What is labiaplasty?
Labiaplasty is a surgical procedure to reduce or increase the size of your labia. The surgery is done to improve the appearance of your labia, to reduce physical discomfort or as part of gender-affirming surgery.
Your labia are the folds of skin around your vagina opening. You have two folds of skin. The outer folds are called the labia majora, which means large lips. These folds are the larger fleshy folds that protect your external genital organs and are covered with pubic hair after puberty. The inner folds are called the labia minora, which means small lips. These skin folds protect the opening of your urethra (where your pee leaves your body) and vagina.
During a labiaplasty and depending on why it’s being done, your surgeon either:
- Removes some tissue from the labia to reduce its size.
- Injects a filler material or fat into the labia to enlarge it.
- Reconstructs a labia from other tissue.
What are the reasons for wanting a labiaplasty?
Medical and physical reasons
- To reduce the size of labia minora so it doesn’t protrude beyond the edges of the labia majora. Excess labial tissue can twist, turn, or get pinched or tugged, and cause physical discomfort and irritation during exercise, physical activities (such as bike riding or jogging) and intercourse.
- To improve hygiene and health since excess tissue can make cleansing more difficult and can harbor bacteria that can lead to the development of urinary tract infections.
Cosmetic and emotional reasons
- To restore a more youthful look after childbirth or aging.
- To reduce asymmetry (uneven shape) of the labia minora or labia majora when one side is longer or shaped differently than the other.
- To increase self-confidence and eliminate the visual lines, bulges or “camel toe” appearance when wearing body-conforming pants or leggings. Tight-fitting clothing can also cause physical discomfort if there’s excess labia tissue.
- To improve comfort, confidence and sexual well-being about the appearance of your genitalia during intimate contact.
Gender-affirming surgery
If surgery is part of a gender-affirming process, labia can be created using existing genital tissue. Labiaplasty may be performed before or after other reconstruction surgeries.
What causes a labia to become oversized?
- Age. Menopause or other hormonal changes can thin the tissue of the labia majora, allowing the labia minora to protrude beyond the labia majora.
- Pregnancy and childbirth.
- Changes in your weight.
- Genetics.
What happens before surgery?
First, you and your surgeon will discuss the reasons why you want to undergo labiaplasty. You’ll discuss your expectations and goals as well as the risks of the surgery. You may undergo a psychological exam including being asked about depression and anxiety.
Next, your surgeon will explain the details of your surgery, including where incisions will be made and what to expect regarding changes to the size and shape of your labia.
You may undergo some presurgical tests including blood work, urinalysis and chest X-ray. You’ll be given instructions about what to wear to your procedure, when to stop food and drink, when to adjust or temporarily stop certain medications and other information on how to prepare for your surgery.
What happens on the day of surgery?
After you arrive at your surgical location, you will change into a surgical gown. A healthcare provider will take your vitals (temperature, pulse, blood pressure, oxygen level, breathing rate). You may have some blood work and urinalysis done again. They'll place an intravenous line (IV) in your arm or hand and they may place a urinary catheter in your urethra.
Next, your provider will cleanse your labia and the skin around it and shave your pubic area if needed. Then, they'll start anesthesia. You may have IV sedation with local anesthesia or general anesthesia depending on the procedure you're having. Your provider will discuss which type of anesthesia is best for you during the planning stage of your surgery.
Your provider chooses which surgical technique according to how your labia (labia majora and/or labia minora) will be resized or reshaped. They usually perform this surgery with a scalpel, scissors or laser.
Reduction procedures
To reduce your labia (labia minora and/or labia majora), there are two general approaches:
- Trim procedure. With this approach, your surgeon removes excess tissue from the outer edge of one or both sides of your labia minora so that it’s even with or receded from the edges of your labia majora.
- Wedge procedure. With this approach, your surgeon removes a wedge or pie-shaped piece of tissue from the inner areas of one or both sides of your labia minora. They leave the submucosa intact so that when the labia is stitched (sutured), the wrinkled edge of the labia remains intact. This retains a more natural look for the labia minora. Similarly, an inner portion of each labium of your labia majora can also be removed if you’re having surgery to reduce the labia majora.
Your surgeon may have other preferred approaches depending on their surgical expertise or your desired result. You and your surgeon will work together to choose the surgical approach that will best meet your goals and concerns.
Enlarging procedure
- To enlarge your labia majora, your surgeon takes a small amount of fat from another body area, such as your abdomen or thigh (in a liposuction procedure) and injects it into your labia majora. Injecting hyaluronic acid into your labia majora is an alternative option.
