit issues.
16. What is the difference between labiaplasty and vaginoplasty?
You may hear these two terms used interchangeably, but they are two totally different procedures, although they may be carried out at the same time. Labia reduction procedures are carried out on the external portion of the genitalia, and their primary function is to improve the visual appearance of the genital region.
Vaginoplasty is a procedure to tighten the vagina, especially around the opening. The vagina can become stretched and loose after giving birth, and this may reduce sexual enjoyment for a woman and her partner. Enjoyment can be restored surgical with a vaginoplasty or by natural tightening methods or a proven cream like V-Tight.