Gynaecology

Labiaplasty

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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Medically Reviewed April 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is Labiaplasty?

It is common for women to have concerns about the size, shape or definition of their labia, the inner and outer folds that sit either side of the vagina. This may be the result of genetics, ageing, or most frequently, following childbirth. Labiaplasty is a quick and straightforward surgical procedure to reshape and resize the labia.

Labiaplasty is surgery to reshape or reduce the size of the labia minora, the small lips of skin on either side of the vaginal opening. The unwanted tissue is cut away with a scalpel or laser before the loose edges are stitched back together with fine, dissolvable stitches. It can be done using either a general anaesthetic or a local anaesthetic with sedation.

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Labiaplasty can also reshape or reduce the size of the labia majora, the large outer lips, although this is less common. Labiaplasty is not the same as a vaginoplasty, which is an operation to tighten the vagina internally.

Labia surgery is usually carried out for aesthetic reasons, although sometimes women may choose to undergo the procedure if they have excessively large labia which causes discomfort when taking part in activities such as cycling and sexual intercourse.

The whole labia reduction procedure at the Cadogan Clinic takes about 1 to 2 hours, and all patients are able to go home several hours later to continue their recovery.


Labiaplasty At a glance

Surgery Time

1.5 hours

Time off work

1 - 2 weeks

Hospital Stay

Day Case

Shower

After 1 day

Reasonable Mobility

After 1 day

Exercise

4 - 6 weeks

Sexual Activity

After 4 - 6 weeks

Sleeping on back

2 weeks

Full Recovery

6 weeks

Driving

1 - 2 weeks


Before and after

Why do people have it?

The motivation for Labiaplasty surgery can be aesthetic or functional in nature.

For many women having larger or asymmetrical labia can cause chafing and discomfort whilst wearing tight fitting clothes, or during physical activities such as sexual intercourse and exercise.

For others the appearance of oversized or asymmetrical labia can be the cause of significant psychological distress or even embarrassment.

This often occurs when the appearance of the labia has changed over time, either with the onset of the ageing process or following childbirth, when the labia have become enlarged, stretched or asymmetrical. Equally, genetics can also play a part.
 
Whilst there is not accepted definition of what is normal when it comes to the size and shape of the labia, for many labiaplasty offers a highly effective, swift, and minimally invasive surgical solution that can solve the problem in a matter of hours.

Who is suitable?

Cadogan Clinic considers individuals fit for the procedure, if all of the following are true of them:

  • Physically and psychologically fit and healthy
  • Bothered by the appearance of their labia
  • Have realistic expectations of what can be achieved by surgery

Words from our clients:


The cost of a Labiaplasty

Labiaplasty cost can depend on many factors. Given the delicate nature of the procedure, you want to be able to proceed with the confidence that you are being treated by the very best surgeons at the very best clinic. The award-winning Cadogan Clinic ensures that you are in safe hands every step of the way. 

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Labiaplasty Procedure techniques

There are a number of different labiaplasty techniques, and we perform three of these here at the Cadogan Clinic - the trim, wedge and de-epithelialization methods.  Each of these methods produces slightly different results. The best one for you will be chosen according to your anatomy and what you hope to achieve through your labia surgery. 

The most popular labia reduction technique, the trim method is exactly as it sounds. Also known as edge excision, linear, and amputation labiaplasty, the trim is the most commonly used technique in labia reduction. The trim can effectively address the common issues of excess length, asymmetry and hyperpigmentation.

The trim reduces the size of the labia minora, effectively trimming bulging or protruding labia, leaving behind smooth, unscalloped and wrinkle-free edges. This method of labiaplasty is best for patients who dislike the thick, darkly pigmented, or rough edges on their labia. For many women, the desire to see this edge removed is one of the main reasons for seeking cosmetic surgery for the labia.  Once the labia minora has healed from a trim, it will look less prominent and sit neatly inside the outer labia (labia majora).

A trim can also be performed alongside other common labiaplasty procedures, such as surgery to reduce the labia majora and reducing the clitoral hood by trimming away excess skin. 

However there is one common problem with trim labiaplasty. If the surgeon does not take sufficient care while carrying out the procedure, it can result in an uneven transition at the clitoral bulb at the centre, where the two sides of the labia meet. Rest assured that all the labiaplasty surgeons operating here at the Cadogan Clinic are experts in their field, which makes this less likely to occur.

