So important is the female reproductive tract that evolution has protected it with not one, but two protectors. This ‘double-door’ consists of a pair of labia majora on the outside that are hair-bearing and padded with underlying fat. The inner – labia minora – are thin, flexible and hairless. Anatomy is highly variable and there is a wide range of what is considered ‘normal’.
Surgery is usually considered for enlarged and visible minora. Perfect symmetry is rare in nature, but wide differences between the two sides may cause significant distress. Other reasons include post-partum trauma (episiotomy or vaginal tears) and simple enlargement with age. Whilst often symptom-free, many experience discomfort and even pain when wearing certain clothes or with some sports, particularly cycling and horse-riding. Less commonly, they may be related to recurrent infections and can be torn during sexual intercourse. Increasingly, women are seeking treatment for sagging and empty labia majora either separately or at the same time.
What is a labiaplasty?
Labiaplasty is surgical alteration of the labia and is taken to refer to the minora, which frequently protrude beyond the outers. The labia majora thin with age becoming saggy and empty and it is becoming more common for women to request surgery to address this aspect.
Originally labia reduction was achieved via simple amputation. This has now been superseded by more refined techniques to avoid the visible, often stiff scars that frequently eliminated the natural contour and colour. Excessive removal seems to occur more often with this method.
The most modern technique involves a flap and it has several benefits including concealed scars, and preservation of the natural skin edge. It does, however, require more technical skill and time.
More questions about labiaplasty surgery?
A general anaesthetic (GA) is preferred to allow the surgeon to comfortably tailor each labia in an operation that usually takes an hour. At the end of the operation a long-acting anaesthetic is administered to minimise pain. Finally, a cold pack is applied to help with swelling.
General anaesthetic (GA) is required and incisions today are placed in the breast crease. Absorbable stitches are used and the procedure can be undertaken as a day-case if preferred.
Any mild discomfort usually subsides over the first few days. It will be helped by cold packs that also reduce the swelling.
The area should be kept clean so showers are better than baths, but short salt-baths can be comforting. Avoid tight, man-made fibres –think Bridget Jones rather than Lycra!
Stitches will absorb over 2 – 4 weeks so do not require removal, but you will see the nurse for a wound check after a week. Review with the surgeon occurs in the clinic 6 weeks after surgery.
Full recovery takes 6 weeks at least so penetration – either with tampons or sexual intercourse should be avoided until the area has completely healed.
Arnica has been found to help reduce post-operative swelling and bruising and twice daily massage will help with scar maturation.