The Designer Vagina Problem

Ultimate Guide — The Designer Vagina Problem: Everything You Need to Know About Labiaplasty (and How to Love Your Vulva Without Cosmetic Surgery)

Today, more than ever before, women and teenage girls are electing to have labiaplasty.

Labiaplasty is defined as a surgical procedure to remove or reduce the size of the labia—the lips or folds of skin that surround the vagina. Most often, the surgery involves cutting back the labia minora so that they appear concealed or tucked inside the labia majora. Labiaplasty is one technique included in a group of procedures labeled female genital cosmetic surgery (FGCS).

closeup of surgical instruments

According to the American Society for Aesthetic Plastic Surgery, labiaplasty procedures increased 23% from 2015 to 2016, with 35% of the physicians who responded reporting they offered these procedures in their practice.

These numbers don’t necessarily suggest that more women are taking charge of their sexual health—that would be a good thing! What it does suggest is that women and teens believe there is something wrong with the size, shape, and color of their vulvas.

Like so many others, you might be wondering if your vulva and vagina are normal. Perhaps you’re worried about how you look down there, especially if you’ve never seen anyone who looks the same as you do.

So, you’re trying to learn more about the pros and cons of labiaplasty, and any other information you might need before you change your body forever.

In this article, you’ll find a lot of information about labiaplasty, from how it works to its risks and limitations. We hope you will use this information to better understand what labiaplasty is and how it may affect you or someone else who is considering the procedure.

You’ll also learn about the common reasons women seek genital cosmetic surgery—and why labiaplasty may not be the best answer. In fact, this and other female genital cosmetic surgeries aren’t always risk-free. Many women find that the promises of “the best sex ever” or “improved self-esteem” are often not met

Next, you’ll see that there’s no such thing as one “normal” or “ideal” vulva or vagina. Despite what you might see in the media, every woman’s private parts are different. Not only do vulvas come in different sizes, shapes, and colors, each side may differ in size and shape from the other. Just like your hands, feet, and eyes, the various parts of your vulva are most typically asymmetrical. All of this is normal. In fact, genital diversity is what’s normal.

Finally, this article will show you how to get to know what makes your vulva uniquely yours.

What Does “Designer Vagina” Mean?

Much like it sounds, “designer vagina” refers to female genitalia that has been reshaped and resized through elective female genital cosmetic surgeries, which include vaginoplasty, monsplasty, labiaplasty, and other cosmetic procedures.

However, the “designer vagina” label isn’t quite accurate in one major way. The label is an umbrella term for all female genital cosmetic surgeries, including those performed on the external genitalia (the vulva)

Vagina and vulva are commonly confused terms. You are in good company if you’re not completely sure what the difference is. Many people are unsure about the words to describe their private parts, as well as what those parts do.

Understanding Your Genitals

Getting to know your genitals and their roles in both sexual pleasure and physical health can be crucial to developing greater body confidence. It’s also important for understanding exactly what different forms of female genital cosmetic surgery change about your body.

Genitals/Genitalia: The term genitals or genitalia are used to describe the reproductive organs in either males or females.

Vagina: You can’t see your vagina when looking at your genitals from the outside (though you can see its entrance). Your vagina is the canal that runs up from the opening between your inner labia to your cervix, which is the lower end of your uterus.

Vulva: The vulva is visible from the outside. In fact, the word vulva encompasses all of your external sex organs. This includes the labia majora (outer lips), labia minora (inner lips), clitoris (or clitoral glans) with its soft tissue hood (or clitoral hood), mons pubis (soft, hair bearing fatty pad above your clitoris), and the vulvar vestibule (opening of the vagina).

Anatomy of vulva

Vaginal Opening, Vestibule, or Introitus: All of these describe the outer most portion of the vaginal canal. It is the opening of your vagina.

Labia Majora (Outer Lips): The labia majora are the outermost portion of the vulva.

Labia Minora (Inner Lips): The thinner, often more wrinkled, labia minora are between your labia majora. The labia minora come in many different sizes, shapes, and colors and are often longer than the labia majora.

Clitoris: The clitoris is a complex female sexual organ. It has three parts—the clitoral head or glans, the shaft, and the legs.

For more complete descriptions of all female genital anatomy and how each part functions, please see the “Female Genital Anatomy” page on our website.

Procedures Often Confused With Labiaplasty

Before we go on to further define labiaplasty and other female genital cosmetic surgery procedures, we feel it important to note this article is not discussing the gender reassignment surgeries transgender people might opt for as treatment for gender dysphoria. Nor are we talking about genital surgeries performed on intersex people (people who were born with both male and female chromosomes and/or sex organs). You can find more information about gender transition and reassignment surgeries, as well as intersex medical interventions, by searching the web.