Another downside of using the trim method is that the resulting scar runs the entire length of the labia minora, although this will be less visible over time.

The wedge method, also known as a central v wedge, is slightly more complex than the trim. Although this labiaplasty technique serves a similar purpose, that is reducing the size of the labia, the results are slightly different. Where the trim method focuses more on cosmetic concerns, such as excess length and hyperpigmentation, the wedge is more concerned with tightening the labia, leaving minimal scarring behind.

In this particular method, the surgeon cuts a v-shaped section of tissue away from the centre of the labia. This is the ‘wedge’. The two cut edges are then stitched together, thus tightening the whole labia, which is not a benefit associated with the trim method.

The wedge method is good for addressing the common problem of asymmetry and excess length in the central third of the labia. Unlike the trim method, the wedge technique does not alter the labia’s natural contours, maintaining the labia minora’s natural wrinkled edge. The wedge is a great option for women who have thin and well-defined labia edges and are not bothered by the appearance of these edges. There is less scar sensitivity when using the wedge method and the scar is hidden in the body’s natural crease.

Unlike the trim method, the wedge avoids any potential unevenness where the two sides of the labia join. However it does leave the darkest parts of the labia minora intact, so the wedge is not the technique of choice if the goal is to remove darkly pigmented edges.

A third technique which may be used as part of a labiaplasty procedure involves cutting the surface tissue of the labia minora and is known as de-epithelialization.

In this method, the surgeon makes an oval-shaped superficial incision in the inner parts of the labia, using a scalpel or a laser beam. The outer epithelial layer is then removed from the labia while the subcutaneous tissue, that is the deepest layer of skin made up mostly of fat cells and connective tissue, is left largely intact. The two edges are then sutured back together.

Since it was introduced in 2000, de-epithelialization has become a popular method of labia reduction. This technique maintains the wrinkles and sensations of the labia area and there are fewer complications associated with this particular method of labia reduction. 

The only potential downside of using this particular labiaplasty technique is that the base of the labia may become thicker after the procedure. This may be due to there being a vertical fold in the subcutaneous tissue, when the two edges of the skin were sutured back together.

Sometimes the de-epithelialization method can be combined with the wedge technique for an enhanced result. Your consultant will discuss which of these techniques will be best suited to help you reach your goals.


Labiaplasty Surgeons

We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.


What to expect

Below you will find some key information to help you prepare for surgery and make necessary arrangements to ensure you have the support you need and that everything runs smoothly on the day.

The first step for all of our patients is to meet with the surgeon we feel is best placed to perform your procedure for a consultation.

At the consultation you will be able to discuss with your surgeon what your hope to achieve from the procedure, as well as discuss in detail what may or may not be possible in terms of results. Your surgeon will examine your labia in order to come to a view of what is realistic in your case. This will take into account the size and structure of your labia, any symptoms you may be experiencing and your own personal desires for the outcome.

Finally a comprehensive discussion regarding risks and complications will take place, alongside a discussion regarding the post procedure and recovery phase. Your previous medical history will also be recorded (including previous surgery, medications, allergies etc.) and an assessment of your fitness for surgery.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed for surgery or otherwise following a two week 'cooling off' period.

Within this period you are welcome to come in and discuss your potential surgery with your surgeon as many times as you like.

The Cadogan Clinic offer chaperones to patients undergoing intimate examinations. Alternatively, patients are very welcome to bring a friend or a relative with them to consultations should they so wish.

If you choose to proceed with surgery, the next time you come into the Clinic after your final consultation will be the day of your procedure.

Before admission the following behavioural changes are recommended / required:

  • In the 6 weeks before your procedure we recommend smoking is discontinued as patients who smoke have a higher risk of wound breakdown, implant infection and, ultimately, the need for implant removal
  • In the week before your procedure you must cease taking Aspirin or any medication that contains Aspirin
  • In the 6 hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid (e.g. still water, black coffee, black tea) which are allowed up to 2 hours before admission

On the day of your procedure we ask that you arrive for your admission an hour before the agreed start time of surgery. At this point a nurse will come and record blood pressure and other relevant vitals, you will meet with your anaesthetist and your surgeon who will make the final mark-ups.

The procedure itself takes place under general anaesthetic over the course of one to two hours, although on occasion it can take place under local anaesthetic. The procedure involves reshaping or reducing the labia either by trimming the edges or removing a section of each labium in the shape of a wedge. The wounds are the stitched up with fine dissolvable stitches.

