For a long time female genital surgery has been related only to female genital mutilation. Only in recent years the field of aesthetic surgery has grown and is steadily gaining more in acceptance – especially with regard to labioplasty, a medical intervention in order to reduce the inner lips. The reasons are manifold: our society is probably more open-minded than 10 years ago, we experience a greater acceptance of nudity in movies and advertising, a greater openness towards the porn industry and - probably most important - changed depilation habits. Among others these factors might be reasons why more and more women now are seeking help for this very private issue.

One thing is clear: There is a huge variety of appearance of the genital area. Just like you hardly will find equal faces, you hardly will find equal vaginas. So, it is mostly all about aesthetics and the patient’s expectations.

Surgery of the labia is called labioplasty and usually refers to adjusting the labia minora (small-lips), but also includes the labia majora (outer lips) and adjusting the skin of the clitoris hood (the cover of the clitoris). In order to explain and to better differentiate between the different medical interventions, the three areas will be discussed separately, starting with the labioplasty of the labia minora – the most frequently performed cosmetic surgery:


Large or long labia minora is a condition that affects many women. Sometimes they are changing their appearance within the years, after pregnancy or vaginal deliveries, but sometimes they just grow excessively during puberty. If the small (inner-) lips, the labia minora, are too big, it is not always only a question of appearance. It can be unpleasant or even painful during workout (such as running, cycling or horseback riding), sexual intercourse or simply during sitting.

Large or long labia minora can be corrected in a minor procedure. Depending of the conditions of the labia minora, with asymmetries, and more or less excessive tissue, various surgical techniques are performed to reduce the labia minora so these do not hang out of the labia majora any more. The procedure should take place in operation theatre under the greatest possible sterile conditions and usually needs general anaesthetics or epidural. It is not advisable - although some surgeons are doing so – to perform these kind of surgeries in local anaesthetics due to intraoperative swelling and the inferior final results.

The surgery usually is performed as an outpatient procedure, so the patients go home a few hours after the surgery. Depending on their workplace and job specification, they can attend work the next day. The surgery and the recovery are surprisingly painless, except from some itching of the healing process. The stiches can be self-reabsorbing or are taken out about two weeks after the surgery.

Local antisepsis can be supported by genital washing with salty water or camomile water.

It is recommended to refrain from sports and physical activity for about six weeks after the surgery. There is nothing against walking around as much as desired, but this might lead in some discomfort due to rubbing while walking. Furthermore no tampons should be used for around six weeks and abstinence from sexual intercourse needs to be kept for the same time period.

When the excess of skin and tissue extend to the clitoris hood, the procedure should best be combined with a clitoris hood lifting. Both are minor surgeries, which can easily be combined with any other aesthetic surgery, such as breast augmentation, if desired.

There are voices saying that a possible slight lightening of the border of the labia minora – the border is normally darker, up to brownish – is a disadvantage of some of the above described techniques. But since vaginal and anal bleaching are becoming more popular, a slightly brighter and rose colour of the outer border of the labia minora is desired, experienced as a positive side effect or at least easily accepted by most patients.

As the texture of the genital areal is healing very well, after two to six months, usually, scars are no longer visible and even the experienced eye will have difficulties to detect a prior surgery.

Updated: 2017-02-22


Dr. Alexander T. Hamers is board certified plastic and aesthetic surgeon with clinics in Cologne and Malaga. He is specialized in body contouring procedures such as supercharged breast and buttock augmentation with fat grafting and implants as well as the Brazilian Butt Lift.


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