Of equal importance, throughout this article, we are addressing women who were born biologically female and continue to identify as women. Our goal is not to exclude, but to discuss issues impacting women who were born with female genitalia.

It is also crucial to distinguish between elective genital cosmetic surgeries and medical procedures for genital conditions.

Many women investigate genital surgery because of issues with painful sex or concerns about a medical disorder of the genitalia. Remember that cosmetic surgery is an elective procedure, whereas surgery for a properly diagnosed health issue is not. There are times that surgical removal of vulvar and/or vaginal tissue is a recommended part of treatment, such as in cases of vulvar and/or vaginal cancer or severe dermatological disease.

You can find resources on sexual health concerns such as vaginismus (difficult or painful vaginal penetration), dyspareunia (painful intercourse), vulvodynia (vulvar pain), and vestibulodynia (vulvar pain when touched) here.

A Word on Female Genital Mutilation (FGM)

The World Health Organization (WHO) defines FGM as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reason.”

According to WHO, “FGM is recognized internationally as a violation of the human rights of girls and women.” It is also illegal in many countries.

Most argue that labiaplasty is not FGM. We invite you to read on and decide for yourself.

Common Types of Female Genital Cosmetic Surgery and Related Procedures

Labiaplasty (a.k.a. Labia Reduction)

Labiaplasty, as defined earlier, is a surgical procedure that permanently changes the size and shape of the labia. Most often, this means cutting the labia minora to make them smaller.

This cosmetic surgery is aimed at women who feel self-conscious about their long or asymmetrical labia, and it’s performed for purely aesthetic reasons. As we will explore, there is nothing medically—or aesthetically—wrong with the natural diversity of labia.

Labiaplasty Techniques

Two of the most frequently used surgical techniques are the trim and wedge techniques.

The Trim Technique

During the trim technique, tissue is cut from the labia minora along its long edge, leaving some width (at least 1cm) of the inner lip close to the body. This surgery is typically used for women who complain of excessive labia minora length and/or thickness.

The downsides of the surgery are problems at the cut edge, where excessive scarring and scalloping can occur. There can be a loss of skin tone and unevenness at the scar. Cutting away most of the normal, healthy inner lips may also leave the clitoral hood looking excessively large and misshaped.

This surgery may lead to another, as some women are not satisfied with the results.

The Wedge Technique

Rather than cutting away all of the length of the inner lips as above, the wedge technique was developed to try to save some portion of the labia minora’s natural edge. It, too, is chosen by women distressed by the size and shape of their labia minora.

There are several different techniques included in this approach, each taking away various sized “wedges” of the labia minora itself, leaving more or less of its edge.

This surgery is more complicated than the trim approach. It requires extreme attention and care during surgery, as the labia minora have a multitude of nerves and blood vessels. Some physicians using this approach suggest keeping more of the skin’s edge will help maintain labia minora sensation, blood flow, and natural appearance.

Yet, others warn that the deep cuts of the surgery may cause damage to the nerves and blood vessels that provide both pleasurable and sexual sensation. The further downside of the wedge approach is that healing is more difficult. The skin edges may not heal properly, which can leave holes in the labia or uneven edges where the tissues were stitched together. Cysts in the scar have also been reported. If the surgery is too aggressive, it may restrict the size of the vaginal opening.

Some women require further surgery to correct problems after the wedge approach.

The Composite Reduction Labiaplasty

In a paper published in 2013, Stefan Gress suggested a more complete approach to labiaplasty—the composite reduction procedure. This procedure addresses reduction and tightening of the entire labia minora, including the clitoral hood, leading to less clitoral protrusion if present.

The downside to this procedure was wound breakdown that required additional surgical repair.

The Deepithialiazation Technique

Another popular approach to reducing labia minors is the deepithelialization technique. Suggested for distressed women who have less labia minora that they would like removed, this technique was developed to preserve the natural shape and blood and nerve supply of the labia minora’s edge. Deepithelialization removes some portion of the top layer of skin (the epithelium) on the inner surface of the labia minora, then connects the open edges.

The downside of this procedure is the potential thickening of the labia minora tissues after surgery. Some women find that the procedure doesn’t remove enough of the inner lips and opt for further surgery.

The Barbie Procedure

This form of labiaplasty involves cutting away the entire labia minora, leaving minimal to no tissue at its base. Its goal to create a vulva that looks prepubescent and flat, just like that of a Barbie doll. The procedures surgical risk is similar to that of the trim labiaplasty; however, no revisions are possible given the entirety of the tissue is removed and cannot be surgically restored.

Vaginoplasty (a.k.a. Vaginal Rejuvenation or Vaginal Tightening)

Vaginoplasty is the surgical removal of wedges of vaginal tissues meant to “tighten” the vaginal wall. This procedure is often accompanied by perinoplasty, which tightens the vaginal opening by stitching the vaginal wall and shortening the superficial muscles of the pelvic floor muscle complex.

