Labiaplasty

What Is Labiaplasty?

The labia minora, known as the inner lips, are band-like structures that lie between the outer lips, the labia majora. They join at the level of the clitoris at the top and taper off into an indistinct ring at the bottom. The size and shape of the inner lips vary from person to person.

It can be considered normal for the inner lips to extend beyond the outer lips. In some women, however, the inner lips may be excessively saggy and/or enlarged. The two sides may also be asymmetrical and differ from each other in size.

This not only affects the appearance of the genital area but can also cause functional problems such as pain and irritation during intercourse. Friction while exercising or wearing tight trousers and bikinis can cause chafing, and the visible outline can undermine a woman's self-confidence and psychological well-being.

If the labia minora (inner lips) are larger than normal, excessive secretion may force patients to use pads even outside their menstrual period. Irritation and swelling after walking or exercise, and unpleasant odor in the genital area, may also occur.

Irregularities in the shape of the inner lips (labia) are corrected with various operations, collectively known as labiaplasty. Labiaplasty can be performed on all women; it does not damage the hymen and does not interfere with pregnancy or vaginal delivery. Labiaplasty does not impair sexual intercourse or pleasure; on the contrary, it enhances them.

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4 Different Labiaplasty Techniques

1) Trim Labiaplasty

This technique uses general or spinal anesthesia. The inner lips are trimmed with scissors to reduce their size, and the remaining tissue is repaired with fine sutures. However, because this method offers poor bleeding control and creates an inward-curving edge rather than a clean, straight cut on the labium, tissue healing lags behind that of radiofrequency.

2) Wedge Labiaplasty

The wedge labiaplasty technique involves removing a triangular section from the middle of the labium and joining the remaining edges. It is considered an effective solution for large, fleshy labia. When before-and-after images of wedge labiaplasty are examined, the results are gratifying. That said, this method carries a 1% risk that the wound edges will not adhere and will separate. To minimize this risk, slowly dissolving or non-dissolving sutures are preferred.

Wedge labiaplasty is performed under general or spinal anesthesia, and the operation takes between 1 and 2 hours depending on the case. If the operation is performed in the morning, the patient can be discharged the same evening; if it is performed in the evening, the patient can be discharged the next day. Patients are advised to attend regular follow-up visits for 2 months, with new photographs taken at each visit and compared with the previous ones.

3) Laser Labiaplasty

The laser labiaplasty method is similar to trim labiaplasty, but here a 980 nm diode laser is used instead of scissors. Contrary to popular belief, the laser cuts the tissue by burning rather than joining it. This procedure can be performed under general or spinal anesthesia. The operation takes between 1 and 2 hours depending on the severity of the case. As with wedge labiaplasty, if the operation is performed in the morning, the patient can be discharged the same evening; if performed in the evening, the patient is discharged the next day. Patients are called in for regular follow-up visits over 2 months, with new photographs taken at each visit and compared with the previous ones.

4) Radiofrequency Labiaplasty (RF Labiaplasty)

Radiofrequency labiaplasty uses radiofrequency instead of a laser for the cutting. This method has fewer side effects than the others and is more effective. While burns can occur in the tissue during laser cutting, the radiofrequency device cuts by vaporizing the tissue coldly, so no damage occurs in the surrounding tissues. (See the image below.)

I myself have preferred the RF labiaplasty method for many years. Radiofrequency has been proven superior to laser in many respects.

For RF labiaplasty, the patient is admitted to hospital and the operation is performed under general or spinal anesthesia. Labiaplasty surgery takes 1-2 hours depending on the severity of the case. Photographs are taken before and after the operation. Morning cases can be discharged by evening; evening cases can be discharged the following day. Once the labia have been shaped, the incisions are closed under the microscope with very fine sutures; the sutures are dissolvable and do not need to be removed later. During the 2-month period after labiaplasty, we call the patient in for a check-up every 15 days, documenting the process with photographs at every visit and tracking the change. Full healing after labiaplasty takes 2 months. Since swelling may persist before then, it is not appropriate to judge the result early.

Recovery After Labiaplasty

After labiaplasty surgery, patients are advised to avoid intercourse for 6 weeks. Once home, patients may bathe right away, but loose, comfortable clothing is recommended for the first few days. There is no severe pain after the operation.

Labiaplasty can also be performed under local anesthesia, but I have not favored this approach for a long time. Because the local anesthetic is injected into the inner lips (labia), they swell, making it difficult to achieve symmetry. It is therefore common, after operations performed under local anesthesia, to find that lips which looked symmetrical are in fact not symmetrical once the swelling subsides. For this reason, I do not consider any local anesthetic injection that disrupts the integrity of the tissue to be appropriate.

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