Labial Protrusion & Labioplasty

Introduction to Labial Reduction Surgery

Enlargement of the labia minora (inner vaginal lips) is a true personal concern that affects many women. The medical term for this is called Labial hypertrophy. Many women that have enlarged labia minora that are much larger and protrude beyond the labia majora (the typically larger outer lips) may suffer from multiple symptoms because of this or just may not be comfortable with their appearance. Labial hypertrophy may be congenital in nature and therefore affect young women in their late teens or early twenties, or it may develop later in women after pregnancy and/or vaginal childbirth. The labia may become elongated or stretched out due to hormonal changes or because of labial, the process of one or more vaginal deliveries. In some cases, the labia are very asymmetrical with one labia being much larger than the other one or of different shape and thickness. Regardless of the cause, this condition can be addressed through labiaplasty surgery.

Symptoms of Labial Hypertrophy

Enlarged labia minora can cause symptoms such as pain or discomfort with activities such as exercise, sexual intercourse or even just with wearing tighter fitting clothes such as jeans. Many women have discomfort with this condition because the enlarged labia rub against tight fitting clothes, get pulled in or out during intercourse, or get irritated when doing activities such as riding a bicycle. Sometimes the enlarged labia can actually have an abnormal appearance and protrude out in tighter fitting clothes or bathing suits. This can be very bothersome and distressful to the woman and can affect her self-esteem. This may be especially true in younger women who are born with larger labia and become very self-conscious because of their appearance through their high school or college years. This can cause insecurity or embarrassment with sexual partners as well. Many women prefer that the inner lips do not protrude past the labia majora at all, giving them a much more appealing shape and eliminating many of the symptoms of enlarged labia

Labioplasty

Labioplasty is performed under local or general anaesthesia, and it involves trimming the inner lips of your vulva (excision method), so that its overall size and width is reduced. It is also possible to undertake labial reduction by taking out a wedge of skin (wedge method) and re-stitch the labial into a smaller outcome. Sometime a combination of methods may be necessary to achieve the best appearance. Careful incision is made to ensure that this is achieved and particularly that inner pink skin does not show. The edges are thereby either reduced or a wedge shaped piece is removed and the lips sewn back together with stitches that will dissolve over a short period. Local anaesthetics are sometimes injected to reduce pain immediately after.

When the outer lips are reshaped or sculptured, an incision of varying length depending on the desired result is made either on the near or far side of the outer lip. The fat underneath and excess skin is then removed to give a pleasing appearance. Everyone is shaped differently and result may vary. The operation will take just over 1 hour. A pressure dressing may be applied, especially with the outer lip reduction. A catheter is only inserted, if it is really necessary and for a short period only. You will be sent home with antibiotics for about five days.

More advanced labioplasty involving taking excess skin off the side of the clitoral hood or re -shaping of the vaginal entrance if there is excess skin are associated procedure that may be suggested, to achieve an overall more pleasing vulva and labial appearance.

What about recovery?

After surgery, there will be some discomfort around the stitches. There may also be some swelling. This may take up to 2 weeks to disappear. You need to avoid bruising to the area. This can happen for example with vigorous or gym exercises, horse- or bicycle riding or prolonged sitting or during vaginal intercourse. There may be a little bleeding, which quickly changes to pink and then disappears. You will need to wear a panty liner during this period. By four weeks, you should be able to resume gentle exercises and sex. You can take a daily bath or gentle shower to ensure quick healing. Follow up visits will be scheduled to check on your progress. This can be mutually arranged with your surgeon. It is usual to be able to return to work in about 5 – 7 days, but this depends on the individual. In some people this can take up to 4 weeks. Resting is important to healing process.

Are there any risks?

No one wishes for any complications, but in the best of hands, these do happen. Your surgeon will explain this further before you gave consent for the operation and he will be able to reassure y ou. These include:

• Bleeding may occur from the edges of surgery
• Bruising and swelling
• Infection, usually responds to antibiotics
• Delayed wound healing
• Changes in skin sensitivity, such as numbness and sometimes strange sensations
• Undesirable scarring – this is very rare with inner labia reduction, but more common when outer labia reduction is carried out.