Collagen Rejuvenation

This is a non-surgical type of vaginal rejuvenation. Collagen is the protein responsible for making your hair, skin, and every other tissue strong and flexible.

In this procedure, energy-based devices, such as lasers, are used to treat the vaginal wall. This prompts increased collagen production in the vaginal tissues.

There currently are no well-designed, prospective studies looking at the long-term impact of this procedure on the vaginal wall or the pelvic organs that are exposed to laser treatment. However, the Federal Drug Administration released a warning against the use of energy-based equipment that is used in vaginal rejuvenation or vaginal cosmetic procedures.

Monsplasty (a.k.a. Mons Pubis Reduction)

The mons pubis is the soft mound of flesh above the labia and on the pubic bone. Monsplasty reduces the size of the mons pubis by lifting and tightening the tissue. It is done purely as a cosmetic procedure.

Liposculpturing

Liposculpturing changes the size and shape of the fat found in the mons pubis and outer labia. This commonly involves the use of liposuction, which removes fat. This, too, is used purely for cosmetic reasons.

Bleaching/Whitening

Bleaching/whitening procedures aim to make the labial tissues lighter and pinker.

Vulvas naturally represent a wide range of sizes, shapes, colors, and shades: pink, red, tan, dark brown, purple. And, because the labia are so full of blood vessels, their color changes, often going from pale to a more deeply saturated color as arousal increases.

It’s also possible for your vulva to be lighter or darker than the rest of your skin, regardless of your race. That said, the idea that the “perfect vulva” must be rosy pink potentially shames and excludes women of color.

Clitoral Hood Reduction

The clitoral hood is the fold of skin that sits around and over your clitoris, much like the hood of a sweatshirt covers the top of your head. It protects the clitoris from irritation and damage. Like the clitoris, it is sensitive to the touch and plays a role in providing sexual pleasure.

Clitoral hood reduction involves snipping portions of the clitoral hood to make it smaller. This cosmetic surgery is often touted to improve sexual pleasure. Remember, however, whenever you cut tissue, it heals by forming scar tissue. Scar tissue anywhere in the body results in diminished sensation, calling into question that clitoral hood reduction improves sexual pleasure.

The procedure can leave the clitoris exposed and unprotected as you go about your daily activities, as well as lead to unpleasant over-stimulation during sexual activity.

G-Shot (a.k.a. G-Spot Amplification)

The G-spot is an area of sensitive tissue located at the front wall of the vagina. Many women feel a great deal of sexual pleasure when their G-spots are stimulated. A G-shot injects filler (hyaluronic acid) into the G-spot, making it larger.

According to the American College of Obstetrics and Gynecology, “The safety and effectiveness of these procedures [including vaginal rejuvenation, designer vaginoplasty… and G-spot amplification] have not been documented. No adequate studies have been published assessing the long-term satisfaction, safety, and complication rates for these procedures”.

Why Are So Many Women and Teens Choosing Labiaplasty?

blond woman waiting for doctor

It’s crucial to understand that labiaplasty is a cosmetic procedure, not a medical one. When a vulva is cut for a medical purpose, the surgery is not called labiaplasty, but vulvectomy.

So, why are so many women and teens seeking this cosmetic surgery?

Physical Discomfort

Some women have long inner labia. It’s not unusual for the labia minora to hang down past the labia majora. Sometimes, this can feel physically uncomfortable. You might experience mild soreness or chafing, especially in tight clothing or when riding your bike.

Physical discomfort is a real concern; however, many women are seeking a permanent surgical solution for minor discomfort that should be addressed with a simpler approach.

Psychological Discomfort and Low Self-Confidence

Psychological discomfort—shame, embarrassment, worry, self-criticism, etc.—over the size, shape, and color of their vulva is an issue many women describe.

A contributing factor to this discomfort is that many women with long or asymmetrical labia have never seen another pair of labia that looks like theirs, making them feel different

Another factor that can cause psychological discomfort is hearing cruel comments or off-color jokes making fun of female genitalia. They may come from coworkers, friends, family members, or romantic partners. Such comments are hurtful. Because we rarely talk about our genitals unless using derogatory or demeaning language, speaking back to such hurtful words and deflecting the talk can be difficult.

Such comments can contribute to lowered self-confidence and lead to feeling shame about your body, especially your genitals. You may be overwhelmed, hating your labia and feeling alone, broken, or abnormal.

These distressing emotions are valid. It’s painful to feel “different” and to hear negative comments or remarks from others. Low self-esteem and poor body image affect many of us. They certainly don’t make it easy to feel good in your skin.

Many others seeking labiaplasty share your feelings.