Following the procedure, you will recover in our ambulatory recovery rooms for between one to two hours, dependent on the scale of the procedure. Once our specialist nursing team are happy that your initial recovery is complete and you are safe to return home, you will be allowed to leave the Clinic accompanied by a friend or member of your family.

Once home you will have access to our dedicated oncall nursing team 24 hours a day, 7 days a week. This team of specialists are dedicated to your comfort and pain control, and are there to field any questions you may have in the immediate post operative phase.

We advise total rest for several days after the procedure, during which time your pain and swelling will subside. We advise against strenuous exercise in the first few weeks, and against sexual intercourse in the first 6 weeks.

We ask that you come in and see our nursing team 1 week after surgery to ensure your incision sites have been properly reviewed. At this juncture we also recommend you meet with one of our on site aestheticians to discuss ongoing treatment to support the healing and scarring process.

We ask that you come in to see your surgeon after 6 - 8 weeks for a final check up.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

The labia are the folds of skin that surround the vulva, the outer part of the female genitals. The labia majora are the outer lips and the labia minora are the inner lips.

Labia come in all different sizes and shapes. The size, shape and symmetry of labia can easily be amended by swift and highly effective labial reduction surgery in the hands of a qualified plastic and reconstructive surgeon.

Labial reduction surgery is particularly effective in instances where a woman suffers from excessively large labia. The cosmetic appearance of large labia can make women feel self conscious and unhappy with the appearance of a very sensitive area of their body.

These large labia can swiftly be reduced in size via straightforward labial reduction surgery.

The primary issue with large labia is typically psychological, with large labia the cause of embarrassment and even significant psychological distress.

It is also true that large labia can cause some functional issues as well. Excessively large labia can chafe on clothing, and cause discomfort when wearing certain items of clothing, such as swimming costumes. Large labia can also impact the enjoyment and comfort of sexual intercourse and exercise, such as cycling or horse riding.

A labiaplasty can help to alleviate this discomfort and allow a woman to live her life free of the restraints caused by a large labia.

The surgeon will carry out a thorough consultation to assess your suitability for a labiaplasty.

Women who are concerned about the shape, size, or symmetry of their labia, or if their labia is causing them discomfort which is impacting on their day-to-day lives, then they are suitable for labia reduction surgery. 

The surgeon must also determine that you are physically and psychologically fit and healthy and have realistic expectations of what can be achieved by labia surgery. All of these criteria must be met before proceeding.

A labiaplasty can be carried out using either a general anaesthetic or a local anaesthetic. If a local anaesthetic is opted for, it can be performed with or without sedation. The procedure involves reshaping or reducing the labia using one of several different techniques. These include trimming of the edges or removal of a section of each labium, for instance in the shape of a wedge. The specific technique will have been discussed with you in detail at the time of your consultation. The wounds are the stitched up with fine dissolvable stitches. The whole procedure takes about one to two hours and a patient is able to go home the same day, regardless of the type of anaesthetic used.

Labiaplasty is not a particularly painful procedure, and patients are encouraged to be up and about straight away, although we suggest you take one or two weeks off work immediately after surgery. Most of the swelling usually settles in the first few days or early weeks. 

Some residual swelling may persist for months, but this does not normally interfere with day to day activities. Sexual activity and exercise, including going to the gym, should be avoided until four to six weeks post-surgery. Most patients will have returned to all normal activities by this time.

 Your surgeon will discuss the aftercare plan with you in greater detail.

Following labial surgery, patients are advised to take a few days off work with the option of a full week if required, with a view of returning to normal day-to-day activities after about one week. Swelling is greatest during the first few days and the treated areas can be quite uncomfortable with excessive movement.  Although it is advisable for patients to mobilise as soon as is comfortable following surgery, they should be sensitive to their body and not to do too much too soon.

Labial reduction surgery is not quite the same as ‘designer vagina’ surgery.

The phrase ‘designer vagina’ surgery refers collectively to the full spectrum of cosmetic gynaecological surgeries that include labial reduction surgery (labiaplasty), vaginal tightening surgery (vaginoplasty), and other vaginal rejuvenation procedures.

 ‘Designer vagina’ surgery is the colloquial term to describe any or all of these procedures as a standalone, or as a group when performed together.