Being Realistic

It is important to realise that this procedure is being performed for cosmetic reasons, and your expectations needs to be realistic. The result is often assessed subjectively. While you have been advised as to the probable results, this is in no way be interpreted as a guarantee. It is important to recognise that it is not always possible for your surgeon to predetermine your individual and psychological reaction to operative complications. Please do not hesitate to discuss your anxieties with your surgeon before your operation. You will have 24-hour emergency support from the hospital (direct line as above) and your surgeon in case of any complications.

Labial Reduction – Frequently asked Questions

This operation is carried out to reduce the size of or to re-shape your labia minora. The operation can make them look more attractive to your partner and boost your self-confidence. The operation is also known as Labioplasty, especially when it is combined with procedure like clitoral hoodectomy.

What are my labia and where can I find them?

Your vagina is surrounded and protected by labia. There are two pairs of them: labia majora – the larger protective pair that are similar to a pair of lips. When these ‘lips’ are parted, a smaller pair becomes visible and they are called labia minora. These give the vagina entrance extra protection and cushioning.

What causes problems with my labia?

Problems can arise with the labia minora. They can be distorted by becoming stretched, usually in childbirth, with ageing or even enlarged due to chronic irritation. It may even be congenital. Your labia are individual to you and may well be different to those of other women. Some women have enlarged labia minora (inner lips), others have lopsided or uneven ones where one labia is bigger than the other. When the inner lips are so enlarged it can affect the appearance of your labia majora (outer lips). These may appear unusual, distracting or unappealing to the opposite sex and may, understandably, affect your confidence and sex drive.

Unfortunately, enlarged labia can show up under tightly fitting clothes like swimwear and cause embarrassment. They may even interfere with lovemaking. Women can feel under pressure, especially from their partners, to have perfect looking genitals like those of models in pornographic magazines.

Can my labia be restored to normal?

Yes, your labia minora can be surgically improved to look smaller and much neater. We usually say that your labia are “normal, but different”.

What does the surgery involve?

There are generally two ways to reduce the protruding labia. They may be cut down to normal size, following their natural line. This way their natural shape is retained and they can no longer be seen emerging from the outer lips (labia majora).

Alternatively, a wedge of tissue in the shape of a ‘V’ is cut out of each labia and the edges stitched together individually. Again, the natural line of the labia is followed to ensure it looks as natural as possible. You may be given local or general anaesthetic and this can be discussed with your surgeon beforehand.

What will happen in the recovery period?

The incisions made should heal in approximately two weeks. You may experience swelling in your labia minora and the surrounding area. This should decrease in approximately two weeks. Your surgeon may use dissolvable stitches which would be better for you.

If your surgeon uses a laser instead of a scalpel to cut the excess tissue away, stitches may not be required. This is because lasers cauterise (seal) tissues as they cut, causing no bleeding because all blood vessels coming into contact with the laser are sealed. Sexual intercourse should be avoided for a month or so and no energetic activities undertaken for about a fortnight.

Will there be complications?

Labioplasty is a simple operation and the only risk or complication is the possibility of infection.

How long does the surgery take?

A Labioplasty can take between 1 and 2 hours. You may be able to go home but if not, an overnight stay should be all that’s needed.

What is the recovery time?

You should be fully recovered in a week after your operation and can return to work. A further 2 to 3 weeks should be allowed before sexual intercourse can take place again.

What can I expect from the surgery?

After the swelling has gone down, you can expect to have a pair of labia minora that are normal in size and appearance.

Clitoral Hoodectomy – Frequently Asked Questions

A Unhooding Hoodectomy, also known as Clitoridotomy, involves the surgical removal or splitting of the protective fold of skin that surrounds your clitoris. Lateral Hoodectomy refers to the trimming (remova)l of skin of the clitoral hood, from the sides of the hood.

What is my clitoris and where is it?

