Before you dive into the document, please know we’ve done a ton of research on the subject and have a lot to say. The end result is this comprehensive guide to understanding labiaplasty. We have sections on why women elect to have it done, what the different forms of labiaplasty are, we discuss other procedures performed on the vulva and vagina, and we describe the risks involved including numerous warnings against it.
We offer you ways to learn more about your unique vulva in order for you to understand just how normal and beautiful your shape, size and color are. To that end, we have divided the document into three parts. All of the sources for the entire document can be found at the bottom of Part 3. Read on!
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).
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.
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).
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.
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.
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 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 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”.
We’ve just given you a lot of information. Take a break and let it sink in before reading Part 2: Why Are So Many Women and Teens Choosing Labiaplasty?