According to a study published in the October 2016 issue of Aesthetic Surgery Journal, “[Female genital cosmetic surgery] patients tested at baseline showing body dissatisfaction, negative genital self-image, and poorer indices of sexual satisfaction. Preoperative body image of study patients was in a range considered to be mild to moderately dysmorphic.”

Another study, this one published in Psychological Medicine, also found that women seeking FGCS struggled with low body image. In fact, “Of the 55 women seeking labiaplasty, 10 met diagnostic criteria for body dysmorphic disorder.”

Body dysmorphia causes fixation on real or perceived physical flaws. Because of it, you become obsessed with the slightest “imperfection”—making it extremely difficult to see your body as it really is.

Negative, dysmorphic body image and labiaplasty seem to go hand-in-hand. Many women and girls are convinced that they’re just not “normal.”

So, what’s warping women’s genital self-image?

Societal Expectations and the Illusion of “Normal”

woman sitting in sun

There is no one “normal” vulva. It’s understandable if you’ve never heard that before reading this guide.

Images portrayed as representations of a singular “normal” are everywhere—on television, in the movies, spread across magazines and billboards.

Those images , however, do not reflect reality. They are retouched, airbrushed, cropped, and blurred.

Even if you know that the retouching was done, when you only see “perfect” bodies, no matter how altered they might be, they start to look normal to you. They start to look like the body you should have—like the ideal.

The idea of the “designer vagina” has been perpetuated by the media, especially by the media that puts it on display.

Pubic Hair, Porn, and Problematic Images

Thanks to the Internet, porn is more easily accessible than ever before.

Unfortunately, the people seen in pornography certainly do not depict realistic bodies or female genitalia.

In mainstream pornography, it seems that almost every vulva is hair-free, which means more vulvas are visible. As a result, making comparisons is easier than ever.

Removing pubic hair via shaving, waxing, and laser is currently very popular, especially for women. A 2015 study of college students found that 50% of the female participants were “typically hair-free,” versus 19% of the male.

Why is that a problem?

Just like the images in magazines, the images in porn do not accurately reflect the expansive diversity of human bodies or vulvas.

In fact, in Australia, the law demands that every vulva must be digitally altered.

Kristen Drysdale, an Australian Journalist, challenges her readers to find an “outie”—or a visible labia minora—in a soft-core magazine.

“You won’t. And it’s not because they’ve chosen to only photograph women with ‘innies.’ Many of those models actually have outies in real life, which have been ‘healed to a single crease’ (that’s the charming term used in the magazine industry) with the aid of image editing software. Think of it as ‘digital labiaplasty.’”

While digital labiaplasty is legally mandated in Australia, its use is widespread in other countries. .

As this study shows, when women are exposed to images of modified vulvas, they don’t question the picture—they question their own bodies. Without other images for comparison, they believe what they see must be normal. Which means their own genitals must not be.

And, it’s not just adults watching porn. Children, preteens, and teens are viewing it too—and absorbing troubling lessons about sexual health. This includes “unrealistic beliefs and expectations in relation to female orgasm,” as well as confusion about “natural” genital appearance and function.

Take this account from a girl in England, who started wanting the procedure when she was 14: “I just picked up from somewhere that it wasn’t neat enough or tidy enough… People around me were watching porn and I just had this idea that it should be symmetrical and not sticking out. I thought that was what everyone else looked like, because I hadn’t seen any normal everyday [images] before then.”

In the long run, this girl did not get labiaplasty. Later, she expressed her relief. “I’m totally glad I didn’t get it done. I didn’t need it. I look totally normal. Completely and utterly normal.”

Many other women and teens, however, do go through with the procedure.

Add-On Surgery

Many women chose to add labiaplasty as an add-on surgery while under general anesthesia for other cosmetic procedures, such as a tummy tuck or breast enhancement.

Some women request this add-on specifically. Some agree to it after being encouraged by their doctors. Many surgeons suggest labia reduction because they—in their own opinion—think the woman’s vulva will look better once it’s surgically altered.

When looking to have an elective, cosmetic procedure, it’s imperative that you do your own research before agreeing to any add-on surgery.

Labiaplasty Myths

As mentioned above, some women seek labiaplasty because they believe it will solve a medical issue, or that it will reverse effects of childbirth or aging (including vaginal dryness after menopause).

Labiaplasty is not a treatment for medical conditions or disorders. It does not reverse the effects of childbirth or aging. In fact, it can increase issues with vaginal dryness, as many glands that create natural lubrication are in the labia.

Both the American College of Obstetricians and Gynecologists (ACOG) and the Royal College of Obstetricians and Gynaecologists (RCOG) have published their concerns about female genital cosmetic surgery.

