For looks or for function: do I need a labiaplasty?

How their genitals look or how they are functioning is a common insecurity women have and may seek professional advice regarding what to do. Specialist obstetrician and gynaecologst Mr Timothy Hookway discusses what a labiaplasty is, what the procedure involves, and when it is recommended. 

What is a labiaplasty?

A labiaplasty is an operation to change the size, often a reduction, or the shape of the labia. These are the skin folds to the entrance of the vagina.

Why is it performed?

A labiaplasty can be performed for cosmetic reasons, but it is mainly performed to repair a problem after childbirth. For example, if the labia or vagina hadn’t healed properly and had left a degree of scaring and pain. It is also performed for functioning reasons, such as for women who wear tight clothing—perhaps cyclists, gymnasts or other sports people—or if the shape of the start of the labia interfered with intercourse or with wearing clothing. It can also be performed for people who spend a lot of time riding horses as sitting on enlarged labia can cause a certain degree of discomfort.

Can it help with yeast infections?

Many people ask if labiaplasty can help with yeast infections, but unfortunately, it’s not something that would tend to help. Yeast infections are very common and there are a number of strategies that can be used, both in terms of personal hygiene and also using over-the-counter medications. If yeast infections were to become a problem, then there are longer-course treatments available and these would need to be discussed with either a general practitioner or a gynaecologist.

What should a patient expect?

It’s very important to note that ‘normal’ has a very wide range, particularly when it applies to the vulva. Some women are told by colleagues in a changing room or a partner that things are abnormal, and often all that is required is an examination or a consultation with a gynaecologist to reassure that everything looks normal and that there is absolutely nothing wrong. If there are any functional problems, such as getting the labia caught on underwear or sports clothing, then there can be a discussion about how much skin can be removed and what the resulting labia might look and feel like.

Once the diagnosis is made and the decision to perform surgery is made, then it’s normally carried out under a general anaesthetic. This is because the labia can be quite a sensitive area. Once the patient is asleep, a further examination takes place in the theatre and a small area of skin is excised from the labia. Then some very fine sutures are placed to ensure the edges heal appropriately. The stitches normally dissolve and don’t need to be taken out afterwards. There’s often some local anaesthetic used during the operation as well which will help with pain relief post-operatively, and sometimes a small dressing is placed. The procedure is normally done as a day case and you would go home on the same day as the operation being carried out.

How long is the recovery time after the operation?

After going home following a labiaplasty, there may be a degree of discomfort and simple pain relief should be all that’s required to improve this. The area should be kept as clean and as dry as possible, and healing should start within the first couple of weeks to be able to resume normal activities. Things like intercourse, where obviously the repair could become disrupted, should be delayed a little bit longer than that. I would normally advise leaving at least four to six weeks post-operation before resuming sexual intercourse.