Hypertrophic (enlarged) labia can be a source of embarrassment causing some women to avoid, for example, swimming in public swimming pools or forming or sustaining intimate relationships. They may also report functional problems such as irritation or catching in underwear.
Accepting that there is great diversity among the female population with regards to the shape and size of the external genitalia, with no clearly defined ‘normal’, the general aim of cosmetic labiaplasty is to reduce the size of the labia such that the free edges of the labia extend to the same level as the labia majora.
A number of different techniques have been described to achieve labial reduction which can be undertaken under local anaesthesia (with or without sedation) or under general anaesthesia, often as a day case procedure. The simplest operation removes the free edge of the labium and the edges are closed with dissolvable sutures.
Post-operatively patients are advised to rest for up to a week and to try to keep the area clean and dry. The inevitable swelling that develops in the early post-operative phase gradually abates over three to seven days.
The risks associated with reduction labiaplasty can be regarded as generic risks (i.e. those risks associated with any surgical procedure) and specific risks (those that may arise from the specific nature of the operation). Generic risks include scarring (permanent, occasionally lumpy and tender), infection, bleeding (haematoma and re-operation) and wound breakdown. Specific risks of labiaplasty are over- or under-correction, asymmetry, scar contracture and unhappiness with the cosmetic result. Very occasionally patients may experience discomfort at intercourse or a disruption to the urinary stream following labiaplasty surgery.
Labiaplasty is a commonly-performed procedure in the UK and may be undertaken by either plastic surgeons or gynaecologists.