ACOG states, “It is deceptive to give the impression that vaginal rejuvenation, designer vaginoplasty, revirgination, G-spot amplification, or any such procedures are accepted and routine surgical practices.”

In 2017, ACOG also published specific recommendations for girls under 18 who request labiaplasty. They strongly suggest that teens do not have surgery, except in extreme cases.

Why have organizations like these taken such a hard stance? Read on.

The Designer Vagina Problem

You likely have your own unique reasons for considering labiaplasty, or for searching to learn more. Maybe you are worried that there are no other alternatives—there is no other way to feel happy in your body.

Googling “labiaplasty” and related terms is likely to bring you to pages of plastic surgery offices. Too many plastic surgeons’ websites do their best to cement the belief that FCGS is the best and only option. In addition, they often use shifting terminology or vague language to describe surgeries, making it difficult to know what exactly you are selecting.

Seeking the advice of a medical physician might not be entirely helpful either. In fact, a 2016 study shows that “75% of general practitioners rated their knowledge of FGCS as inadequate,” and that “nearly half reported they had insufficient knowledge of risks of FGCS procedures” to provide counseling to their patients.

Ultimately, the decisions you make about your mental and physical health are yours. What we hope is for you to get the education and information you deserve in order to make a careful, informed choice.

That means keeping in mind surgery’s potential benefits and its problems.

What “Should” Labia Look Like? No Surgical Standards and No True “Ideal”

As we’ve discussed, there is no such thing as one “normal” vulva, let alone one “ideal” vulva.

The major reason women have surgery is entirely cosmetic. And, while your opinions about your body are valid, it’s important to consider how they’ve developed. If you think your labia aren’t “normal,” we encourage you to consider where and how you learned this. At the end of this guide, you’ll find valuable and extensive information about genital diversity to assist you in developing a more objective understanding of “normal.”

According to ePlasty, an online journal of plastic surgery, “There are no widely accepted guidelines for labiaplasty, and it is carried out for a variety of reasons… What constitutes labial hypertrophy [enlargement] is poorly defined in the literature…there is no established anatomic standard.”

Without a standard, what prompts surgeons’ recommendations?

A study published in The Journal of Sexual Medicine shows that physician’s personal opinions and preferences regarding genital appearance play a large role in whether or not they’ll recommend labiaplasty.

According to the study, “More plastic surgeons regarded the picture with the largest labia minora as distasteful and unnatural, compared with general practitioners and gynecologists.” And, “Male physicians were more inclined to opt for a surgical reduction procedure than their female colleagues.”

In other words, a plastic surgeon might recommend labiaplasty based purely on their subjective aesthetic preferences—not on the preferences of their patients.

Pressure from Surgeons

doctor picking up surgical instruments

Many women enter a plastic surgeon’s office without knowing exactly what they want. For example, you might see a surgeon because you’ve noticed something that concerns you, or because you have questions about your genital health. Instead of getting objective answers, you may be misinformed and pressured into having a surgery you don’t need.

Unfortunately, “Aesthetic vaginal surgeons may unintentionally blur legitimate female pelvic floor disorders with other aesthetic conditions.”

That means some women follow their surgeon’s recommendations, only to have surgery to correct a condition that they don’t actually have. And even if they did have a condition, FGCS more than likely will not correct it.

Further, women often compare their labia to “before” images on plastic surgeon’s websites. They do not view these as advertisements, but as “valid representations” of what’s flawed versus what’s normal. They seek surgery to follow the presented example of women with labia like theirs, believing that they, too, must “correct” features advertised as flaws.

More and More Reduction and Removal

Labiaplasty is becoming more complex, and surgeons are cutting away more and more tissue.

Journalist Kirsten O’Regan conducted an in-depth, two-part investigation of labiaplasty. In addition to going undercover as a potential patient, she interviewed a few well-known plastic surgeons.

This includes urogynecologist Dr. Red Alinsod, who claims he invented “The Barbie Procedure” as a response to patients “who wanted almost all of it off.” Remember, this procedure aims to shape women’s vulvas so they look like those of a child or a Barbie doll.

Dr. Alinsod says that “The Barbie” is safe, and that it’s his most-requested surgery. However, he also says, “The problem with this surgery, frankly, is that it looks easy, but there’s a lot of finesse involved. If you don’t know those nuances, you’re going to have dog-ears, or complete removal of the labia when that’s not what’s requested. That’s when the lawsuits occur.”

Remember: Labia, once removed, do not grow back. When the surgery is over, it is irreversible.

O’Regan also spoke to urologist and plastic surgeon Dr. Gary Alter, a physician often sought be women whose labiaplasty procedures were less than satisfactory. According to Alter, “Many women are given Barbie-style surgeries without their consent, resulting in the amputation of the entire inner labia.”

