You've likely seen click-bait headlines about 'designer vaginas,' but vaginal rejuvenation is no passing fad. While the term encompasses an array of procedures (think: vaginoplasty, skin tightening, etc.), the most common component is labiaplasty (i.e. a surgical procedure that removes excess tissue from the labia minora, or 'inner lips' of the vulva).
According to the American Society of Plastic Surgeons (ASPS), more than 10,000 labiaplasties were performed in the U.S. in 2018 alone. Unlike some procedures, which can solely be classified as plastic surgery or solely classified as cosmetic surgery, labiaplasty has both medical and aesthetic benefits.
Excess labia tissue can lead to pain and discomfort during exercise and intercourse, in addition to interfering with other routine activities. Conversely, the appearance and size of the labia may simply not align with a patient's preferred aesthetic. Regardless of the reasoning, a labiaplasty procedure can address everything from sexual health to general well-being.
While a vaginoplasty addresses the size of the vaginal opening, a labiaplasty procedure is performed to correct the shape and size of the labia. According to Beverly Hills-based board certified plastic surgeon Johnson Lee, MD, there are two types of labiaplasty:
- Trim Labiaplasty: “The trim, or direct excision, method removes the amount of excess labia minora directly along the border of the labia," he explains. "This is perhaps the simplest method for most surgeons and allows accurate reduction of large labia. The downside to this procedure is that the natural darker corrugated edge of the labia minora is removed and the scar line becomes the new border."
- Wedge Labiaplasty: "The wedge excision, which I prefer, requires more measurement and design to ensure a proper final length of the labia," Dr. Lee says. "The wedge excision leaves the natural border of the labia intact. The scar is on the inside of the labia, which is less visible.”
No matter the technique, a labiaplasty is generally an outpatient procedure performed under local anesthesia. According to Dr. Lee, the procedure will not interfere with a woman's ability to give birth, though he does recommend new moms wait at least six months after a vaginal birth "to allow the tissues to stabilize and inflammation to resolve." This, he says, will ensure "the most accurate results.”
Recovery time for both types of labiaplasty is usually around two weeks, but the downtime is minimal (if any). Patients will likely experience a bit of pain and swelling, which can be relieved with ice pads and medication (as directed by your surgeon). Intercourse and soaking in baths should be avoided for up to 40 days post-op.
As with any surgical procedure, there are some risks associated with labiaplasty. Dr. Lee says “contour deformities or asymmetry, infection, scarring, pain, sensation changes, and wound healing complications” are the most common post-procedure concerns.
To better understand the labiaplasty procedure and recovery process, we spoke to three women who chose to undergo the surgery for different reasons. Their names have been changed to protect their privacy.
Lois, New York, NY
Lois opted to undergo a labiaplasty procedure because her labia were asymmetrical and she experienced pain when she was worked out. The appearance also made her feel self-conscious.
The AEDITION: What led you to have a labiaplasty?
Lois: When I was in my teens, I noticed my labia were uneven. One side was a fair bit ‘longer’ than the other. As I got older, I started to find it would become painful when I was wearing tight pants, and it was becoming a real ‘thing’ for me. I became really self-conscious about it. I was approaching the end of college and was still so embarrassed about it when I was dating that I decided to consult a plastic surgeon. We discussed the potential benefits, what the results could look like, and I had some questions about potential consequences in terms of loss of sensation. I weighed up the pros and possible cons and decided to go ahead with the surgery.
The AEDITION: How was the recovery process?
Lois: Recovery was relatively straightforward for me. I truly didn’t know what to expect. I’d never had any kind of surgery before! But I went home and was looked after by my mom. I followed the instructions I received from the clinic, and it went well. I took antibiotics for a few days after the procedure and used ice packs when it was painful. I just generally took it easy for about a week or so. After that, the pain wasn’t bad at all. I had some numbness for around a month after, but, aside from that, I had no complications. The results have been great, too. It gave me the confidence boost I was hoping it would.
The AEDITION: Would you recommend the procedure?
