Labiaplasty: What it is designed to do

I get many requests for Labiaplasty, and it always surprises me how many different types of women contact me in my Baltimore practice. Whether it is a young single woman who has not had children, or an older person who is finished with childbearing, it can be difficult to find a surgeon who is experienced with the procedure.

Labiaplasty changes length of labia

One question I always clarify is what the labiaplasty procedure is designed to do. Does it enhance sexual experience, improve the appearance of the vagina, or both? Since the procedure is a type of ‘vaginal rejuvenation’ there is a lot of confusion from the media as to why exactly the goal of the procedure is. Furthermore, many gynecologist equate vaginal rejuvenation mainly with sexual enhancement. However, for most plastic surgeons, the purpose of the Labiaplasty is to improve appearance only. The Labiaplasty procedure addresses the patient complaint that the labia is too long or that it bothers them with tight clothing.

Let’s review the media sound bites about the procedure from both gynecologists and plastic surgeons.

Is the procedure performed for function or aesthetics?

The American College of Obstetricians and Gynecologists (ACOG) has come out with an official statement against “vaginal rejuvenation” procedures. Therefore, many gynecologists, who are the first health professional a woman would typically ask, are either not familiar with the procedure, or will not endorse it. Shortly after the ACOG issued their statement, the American Society of Plastic Surgeons (ASPS) was asked to issue an opinion, and despite some internal debate the decision was made to support the ACOG.

Because of my experience with the Labiaplasty procedure, I was asked for an opinion by the media. My opinion was that “Vaginal rejuvenation surgery” can be divided into Reconstructive Surgery, whose purpose is to restore some functional problem, and cosmetic surgery, whose purpose is to improve how something looks.

The problem with reconstructive vaginal procedures such as tightening or enhancing the “G spot” is that sexual function is is as dependent on the brain as on the sexual organ. I don’t perform these procedures because I don’t think I am helping the patient. On his I agree with the ACOG position.

On the other hand, a cosmetic procedure such as Labiaplasty does what it’s supposed to do, which is just to change the length of the labia. On this, I disagree with the ACOG position. My patients love the result because they get what they want. Some women’s labia are larger than others and seem to “hang” beyond the vagina. The tissues are very thin and wrinkly. In addition, the labia are usually darker than the surrounding tissues, so they are very noticeable. I think the problem is noticed nowadays more because a lot of women shave the vaginal mound, so the labia are more noticeable. The procedure is extremely effective in eliminating the extra tissue and giving a “clean” look.

Who is qualified to perform Labiaplasty?

When looking for a surgeon to perform this procedure, make sure he is a board certified plastic surgeon. The question to ask is “Are you a member of the American Board of Plastic Surgery?” A lot of surgeons will say they are “board certified”, but in may be in something other than plastic surgery. You should also make sure he is experienced with the procedure and performs it often. I enjoy doing this procedure because the results look really good, patients are very happy, and I have never had a major problem. I just wish more people knew this procedure can help them.