CloudHospital

Last updated date: 09-Mar-2024

Medically Reviewed By

Written by

Dr. Lujain Badea Ali

Originally Written in English

Labia majoraplasty

    Overview

    Labiaplasty is a surgical treatment used to reduce the size of the labia minora, which are the skin folds that surround the urethra and vagina. Excess skin can become twisted and squeezed during exercise, physical activities, and intercourse, producing pain. Labiaplasty is also performed for aesthetic purposes as well as as part of gender-affirming surgery.

    What is Labia Majoraplasty?

    Labiaplasty

    Labiaplasty is a surgical technique that may be used to either reduce or expand the size of your labia. The procedure is performed to improve the look of your labia, to alleviate physical pain, or as part of a gender-affirming procedure. Your labia are the skin folds that surround your vaginal entrance. You have two skin folds. The outer folds are known as the labia majora, which translates to "big lips." These are the bigger fleshy folds that shield your external genital organs after puberty and are covered with pubic hair. The inner folds are known as the labia minora, which translates to "little lips." These skin folds protect the openings of your urethra and vagina (where your urine exits your body).

    Depending on the reason for the labiaplasty, your surgeon will either remove some tissue from the labia to make it smaller ,to enlarge the labia, a filler material or fat is injected and rebuild a labia from other tissue.

     

    What are your goals for choosing a Labiaplasty?

    Choosing labiaplasty

    Reasons medical and physical

    • To make the labia minora smaller so that it does not protrude beyond the margins of the labia majora. Excess labial tissue can twist, spin, or be pinched or strained during exercise, physical activities (such as biking or jogging), and intercourse, causing physical discomfort and irritation.
    • To promote cleanliness and health because extra tissue makes washing more difficult and might contain germs that can cause urinary tract infections.

    Cosmetic and emotional considerations

    • To regain a more youthful appearance after childbearing or age.
    • When one side of the labia minora or labia majora is longer or formed differently than the other, asymmetry (uneven shape) is reduced.
    • To boost self-esteem and remove the appearance of visible lines, bulges, or "camel toes" when wearing body-conforming trousers or leggings. Tight-fitting clothes can also cause pain if there is extra labia tissue.
    • To increase your comfort, confidence, and sexual well-being when your genitalia show during personal contact.

    Gender confirmation surgery

    Labia can be generated from existing genital tissue if surgery is part of a gender-affirming process. Labiaplasty can be done before or after other reconstructive procedures.

     

    What causes an enlargement of the Labia?

    • Age. Menopause or other hormonal changes can cause the labia majora tissue to weaken, enabling the labia minora to protrude beyond the labia majora.
    • Childbirth and pregnancy
    • Weight fluctuations
    • Genetics.

     

    Considerations for Labia Majoraplasty surgery

    Labia majoraplasty surgery

    Before deciding on labia majoraplasty surgery, bear the following points in mind:

    • You should expect to have scars. Although the scars will diminish over time, they will always remain noticeable.
    • Labiaplasty does not shrink or tighten the vagina. This necessitates a separate procedure known as vaginoplasty.
    • Consider the financial strain. Cosmetic surgery is often not eligible for Medicare or private health insurance company reimbursements.
    • Smokers are more likely to have difficulties. If you intend to get cosmetic surgery, you should strive to quit smoking. 

     

    Medical concerns with Labia majoraplasty surgery

    Medical concerns

    Before surgery, you should talk to your doctor or surgeon about a variety of medical conditions, including:

    • Physical health- a checkup will assist your doctor or surgeon in determining whether or not the therapy is appropriate.
    • Medical history - certain pre-existing diseases and previous procedures may impact decisions concerning this surgery, including the type of anesthesia used.
    • Psychiatric history- some surgeons may recommend or require that you seek counseling before undergoing cosmetic genital surgery.
    • Risks and potential problems - It is critical that you understand the risks and potential issues so that you can decide whether cosmetic genital surgery is correct for you.
    • Preparations and supplements - inform the surgeon about any you take on a daily basis or have recently taken, including over-the-counter preparations like fish oils and vitamin supplements.
    • Previous pharmaceutical responses - inform the surgeon if you have ever had a negative reaction or side effect from any medicine, including anesthetic.
    • Preparation for surgery - Your surgeon will provide you with detailed instructions on how to prepare for surgery at home. For example, you may be advised to take a specific medication or to adjust the dose of an existing medication. Follow all instructions exactly.

