Labiaplasty: everything you need to know

Labiaplasty surgery is something you may have heard of, but you may lack information about what it actually is. Leading consultant plastic, reconstructive and hand surgeon Mr Alexander Armstrong explains everything you need to know about the surgery, including the different treatment options available.

What is labiaplasty surgery?

Labiaplasty aims to reduce the size of the labia minora – the mucosal flaps of skin at the vaginal opening.

Why have labiaplasty?

Some women request a labiaplasty because they have symptoms associated with an increased size of their labia. These symptoms can include discomfort of the labia when riding a bike or during intercourse, itching, irritation, and self-consciousness.

Before undergoing surgery, it is vitally important that patients gather information and ensure that a labiaplasty is right for them. Psychological support and managing symptoms by simple means may be more appropriate than surgery.

Ideally, your weight should be normal before the surgery and you should avoid smoking.

A labiaplasty performed can make a significant difference to symptoms, quality of life, and confidence for those who require it.

What will happen before my operation?

Before the operation, you will meet your specialist surgeon to talk about why you want surgery and what you want. They will make a note of any illnesses you have or have had in the past and also make a record of any medication you are on, including herbal remedies and medicines that are not prescribed by your doctor.

After this, they will examine you. They will ask you if you want to have someone with you during the examination and ask you to sign a consent form for taking, storing, and using the photographs.

If you are overweight, your surgeon may suggest delaying your operation to reduce risks and you may also be asked to cut back or quit smoking (including vaping), if possible.

How is the surgery performed?

There are several techniques for reducing the labia minora, and all these techniques have certain advantages and disadvantages. The most appropriate for your needs will be discussed with you. Below are common techniques used:

Wedge procedure

A wedge is removed from the thickest part of the labia minora. The submucosa (layer tissue beneath a mucous membrane) must be left intact by removing only a partial thickness. This procedure gives the vagina a natural look after the surgery, as well as preserving the wrinkled edges.

Trim procedure

In this procedure, the excess part of the labia minora is removed and sutured so that it is symmetrical with the labia majora.

Anaesthesia for a labiaplasty

Labiaplasty can be performed as a day-case procedure. The procedure takes about an hour. It can be performed under local anaesthesia, sedation, or general anaesthesia depending on the surgical plan and your preferences.

Sutures

The stitches used are dissolvable, and will flake away over days and weeks.

Dressings

This is a tricky area to dress so will likely not require dressings, or a Vaseline-based ointment.

How can I help my operation be a success?

It is advisable to be as healthy as possible before undergoing the operation. It is important to keep your weight steady with a good diet and regular exercise.

If you smoke, stopping at least six weeks before the operation will help to reduce the risk of complications.

What to expect after the operation

Labiaplasty surgery is carried out under a general anaesthetic or under local anaesthesia depending on your needs. The operation usually takes about one hour and is performed as a day-case procedure.

When you wake up from your operation, you may have a drip to give you fluid while you are not drinking. You will be given antibiotics during surgery, and a course of antibiotics will be given to keep the wound clean. Your labia will feel swollen and sore, but some simple painkillers should be enough to keep you comfortable.

Recovery

You will be able to get out of bed on the same day as your surgery and do light activities after two weeks. You should be back to normal exercise between four to six weeks, depending on the type of procedure you have had.

Your aftercare

The post-operative care is vital for the success of the operation.  There will be some post-operative instructions you need to be aware of before having the procedure:

• You will be asked to regularly and gently shower the area to keep clean, patting the wound dry each time.
• An antibiotic course will be given as a precaution.
• You may need about two weeks off an office-based job, and longer for more strenuous jobs. 
• Physical activities such as riding bikes, running, and other exercise will need to be avoided until you have been given assurance it is the right time to do so. This can take four to six weeks. Early return to the activities can put pressure on the wound, delay the healing and could result in the wound breaking down.
• You should not wear tight clothes or underwear as they can cause friction to the wound.
• You must not have sexual intercourse for at least four to six weeks.
• You will be seen approximately a week post-operative to check the wounds.
• If ongoing wound care and advice is needed, you may need to be seen multiple times post-operatively as part of your care package.

Seeing the results

At first, your labia will feel swollen and uncomfortable. This usually settles down within six weeks of the surgery. Most patients are pleased with the final result, but some find the change difficult to get used to. This may happen to you.

You may have more or less sensation in the skin of your labia, and this can change over time.

It is important to look out for the following problems:

• Bleeding after surgery can cause swelling, a change in colour, and pain, usually just on one side. The signs of an infection are pain, redness, swelling, and pus in the wound, and you may also have a temperature.
• A blood clot in the leg can cause swelling and pain in the calf. If the clot goes to the lung, you might be breathless or have pain in your chest.
• If the wound is not healing well, it may be sore and weep. If you have any worries after your operation, you should speak to a doctor or go to A&E.

If you are considering a labiaplasty and would like to book a consultation with Mr Armstrong, do not hesitate to do so by visiting his Top Doctors profile today.