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VULVAPLASTY

REPAIR OF LABIA AND VULVA

One of the least talked about areas of cosmetic plastic surgery is reconstruction of the external genitalia after childbirth. 

It is common for the labia to be larger, more loose and darker than before you were pregnant. During delivery, tearing and stretching of the genitalia may occur resulting in an abnormal or unattractive appearance. Sometimes an episiotomy is performed which heals poorly, distorting the vaginal entrance. Many woman have not had children and for them it is simply the result of asymmetrical, or excessive growth.

There are significant differences in the appearance of the labia in different ethnic groups and at different ages. Between 30 and 40 significant aging changes occur, especially in women who have children.

Many women request labial rejuvenation, or external vaginal cosmetic surgery, despite not having children. For them, the most common reason for requesting labioplasty is to get an improvement in appearance. One in seven women feel that the appearance of their labia is abnormal.

Almost as common is a functional problem, such as irritation when riding a bicycle or horse. Soreness or pain during intercourse or sexual activity is another common reason to request a labioplasty. Rarely surgery is needed for reasons for hygiene.

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By increasing their self-confidence labia surgery may enhance sexual satisfaction for some women. However, if emotional issues exist that affect sexual pleasure, these need to be addressed separately and female surgery may not the answer.. The so-called camel toe appearance that bothers some women may, or may not, be changed by surgery.  Indeed some women seek labioplasty to create the camel-toe appearance.   It is caused by fullness in the labia majora, and surgery on the inner labia, or minora, will not usually change this area.

pictures of labiaplasty

The resultant scar and stretching may make an already difficult problem even worse. Many women complain of pain during sex or sexual intercourse, an unattractive appearance and considerable discomfort and inconveniece during activities like jogging or riding.  

Surgical correction depends on accurate diagnosis of the problem. After evaluation the plastic surgeon can give an assessment of the type of surgery needed. In many cases revision of a contracted scar is enough but each case is very different and correction is not easy. In many cases a labioplasty or labiaplasty corrects the problem by removing excess tissue restoring a more normal appearance. As with much in medicine the decision may rest on what method provides the most benefit with the least complications.

Surgery of the clitoral hood, or female foreskin, is unusual but  is sometimes performed for hygiene reason when adhesions cause the collection of smegma behind the hood. Genital hygiene in men also involves cleaning the folds of skin around the head of the penis called the prepuce.

The labia can be so long that they will cross over each other. This makes any exercise including riding, jogging or even sexual intercourse uncomfortable.

Patients who have pain in scars after delivery may gain some relieve when the scars are released. However in patients who have deep neuromas, or scar tissue around nerve endings, the pain will persist after surgery.

All genital surgery has risks, and when performed for purely cosmetic reasons may raise important questions regarding social attitudes about sex and our bodies. Still most woman are pleased with the outcome and are satisfied with the results of labiaplasty.

It is important to remember that no surgeon can give a guarantee about the final outcome, including appearance, shape, size and so on.  You should have a realistic attitude about the outcome, and remember that all surgery has good and bad aspects. That there is no such thing as ‘perfect surgery’. 

The satisfaction rate for cosmetic surgery is around 90%,  and although a satisfactory outcome is anticipated this means that 10% of people do not achieve the result that either the patient or the surgeon would like.  

If things do not go well, you may need revision or secondary surgery. Although many surgeons do not charge for this, there is often a charge for anesthesia and operating room costs.

Outsmarting Mother Nature: A Woman's Complete Guide to Plastic Surgery

Iliana E. Sweis MD FACS

Alternative names:  labiaplasty, labioplasty, genitoplasty, designer vagina, vulvarplasty, vulvaplasty, vaginal entrance surgery, camel-toe, camel toe, labia minora cosmetic surgery.