It is simply the surgical repair of the labia majora (outer labia), also known as the labia majora of the vagina, or the labia minora (inner labia), which is located just below the labia majora. Labia minora, or inner labia, are constantly moist structures that do not contain fat and hair cells, are not visible from the outside because they are located under the labia majora, and are rich in blood vessels and nerve endings. The labia minora are two in number and fold into a pleat on the clitoris. Anatomically, the labia minora cover the labia majora, i.e. the labia minora are located under the labia minora and are not visible from the outside.¹

When it comes to labiaplasty, what is mostly meant is the elimination of defects related to the inner labia rather than the outer labia. The labia minora being larger than normal or sagging due to various reasons is one of the most common genital aesthetic problems. During labiaplasty, the excess tissue in the overgrown or sagging labia minora is removed by the specialist physician and the labia are reshaped.

The demand for aesthetic gynecology is increasing day by day by both physicians and patients² . Labiaplasty is one of the most common genital aesthetic operations performed today. There are no national or international medical guidelines that shed light on in which cases surgical intervention should be performed, except for labia majora enlargement (hypertrophy) that constitutes a medical necessity. Patients who prefer genital aesthetic surgery state that they seek medical help primarily due to aesthetic concerns and decreased sexual satisfaction.³ According to the cosmetic surgery statistics published by the American Society for Aesthetic Surgery (ASAP) in 2017, the number of people undergoing labiaplasty has increased by 217.3% in the last 5 years.^.4 Labiaplasty and other genital aesthetic operations, which were preferred only by celebrities at the beginning of the 1980s, have started to be preferred by women in our country as sexual problems have ceased to be taboo and started to be discussed.

Why is labiaplasty performed?

Labiaplasty is considered a medical necessity when hypertrophy (excessive enlargement) of the labia minora causes recurrent vaginal and urinary infections, irritation, painful intercourse (dyspareunia) and restricted movement despite treatment.^5,6 

The inner lips, which are structurally normal in size, sag due to multiple births, traumas during vaginal delivery, hormonal changes due to menopause, rapid weight gain and loss and other reasons, and the outer lips become unable to completely cover the inner lips. In women who have never given birth and whose labia minora are of normal size at birth, sagging may also occur due to a decrease in subcutaneous fat tissue with advancing age. In some women, one or both of the inner lips of the vagina are structurally (genetically) larger than normal and constitute an asymmetrical appearance.

For whatever reason, when sagging exceeds acceptable dimensions, it can create an aesthetically unpleasant appearance, making the person feel bad and cause loss of self-confidence. Even if there is no medical necessity, this situation can negatively affect the person’s life in various ways. For example, when the sagging of the inner lips is advanced, it may prevent wearing swimsuits, bikinis or tight clothes. It can affect the work life of women from professional groups related to sports and performing arts, where physical appearance is prominent, and it can affect the sexual life of all women, causing loss of self-confidence and a decrease in quality of life.

Who can undergo labiaplasty?

It can be applied if the sagging of the inner lips of the vagina has reached a level that negatively affects the quality of life of the person or if labiaplasty has become a medical necessity. If the physician deems appropriate, it can be applied to adult women of any age who do not have any other disease that prevents surgical intervention. It can be applied for postpartum sagging, as well as women who have never given birth can be candidates for labiaplasty as an examination to regain their self-confidence.

How and where is labiaplasty performed?

Labiaplasty is a procedure that should only be performed by a specialist physician and in a hospital environment, where sterility is important. First of all, your specialist will evaluate whether you are a suitable candidate for labiaplasty. If you are found suitable, your physician will inform you about the details of the procedure and what to do after the procedure. The procedure is usually performed under local anesthesia, but your physician may sometimes consider general anesthesia appropriate. Although the duration of the operation varies from patient to patient, it is approximately 30-60 minutes. Since anesthesia is applied during the procedure, no pain is felt.

What awaits you after labiaplasty?

• Post-procedure complications are usually not seen. Complications such as infection, tissue damage and bleeding are possible complications after all surgical interventions. For this reason, labiaplasty must be performed by a specialist physician, under sterile conditions and in health institutions with the necessary equipment.
• Postoperative bleeding is not expected, rarely only a very mild bleeding in the form of leakage and spotting on the suture line can be seen.
• In the first days after surgery, the vulva may be completely swollen, red and sensitive due to edema. Cold compresses as recommended by your physician will remove the edema in the area.
• Since the labia is a blood-rich area, the wound heals quickly.
• The stitches in the area are absorbed or fall off within 10-15 days depending on the type of suture material used.
• You may experience pain after the procedure and your doctor may recommend pain treatment.
• Although it varies from patient to patient, you can usually return to work a few days after the procedure.
• In the absence of any complications, it normally takes an average of 30 days for the area to heal completely.

Pay utmost attention to hygiene during the healing period and for 4 weeks until complete healing of the area is achieved;

• Your dressings should be done as often as recommended by your physician.
• Sports that will cause tension in the area such as yoga and pilates,
• Sports that may cause compression in the area such as horse riding and cycling should be avoided.
• As always, toilet cleaning should be done from front to back during this period.
• In order to prevent the risk of infection, you should not enter the pool, hammam, sea, jacuzzi for the period recommended by your doctor, and you should prefer to take a standing shower instead of bathing in the bathtub. Generally, your doctor will allow you to take a standing shower from the first day.
• Until full recovery, sexual intercourse should be avoided for 4 weeks.
• Again, applications such as epilation and waxing should not be applied to the area until complete healing is achieved.

Frequently asked questions about labiaplasty

IS LABIAPLASTY AN OBSTACLE TO GIVING BIRTH?

Labiaplasty is not a procedure that affects the birth canal, it does not affect vaginal (normal) delivery or cesarean section.

WILL THERE BE A STITCH MARK AFTER LABIAPLASTY?

After the operation performed by an experienced and specialized physician, there are no stitch marks and it is not understood that you have undergone this operation.

DOES INNER LABIA SAG AGAIN AFTER LABIAPLASTY?

There is no tissue regrowth and sagging in the area where excess tissue is removed after surgery.

CAN LABIAPLASTY BE APPLIED TO SEXUALLY INACTIVE WOMEN?

Since the hymen is located inside the vagina, it is not damaged during the procedure, and the procedure is suitable for people who are not sexually active.

IS THERE AN AGE LIMIT FOR LABIAPLASTY?

There is no age restriction, it can be performed on people whose quality of life has deteriorated due to sagging of the inner lips or for whom surgery has become a medical necessity as a result of excessive sagging of the inner lips, if the physician deems it appropriate. The procedure can be performed on adult women of any age who are over 18 years of age, married or single, who have given birth or not.

Like any surgical intervention, labiaplasty should be performed by specialist physicians, in health institutions with the necessary technological equipment, taking care of patient privacy and patient rights. You can also make an appointment with your physician, come for a check-up and improve your quality of life.