That means there’s a chance you go in to surgery for the procedure you requested and leave with a part of your body permanently altered because the surgeon performed a different one without your consent. That puts you at risk for added complications—complications you did not expect.

Surgical Complications, Scarring, and Loss of Pleasure

There are many consequences that can potentially follow any kind of cosmetic surgery.

It’s important here to note that complications from FGCS do happen. According to a 2015 study by The American Society for Aesthetic Plastic Surgery on the safety of aesthetic labiaplasty, 13% of patients reported “swelling, bruising, and pain” and 3.5% required “revision surgery” or another surgery to “correct” issues from the first.

The British Society for Paediatric & Adolescent Gynaecology reports, “Wound dehiscence [rupturing] has been reported in up to 30% of cases [of labiaplasty] depending on the surgical technique used.”

Other complications include loss of sensitivity, nerve damage, decreased lubrication, increased pain, scarring, irregular shape, texture, and color, bleeding, infection, and necrosis (the death of the tissue).

There are also serious concerns about diminished sexual pleasure. Labia are sex organs. Getting rid of them means losing a part of the body that directly contributes to arousal and orgasm.

The RCOG also discusses the lack of data about medium- and long-term outcomes. There is simply not enough information available to determine whether labiaplasty is safe.

As the labiaplasty industry has grown, so too has an unintended side industry: that of correcting botched surgeries. Dr. Alter “estimates that 20% of his labiaplasties are performed to rectify the mistakes of previous surgeries.”

Labiaplasty when performed by a qualified, experienced, and skilled surgeon will certainly be safer than if performed by an unqualified surgeon. Do your research—unqualified surgeons are more common than you might think.

Lack of Credentials and Regulations

Overall, there is little to no regulation when it comes to labiaplasty. There are no official guidelines for when and why labiaplasty should be performed. And, because labiaplasty is expensive, usually not covered by insurance, and in-demand, many surgeons perform the procedure without any specified training or ability to properly assess for possible disease processes that may affect recovery from the procedure.

International plastic surgery pop-up shops are another modern phenomenon. The Internet is full of websites offering “plastic surgery vacation packages” at discount prices. However, it’s often difficult to tell if those bargain plastic surgeons have legitimate certifications, or if their certifications come from accredited institutions. Undergoing labiaplasty at the hands of an unqualified surgeon heightens the risk of complications.

Don’t gamble the health of your vulva with an unqualified surgeon! Know what you’re getting into and with whom before making any decisions that permanently alter your body.

High Cost and Slow Recovery

Labiaplasty is expensive. According to one plastic surgery website, it can cost anywhere from $3,000–$8,000. In some US locations, the price tag is significantly higher. And because it is elective and cosmetic, most insurance carriers do not cover the surgery.

One surgeon states that her patients can expect to perform the following ritual two to three times a day, for two weeks after surgery: sit in a small tub of warm salt water and then use a hair dryer to dry the wound.

Patients should also take antibiotics, avoid penetrative sex for at least six weeks, and do their best to avoid putting any pressure on the wounds. They can expect “impressive swelling that can follow [and] take weeks for resolution.” It’s necessary that patients see their surgeon for post-surgical follow-up to monitor healing.

All told, it takes around six months to completely heal and recover from labia reduction

Teen Labiaplasty: Permanent Changes to Developing Bodies

teen girl sitting hugging knees

Organizations like ACOG and RCOG are particularly concerned about the dramatic rise of teen labiaplasty. Nearly 40% (159) more girls under 18 underwent labiaplasty in 2016 than in 2015. And, the upward trend is not slowing. Some gynecologists who work with adolescents report they receive requests for genital cosmetic surgery every week.

Having this irreversible procedure at such a young age can have serious consequences that are worth your attention.

The bodies of adolescents and young adults are still developing. According to Dr. Gail Busby, lead adolescent gynecologist at St. Mary’s Hospital in Manchester, England, “In adolescence, the labia are still growing—with the inner lips growing first—so it is normal for them to appear prominent.”

Studies show that teenage girls often struggle with body image, more than teenage boys. But permanently amputating sexual tissue is a poor solution for low self-esteem most likely developed due to beauty trends that are bound to change with time.

It’s no wonder that the British Society for Paediatric & Adolescent Gynaecology echoes ACOG’s recommendations for teenage girls. In their position statement, they write, “There is no scientific evidence to support the practice of labiaplasty and, for girls under the age of 18 years, the risk of harm is even more significant.”

Promises of Self-Confidence

Reports indicate that some women are satisfied with the results of all types of FCGS. Remember the study published in the October 2016 issue of Aesthetic Surgery Journal, in which women reported mild to moderately dysmorphic self-image? Two years after FCGS, those women no longer reported “sexual dissatisfaction or negative genital self-image.”

However, their overall body image did not change.