     

    What happens on the surgery day?

    Surgery procedure

    You will change into a surgical gown once you arrive at your surgery location. Your vitals will be taken by a healthcare practitioner (temperature, pulse, blood pressure, oxygen level, breathing rate). You may be subjected to further blood tests and urinalysis. They will insert an intravenous (IV) line into your arm or hand, and they may insert an urine catheter into your urethra.

    Following that, your provider will wash your labia and the skin around them, as well as shave your pubic region if necessary. They will then begin anesthesia. Depending on the surgery, you may be given IV sedation with local anesthetic or general anesthesia. During the planning stage of your operation, your physician will explain which form of anesthetic is appropriate for you. Your practitioner will choose which surgical approach will be used based on how your labia (labia majora and/or labia minora) will be resized or altered. This surgery is often performed with a scalpel, scissors, or laser.

    Procedures for reducing your labia 

    There are two basic techniques of reducing your labia (labia minora and/or labia majora):

    • Trimming process :Your surgeon will remove extra tissue from the outside border of one or both sides of your labia minora so that it is level with or recedes from the margins of your labia majora.
    • The wedge procedure: Your surgeon will use this technique to remove a wedge or pie-shaped piece of tissue from the inner portions of one or both sides of your labia minora. They leave the submucosa intact so that the wrinkled edge of the labia stays intact when sewn (sutured). This keeps the labia minora looking more natural. Similarly, if you're undergoing surgery to minimize your labia majora, an inner piece of each labium can be removed.

    Depending on their surgical experience or the intended outcome, your surgeon may have alternative preferred procedures. You and your physician will collaborate to choose the surgical technique that will best suit your objectives and concerns. The trim method, in which excess tissue is excised and sewed up immediately, is the most common kind of labiaplasty. The wedge treatment, which keeps a natural border after removing a pie-shaped section of tissue, is the next most common. Extra clitoral hood folds can also be decreased at the same time. Absorbable sutures are often used to close wounds.

    Procedure for Enlarging 

    To expand your labia majora, your surgeon will extract a little quantity of fat from another part of your body, such as your belly or thighs (through liposuction) and inject it into your labia majora. Another approach is to inject hyaluronic acid into your labia majora.

    Gender confirmation surgery

    Your labia can be created using tissue from the penis. Labiaplasty is just one stage in the process of gender-affirming reconstructive surgery. In the operations described above, all wounds are closed using absorbable stitches (sutures) that disintegrate over time and do not need to be removed. Operative dressing has been applied to the surgical site.

    Labiaplasty is performed as an outpatient treatment. Labiaplasty usually takes less than two hours to complete. Gender-affirming surgery would take longer.

     

    What occurs following surgery?

    After surgery

    Your physician will remove your urine catheter (if you have one) after surgery, and you will become more conscious as the anesthetic wears off. You will be examined for bleeding. You will be given information on how to care for your wound while it heals before being discharged. Your physicians will also talk about pain management and educate you about activity limitations and follow-up consultations.

    You should expect bruising and swelling after the procedure, as well as probable numbness, soreness, and discomfort from wearing dressings or bandages.

     

    What are the risks and problems associated with Labia surgery?

    Risk of labia surgery

    Complications are uncommon; however, they can include:

    • Too much or too little tissue is removed.
    • Bruising (hematoma).
    • Infection.
    • Wound healing.
    • Ongoing discomfort, sex-related suffering, or loss of sensitivity
    • The dangers of general anesthesia include allergic reactions, which can be deadly (occasionally).
    • Surgical risks include bleeding or infection, as well as scarring that may be severe, elevated, reddish, and itchy unevenness 
    • The labia may not be symmetrical 
    • Irreversible color change to the labia, nerve damage to the labia , causing permanent loss of feeling, and impotence (inability to get or maintain an erection)
    • Further surgery to manage problems may be required if there is tissue death along the site or skin loss.

    This is not an exhaustive list. Your medical history, for example, or your way of living may place you at a higher risk of certain issues. More information is available from your surgeon.

     

    Is the healing period painful?