There is much media focus on the questions of ‘what is a designer vagina?’ or ‘should I get a designer vagina?’. We typically find it more instructive to refer to the more specific technical terms for the various procedures in question than the colloquial media phraseology of ‘designer vagina.’

Most patients opt for general anaesthetic when undergoing a labiaplasty, so they won’t feel any pain during the procedure. Any discomfort or pain experienced after the surgery will be controlled with medication provided by the doctor and this will usually subside within a few days. Patients may find going to the toilet and sitting down uncomfortable in the days following labiaplasty. Discomfort is usually the result of swelling which tends to subside after the first days of recovery. It is perfectly normal to have soreness, swelling or bruising in the labial area for up to two weeks after surgery.

Yes, you will require stitches when undergoing labia reduction surgery.

Surgeons will use dissolvable sutures which are gone by three or four weeks post-surgery.

Because of the natural folds and wrinkles in this particular part of the body, the scars are well hidden, blending in with the labia minora tissue. 

After the stitches dissolve away, the scar tissue will become firm. This will soften over the course of the following months. To aid the scarring process, it is important to carefully follow all aftercare instructions issued by your surgeon.

Everyone is different and will heal at a different pace, but you can expect to see the results of your labiaplasty from around two weeks. The final results of labia reduction surgery can take several months to appear.

Labiaplasty results are permanent. Subsequent pregnancies and childbirth will not stretch the labia, which will keep its new size. 

Labia reduction surgery will not affect pregnancy, the ability to get pregnant or sexual satisfaction.

Labiaplasty is a safe surgery with minimal risk attached. However on rare occasions, patients may experience one of the following after labia reduction:

  • Bleeding
  • Infection
  • Tissue scarring
  • Reduced genital sensitivity

As with all surgery, there is always the risk of the following complications:

  • Allergic reaction to anesthetic
  • Formation of a blood clot in a vein

We would like to stress that these complications are very rare. Your surgeon will discuss the risks with you at your consultation and answer any questions you may have about the procedure, including the potential for complications.

Certainly. This is a self-contained local procedure, which should not affect you generally. It can be done under Local Anaesthesia or the Cadogan Clinic form of light General Anaesthesia called TIVA (Total IntraVenous Anaesthesia) and always as a Day Case. You will wake up instantly and not be nauseated. Set aside half a day. Simple painkillers will suffice.

Maybe work from home the next day or two. Avoid significant exercise for 2 – 3 weeks and sexual activity for a bit longer.

During the initial consultation, the surgeon will advise patients to stop smoking and will review any medication they may be taking. The surgeon will also provide patients with all information needed to ensure they are fully prepared for the procedure.

There are a number of different treatments which purport to reduce the size of the labia without surgery. These methods include non-surgical radiofrequency technology. The results vary and are not permanent. If you are looking for a guaranteed way to reduce the size of your labia permanently, then surgery is the only way to achieve this.

There are creams, home remedies and  exercises which claim to reduce labia size. These do not work and we would recommend that you don’t waste your time or money on treatments for which there is very little, if any, scientific proof of their effectiveness.

It is important to find a reputable surgeon who is experienced and qualified to carry out your labiaplasty.

A good surgeon should be able to explain the procedure in great depth, including the different labia surgery techniques - the trim, wedge and de-epithelialization methods - and advise which would best meet your needs. The surgeon should also be honest about any potential risks or complications, possible outcomes and help you to manage your expectations.

At your initial consultation, the surgeon should also be able to talk you through the recovery process, including how to manage pain and help the healing process.

You should check that the surgeon is a specialist in labiaplasty and when you have your initial consultation, make sure the surgeon has an extensive portfolio of labiaplasty before and after photographs that they can share with you so you can get a good idea of how the results of your surgery will look. Be sure to check out testimonials from previous patients.

A good labiaplasty surgeon will always put the patient’s mental and physical wellbeing ahead of everything else. If you are not physically and psychologically fit and healthy, an ethical surgeon will not attempt to perform the procedure.

Only registered doctors can perform cosmetic surgery in England. You can check if a surgeon is a registered doctor or surgeon on the General Medical Council (GMC) online register.

Some surgeons may be members of professional associations, such as the British Association of Aesthetic Plastic Surgeons (BAAPS) or the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). However there are some qualified surgeons who are experts in their field but choose not to sign up to a trade body for their own reasons.


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Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. Read our FAQ section for more information.




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