But that’s FCGS overall. For labiaplasty alone, the findings are a little different.

According to a study published in the Aesthetic Surgery Journal in September 2016, “Over half the women reported that their postoperative labial appearance did not quite meet their expectations.”

These women reported that their labia were asymmetrical, or that they were not as small as they’d imagined. They often then seek out additional procedures, costing them more money and time.

Some women were also distressed to find that more of their inner labia had been removed than they’d expected, even though they had not given their surgeon their consent.

Overall, plastic surgery should not be a recommended treatment for poor body image or body dysmorphia. In fact, according to Dr. Katharine Phillips, the director of the Body Dysmorphic Disorder program at Rhode Island Hospital/Brown University, “Sometimes, patients get a lot worse.”

What if you’re still torn between doubts about labiaplasty and the belief that you’d feel better and like yourself more if you had a designer vagina? You don’t want to run the risks—but you also don’t know what to do about the dislike you feel for your body.

How can you possibly learn to feel comfortable with your labia?

Getting to Know Your Unique Vagina and Vulva

woman consulting with doctor

Healthcare professionals understand that one of the best ways to reduce feelings of self-consciousness and unhappiness with your genitals is to learn how much female bodies vary. Thorough sex education can lead to greater confidence, contentment, and pleasure.

Even though they are external, many women have never seen their vulvas in their entirety. You may have seen your outer labia and some of your inner labia, but somehow the thought of looking at your whole vulva makes you feel uncomfortable and awkward or even weird. That’s okay. It’s important, however, to your overall health and wellbeing to become familiar with your genital anatomy. The more you know about your genitals and how they function, the more likely you are to take care of them and experience the full range of pleasure that they can provide.

Here’s a great way to start: make yourself comfortable in a private space—your bedroom, the bathroom, or wherever you feel at ease. Take off your underwear, sit down, and spread your legs. Angle a mirror between your thighs so that your vulva is in view. Make sure the lighting is good. You might have to adjust your pelvis, tilting it up or back so you can see your entire vulva in the mirror. Take a deep breath, and now take another one.

There you go! You’re looking at your vulva.

With curiosity, an open mind, and purposeful lack of self-judgement, sit with yourself for a while and notice what you see. Try not to compare yourself with anything you’ve seen before.

Take note of your individual landscape. Does anything surprise you? What? Is there anything you like more than you thought you would? What are you observing?

What colors and shades can you identify? Are your labia majora puffy, flat, or somewhere in between? Are your labia minora long, short, or asymmetrical? What does your clitoral hood look like? Can you find the tip of your clitoris when you pull back the hood with your fingers? Can you see the opening of the urethra? It is often hard to locate, as it sits deep between your clitoris and the top of the vaginal opening. Can you see how the labia minora go up and form the clitoral hood? This is all normal anatomy! It’s you in your natural state of beauty!

Whatever you see and feel here, remember that your vulva is unique to you. There’s pleasure to be found in that!

The image below was created by the women artist of VaginaChina.org using actual molds of women’s vulvas. See if you can find one that looks similar to yours.

There Is No One “Normal”: Raising Awareness of Genital Diversity

Move cursor over image to zoom. Permission to use image from Vagina China.

As we’ve said, vulvas are wonderfully diverse, just as variable as the lips on a face. Even two sisters in the same family are highly unlikely to have identical labia. The idea that there is one normal is a myth.

If you’ve never seen labia like yours, that doesn’t mean there aren’t women with labia that look just like yours out there.

Women often feel a great deal of shame around their bodies and their sexuality. As a result, they often don’t talk openly about what worries them or what excites them. This can lead many women to feel isolated and strange, suspicious that they are the odd ones out.

In fact, many myths about the “ideal vulva” are based on harmful ideas about feminine “purity.” Labiaplasty often aims to make women look like dolls or young girls, not like the complex, glorious sexual human beings they are.

Luckily, there are many people who are fighting the stigma in their attempt to de-mystify the vulva. It’s possible to (safely and privately) look at and celebrate all the different labia the media edits out.

We’d like to point you to some wonderful resources about genital diversity. We hope you’ll explore these books, websites, art projects, and films featuring educators, artists, filmmakers, and writers from around the world.

With these resources, you’ll have the opportunity to see the variety of vulva sizes, shapes, and colors, as well as brave girls and women sharing their vulnerability. This art expresses the beauty of vulva diversity.

Books

Feminine Beauty: A Celebration, by Mukee Okan: A book of color photographs, displaying diverse genital anatomy.
Petals: Fine Art Photography of Vulvas, by Nick Carras: Photography celebrating unique vulvar shape, size, and color.
Femalia, edited by Joani Blank: Color photographs reflecting female genital diversity.
Cunt Coloring Book, by Tee Corinne: Beautiful drawings of diverse female genitalia.