Gender-affirming surgery
- Tissue from the penis can be used to create your labia. Labiaplasty is one step in the entire gender-affirming reconstructive surgery process.
All incisions in the procedures described above are closed with absorbable stitches (sutures) that dissolve over time and don’t need to be removed. Your surgical site is covered with surgical dressing.
How long does labiaplasty take?
Labiaplasty is an outpatient procedure. Labiaplasty typically takes less than two hours. Gender-affirming surgery would require more time.
What happens after surgery?
After surgery, your provider removes your urinary catheter (if you have one) and you’ll become more alert as the anesthesia wears off. You’ll be checked for bleeding. Before being discharged, you’ll be given instructions about how to care for your wound while it heals. Your providers will also discuss pain control and give you information about activity restrictions and follow-up appointments.
Is the recovery painful?
You will have some swelling, discomfort and pain, but it’s usually easy to manage with over-the-counter medication, such as acetaminophen (Tylenol®), or a limited prescription medication. If your discomfort is not well controlled with the recommended medications, be sure to contact your surgeon. Home remedies, such as a cold compress or icepack, are helpful too. Apply an ice pack to the operative area (on top of a cloth undergarment) on a 20 minutes on/20 minutes off schedule to reduce pain and swelling. Most people report only mild pain or tenderness for a few days.
You may be given an oral antibiotic prescription or topical antibiotic to apply to your surgical wound to prevent infection.
Wear loose-fitting pants and undergarments during the healing period. Tight-fitting clothes or undergarments can cause friction against the wound and prevent or delay healing.
Will there be much bleeding?
You may have some bleeding for days up to a week or so. You can wear a mini-pad to absorb this minor bleeding.
When will results be at their very best?
The initial swelling, soreness and temporary discoloration decrease over the first couple of weeks after surgery. Most swelling is gone after six weeks. However, it may take up to four to six months of healing time for swelling to completely go away before seeing the final results of your labiaplasty. There’s usually little to no scarring.
How do I wash my labia area?
Use lukewarm water only (no soap) to wash your wound. Gently wipe or dab the area dry after peeing; don’t rub the surgical area.
Your surgeon may have you take medication or recommend a diet to prevent constipation so that you do not strain, which could stretch or break your stitches.
Follow all your provider’s post-op instructions for peeing and pooping, for keeping your surgical area clean and free from bacteria, and allowing the surgical area to heal.
When can I return to work, physical activity and sexual activity?
You should be able to return to work and other light activities after a few days. If your job involves physical activity or lifting, you may need to stay home longer. You should avoid the following for four to six weeks or until cleared by your surgeon:
- Strenuous exercise.
- Physical activities such as cycling, running and swimming.
- Sexual intimacy.
Returning to these activities too soon can put pressure on the wound, tear stitches and delay healing.
How long do the results of labiaplasty last?
Labiaplasty performed as a reduction surgery is meant to be a one-time, long-lasting procedure. Unless complications develop, you may never need this surgery again. Enhancement labiaplasty with injections of fat or fillers may need additional “touch-ups” over time.
You should know that if you choose to have children after your procedure, your labiaplasty may be affected. Many people choose to wait to have their labiaplasty until after they’ve completed their families.
When should I call my surgeon?
Call your surgeon’s office if you experience:
- Excessive swelling or worsening pain.
- Increased bleeding, seeing clumps of blood.
- Discolored pus or discharge.
- Severe pain when peeing or pooping.
- Fever.
- Opening of the surgical site.
What questions should I ask my surgeon?
- Am I a good candidate for surgery?
- What recovery time should I expect?
- How will the procedure be performed?
- What are the risks and complications?
- What results should I expect and how long before I fully see them?
- How long do the results last?
- How much does the surgery cost?
- Is the surgery covered by insurance?
A note from Cleveland Clinic
If you’re bothered by the appearance of your labia or experience discomfort when wearing tight clothing, performing certain exercises or engaged in sexual intimacy, labiaplasty could be an option to consider. If you're undergoing gender-affirming surgery, labiaplasty is part of the surgical reconstruction process.
Talking about your genitalia can be uncomfortable. Know that your surgeon is here to support you for all reasons you might be considering such surgery. Don’t hesitate to discuss your goals and concerns with your surgeon. Your surgeon will listen to you, provide extensive details about how the procedure will be performed, what results to expect and answer all of your questions. People who have had labiaplasty report improved self-confidence in their appearance, a more comfortable active life and sex life and an overall increase in the quality of their life.