    Healing period

    You will have swelling, irritation, and pain, but these are normally manageable with over-the-counter medications such as acetaminophen or a restricted prescription medicine. If your discomfort is not properly controlled by the prescribed drugs, contact your surgeon. Home treatments, such as a cold compress or an icepack, might also be beneficial. To minimize discomfort and swelling, apply an ice pack to the operating region (on top of a fabric undergarment) on a 20-minute on/20-minute-off schedule. For a few days, most patients experience relatively minor discomfort or soreness.

    To avoid infection, you may be given an oral antibiotic prescription or a topical antibiotic to apply to your surgical incision. During the recovery time, wear loose-fitting jeans and underwear. Tight clothing or undergarments can produce friction on the wound, preventing or delaying healing. You may have mild bleeding for many days to a week. Wear a mini-pad to absorb any minor bleeding.

    The initial swelling, discomfort, and transient discoloration subside within a few weeks following surgery. After six weeks, the majority of the edema has subsided. However, it may take up to four to six months for the swelling to subside before you can see the ultimate effects of your labiaplasty. Scarring is frequently minimal to non-existent.

     

    Aftercare for Labia majoraplasty patients

    Aftercare for labia majoraplasty

    It is possible that recovery will take at least six weeks. Follow your surgeon's instructions, but here are some general self-care tips:

    • Follow all wound-care recommendations to the letter.
    • Wear penile weights as suggested for many weeks following phalloplasty.
    • For at least six weeks, refrain from having intercourse.
    • Any bleeding, significant pain, or odd symptoms should be reported to your surgeon.
    • Wash your wound with lukewarm water alone (no soap). After peeing, gently wipe or dab the area dry; do not massage the surgical area.
    • To avoid straining and perhaps stretching or breaking your sutures, your surgeon may prescribe medication or suggest a diet to reduce constipation.
    • Follow all post-op instructions from your provider for peeing and pooping, keeping your surgical area clean and free of bacteria, and allowing the surgical area to heal.

     

    When will I be able to resume job, physical exercise, and sexual activity?

    After a few days, you should be able to return to work and other mild activities. You may need to remain home longer if your work requires strenuous exercise or lifting. You should avoid the following for four to six weeks, or until your surgeon clears you:

    • Exercising vigorously.
    • Cycling, jogging, and swimming are examples of physical activity.
    • Intimacy sexual.
    • Returning to these activities too soon might put strain on the incision, rupture sutures, and cause recovery to be delayed.

     

    How long do Labiaplasty results last?

    labiaplasty results

    Labiaplasty usually results in shortened labia that no longer dangle below the hair-bearing labia majora. Most people who suffer from symptoms caused by twisting and straining of their labia find alleviation following surgery. Several studies have found that labiaplasty surgery has a high satisfaction rate of more than 90%.

    Labiaplasty as a reduction surgery is intended to be a one-time, long-term operation. You may never need this procedure again unless problems arise. Enhancement labiaplasty using fat or filler injections may require repeated "touch-ups" over time.

    If you decide to have children after your treatment, your labiaplasty may be damaged. Many people prefer to have their labiaplasty after they have completed their family.

    When should I consult with my surgeon?

    Consult with surgeon

    If you have any of the following symptoms, contact your surgeon's office:

    • Excessive edema or pain worsening
    • Increased bleeding with blood clots
    • Pus or discharge that is discolored.
    • When urinating or pooping, there is severe agony.
    • Fever.
    • The surgical site is now open.

     

    What questions should I ask of my surgeon?

    • Is surgery appropriate for me?
    • How long should I anticipate being out of commission?
    • How will the process be carried out?
    • What are the dangers and pitfalls?
    • What kind of outcomes might I expect, and how long will it take until I see them?
    • How long will the effects last?
    • What is the cost of the surgery?
    • Is insurance going to pay for the surgery?

     

    Conclusion 

    If the look of your labia bothers you, or if you have difficulty when wearing tight clothing, performing specific activities, or engaging in sexual intimacy, labiaplasty may be an option to explore. Labiaplasty is part of the surgical reconstructive procedure if you're having gender-affirming surgery. Talking about your genitalia might be awkward. Know that your surgeon is here to help you for whatever reason you are considering surgery. Do not be afraid to express your objectives and concerns with your surgeon. Your surgeon will listen to you, explain the operation in detail, tell you what results to expect, and answer all of your questions. People who have had labiaplasty express increased self-confidence in their looks, a more comfortable active and sexual life, as well as an overall improvement in their life quality