Websites

The Labia Library: An educational website featuring a gallery of photos of diverse labia
The Labia Project: A body-positivity blog that invites women to send in photos of their labia, along with stories about their personal relationships with their genitals
Tryst Network: A website featuring sex education articles, such as “An Uncensored Guide to Your Lady Parts” and “16 Tips for Anyone With a Vagina.”

Art and Artists

The Vulva Gallery: An extensive gallery featuring wonderful watercolor illustrations of various vulvas.
Betty Dodson: Features artist Betty Dodson’s detailed, black-and-white vulva drawings.
The Great Wall of Vagina: Much like it sounds, this art project is a wall of sculpted vulvas.
Vagina China: This art project celebrates the vulva with “vagina china,” or unique ceramic plates depicting genital diversity in bright, lovely colors.
Suzanna Scott: The website for artist Suzanna Scott’s vulva coin purses

Films and Videos

The Centrefold Project: A free animated documentary short film about labia reduction.
The Perfect Vagina: A free, hour-long documentary about female genital plastic surgery and the designer vagina controversy.
The Pussy Talks: A documentary of women sharing their most intimate sexual anatomy. The creator wrote “For women in particular, viewing The Pussy Talks is an introduction to witnessing and connecting with the most sacred part of themselves and all women.”

We have collected even more informative, affirming resources on our website’s “Resources” page. We invite you to take a look!

What if something really is wrong?

After looking through these images, you might still worry that your labia are abnormal, or that something is wrong with your genitals.

In this case, you might wish to talk to your doctor. We urge you, however, to remember, doctors are often uniformed when it comes to labiaplasty procedures, risks, and outcomes. Some will even go so far as labia reduction based solely on their personal preference and opinion.

We warmly invite you to reach out to us with your concerns. Or, find a women’s health physical therapist, sex therapist, sexological bodyworker, somatic sex educator, or sex-positive sexuality educator in your area. These are some of many skilled professionals who can help you without suggesting a surgery you don’t need.

Loving Your Labia

It can be difficult to unlearn all the negative messages that you’ve absorbed about your body over time. Stopping the cycle of critical self-talk also takes time, patience, and self-compassion.

You don’t have to do it alone.

It’s very possible that your friends and loved ones are struggling in secret, agonizing over what their vulvas look like too. We encourage all girls and women to engage in healthy, open conversation about female genitals and sexuality. When you talk to other women, you have a chance to hear just how wonderfully different our bodies and sexualities really are. Genital diversity is normal.

Whatever your vulva looks and feels like, the tissue, nerve endings, and glands down below are designed to offer you sexual pleasure. There are plenty of ways to enjoy your sexuality without cutting off parts of your body. As you work through negative self-image, you can also discover how your labia can help you enjoy sex in unique, surprising, and exciting ways.

While the clitoris is the primary source of orgasm for many women, the good news is that the labia are also a place to feel pleasure.

The labia are erogenous zones, or areas that respond to sexual stimulation. Just like the clitoris, these sexually responsive tissues are packed with nerve endings and blood vessels. As this study shows, stimulating the labia can lead to the same amount of sexual pleasure gained by stimulating other genital organs. This is true regardless of labial size.

If you’ve never given your labia positive attention before, now is a great time to start. Just as you did when you looked at your vulva, find a private, comfortable place. Then, gently, explore touching your labia. We recommend using a massage oil that’s safe to use on the genitals. (A favorite of ours is coconut oil.) Offer yourself plenty of time to go slow and get to know what feels good for you. Notice how it feels to stroke, tug, pull, tickle, and wiggle the tissue, if your labia size allows such movements. Experiment using different speeds and varying pressure.

Remember the labia minora form the clitoral hood. While touching your labia, you can indirectly stimulate the clitoris, resulting in pleasure.

As you get to know what feels good for you, you may feel better equipped to discuss your preferences with your sexual partners. You might also help them understand the truth about genital diversity and that yours are perfectly normal in size, shape, and color. By enhancing your partner’s understanding, you become a teacher, helping them learn your unique anatomy.

Sexual pleasure can be good for your physical health and mental and emotional wellbeing. For more resources about sexual pleasure, check out the “Bring Back Joy” section of our website.

Say “No” to Surgery and “Yes” to Self-Love

No matter what brought you to this page, we hope you gained some valuable information about the limits of labiaplasty. More importantly, we hope you’ve learned that you are not alone, abnormal, broken, or in need of fixing.

Your vulva is as much a part of you as your nose and ears. It shouldn’t be an off-limits part, separate from the rest of your body. What you might have seen as a mystery full of shame and fear before may now be a place of interest and curiosity. Keep learning and taking pride in the journey of understanding your vulva. In diversity, there is natural beauty.

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