Lois: Absolutely! I was basically able to buy myself confidence, which was, in itself, really empowering. It’s changed my relationship with myself and made me more confident in my relationships with others. The procedure and recovery were much less painful than I imagined. All in all, it’s a definite recommendation from me.
Jane, San Francisco, CA
Jane wanted to boost her confidence after having her children, and, after consulting with a plastic surgeon, decided to have labiaplasty. While she believes the procedure is not something anyone should feel pressured into, she is very pleased with the results.
The AEDITION: Why did you choose to have a labiaplasty?
Jane: I was looking into having some kind of rejuvenation ‘down there,’ but I didn’t know where to start. I consulted my plastic surgeon, who I have been going to for a few years now, and asked her for her advice on the matter. We decided to start with labiaplasty because it would address the changes that bothered me most since I had my children. I do want to say, I think it’s important that women do not feel like they should have to have surgery after childbirth. For me, it was a choice I decided on after giving a great deal of thought, and it was something I wanted for myself. I think that your ‘why’ is a very important consideration before having a procedure like labiaplasty.
The AEDITION: What was the procedure like?
Jane: I was sedated but awake for the procedure with local anesthesia. I felt no pain or discomfort whatsoever during the procedure. The only pain — if you could even call it that — was from the needle they used to put the IV in. I was taken care of very well, and being in a familiar environment with a familiar team put me at ease. I would recommend asking to meet any other members of the provider’s team who will be present during the procedure at your pre-op appointment, if that’s possible. It’s a pretty intimate procedure, so I found it reassuring to be aware of who everyone was in the room while it was happening.
The AEDITION: Are you satisfied with the results of your surgery?
Jane: I am, yes! I achieved the change I wanted to. In all honesty, I just feel more like myself again in that area. It’s something I would urge women to think about carefully. As I said, I think it’s important to consider why you’re considering it. Not that there’s a right or wrong reason, but I just don’t think there should be any pressure for people to feel like they should look perfect unless it’s something that matters to them, for whatever reason.
Lucie, Arlington, TX
Lucie was unhappy with the natural appearance of her labia and opted for surgery to change the aesthetic and improve symmetry. Since the procedure, she has been able to wear clothes she couldn’t before and credits it with improving her overall confidence.
The AEDITION: What led you to have a labiaplasty?
Lucie: I was just really unhappy with the appearance of my vulva. The area was asymmetric; I couldn’t wear certain types of swimwear; and it made me feel kind of bad about myself. I used to always wear shorts and a bikini top if I went to the beach, but I couldn’t really wear swimsuits with a narrow crotch or those high waist. It just didn’t work logistically, shall we say! I started feeling discomfort when I was wearing skinny jeans, and I just felt like, since there was something that could be done about it, I might as well go for it.
The AEDITION: What was the recovery process like?
Lucie: I had to discuss this carefully with my surgeon because I work as a dancer, so the recovery process was going to be important. I decided to have the procedure when I had a break in my schedule for three weeks because I didn’t want to push my body too hard too soon after surgery. This meant I was able to rest, ice the area, and generally take care of myself to help with recovery. I read up on nutrition and which foods can help aid recovery after a procedure, and I made sure to eat extra clean in the run-up to surgery and while I was recovering. In terms of pain, it wasn’t actually too bad — definitely not as bad as some of the injuries I’ve had in the past. I would say it was about a seven out of 10 at its very worst, so totally manageable. I’m pleased I opted to have the procedure when I had a clear window of time with no pressure to rush recovery. I would have said I could’ve gone back after about 10 days to two weeks, but longer was better for me.
The AEDITION: Are you pleased with the results?
Lucie: Oh, totally! It’s just one less thing to worry about. I always feel kind of silly saying that I used to worry about what I looked like. But it’s just nice to know I can wear what I want, I can be confident when I’m dating, and just not have to think about that part of me anymore. It took a little while for me to get used to the new sensations after surgery. It took a little while for sensation to come back at all, and, when it did, it was a bit different. But there hasn’t been any negative impact for me. The procedure was easy to recover from, too, so I’d totally recommend it to anyone who’s considering it.