Your clitoris looks like a tiny bud at the top end of the vaginal opening. It should be pointed out that outwardly women’s genitalia look the same. On closer examination every woman has different sized parts of her vagina. Your vagina and its clitoris is protected by two flaps of skin that look like lips, called labia majora.

What causes problems with my clitoris?

When a woman is sexually aroused the clitoris becomes engorged or full of blood and increases in size. Problems with the clitoris may arise when the skin (or hood) covering it may be too tight to allow the clitoris head to get bigger. A clitoris that is increased in size will stand a better chance of being stimulated during sexual intercourse than one that is covered up by skin. When the clitoris is completely and tightly covered by the fold of skin it is a condition known as Clitorial phimosis. This causes the sensitivity of the clitoris to be either greatly reduced or completely lacking any feeling at all. Most clitoral hood are however trimmed with the lateral hoodectomy method because the skin are rather too excessive, and protrude either separately or in addition to the protruding inner labia.

Can my clitoris be restored to normal?

An Un-hooding Hoodectomy when performed will provide relief by allowing the clitoris to expand and become more prominent during foreplay and sexual intercourse. The reason for removing the ‘hood’ or fold of skin is likely to be because the skin fold has completely covered the clitoris, making sexual intercourse difficult to enjoy. Removing the skin fold to expose the clitoris will make sexual intercourse more pleasurable for you. The Lateral Hoodectomy surgery will help to make your clitoral hood skin less bulging and quite often contained within the groove created by the two outer lips

What does the surgery involve?

The Lateral Hoodectomy procedure involves the trimming of the excess skin of the clitoral hood, at the far side, similar to the trimming of the inner labia. The amount trimed will depend on the overall size, width or ptrotrusion of the clitoral hood, and the overall intention to ensure that the results allow the hood to remain with in the outer labia or not. The un-hooding hoodectomy is similar to circumcision in the male penis. Like the penis the clitoris has a hood that can prevent required sensitivity in sexual intercourse. This operation is extremely delicate and the gynaecologist performing it is an expert with a great deal of experience. This is necessary because the clitoris has more nerve endings in it than in all the tissues surrounding it. The hood is either partially removed or split to allow the clitoris freedom to enlarge when you feel aroused. It is often necessary to trim to reduce the size (width) of the clitoral hood and in addition “fix” the hood, to the side of its groove, so that the clitoral hood does not hang when standing. This procedure is often referred to as Clitoropexy , and can be done at the same time as the lateral clitoral hood reduction. All procedures done to improve the cosmetic appearance of the clitoris are generally referred to as Clitoroplasty . However, Clitoral Hoodectomy is not the same as Clitorodectomy , which is done for the treatment of enlargement of the clitoris tissue (clitoromegaly) itself.

Will there be complications?

The most serious complication may be infection. Excessive bleeding tends to occur when in ethnic cultures a non-medical person carries out this procedure. There is also a theoretical risk of significant changes in sensitivity – either increased or reduced sensitivity of the hood and or clitoris. Because you will be attended to by a fully qualified and highly experienced surgeon, this risk should be much reduced. If it occurs, changes in sensitivity of the clitoral hood skin are more likely than changes in the sensitivity of the clitoris itself. Sometimes the skin appear irregular without forming skin tag, but this is usullay temporary, and goes down when the swelling has settled. Occatioanlly skin tag can form if the swelling blocks the blood flowing into the skin area for long period of time.

How long does the surgery take?

It takes approximately 1 hour, though it can be slightly less.

What will happen in the recovery period?

You may find sitting for long periods painful and this includes driving (which should be avoided temporarily). Strenuous exercise has to be temporarily suspended until swelling is reduced and healing is complete. It may be unwise for you to carry heavy items for about two weeks to avoid straining the area.

What is the recovery time?

Recovery varies from person to person. It could take up to 2 weeks to fully recover. Try to minimise the amount of time spent sitting down, including driving. Do also try to avoid energetic exercise and carrying very heavy objects. You will need to avoid straining any muscles.