Labiaplasty

Labiaplasty reshapes the labia, most often reducing the inner lips where they extend beyond the outer ones. Occasionally it addresses the hood above the clitoris or the outer lips, and the plan is decided at the consultation after an examination.

Before anything else, it is worth knowing how wide normal is. The inner lips vary greatly in size, shape, colour and symmetry between women, and being visible, uneven or dark is entirely usual and is not a deformity. Most women who arrive asking about this are anatomically unremarkable, and a good surgeon will say so. The operation is worth considering where the tissue causes genuine trouble: pulling or catching in clothing, discomfort on cycling, riding or exercise, chafing, hygiene difficulty, or pain during sex.

There are two common techniques. A trim removes the excess along the free edge and leaves a scar line along it. A wedge removes a V-shaped piece and rejoins the natural edge, which preserves the original border and leaves a shorter scar. Neither is better for everyone, and your surgeon will recommend one based on your anatomy and what is bothering you. Surgery is not offered to girls before development is complete.

The procedure is done under local anaesthetic. The area is numbed with injections, which sting for a few seconds, after which you feel pressure and movement only, and you are awake throughout. Sedation can be added if being awake would be difficult, and that is worth raising at the consultation.

Your surgeon marks the tissue with you sitting or standing so that the plan matches how the tissue actually hangs, then removes the excess and closes the edges with fine dissolvable stitches. It takes forty-five to ninety minutes depending on how much is being done and whether both sides are being treated.

This is a Day Care attendance. You are watched for an hour or so, given ice, pain relief and written instructions, and go home the same day. Arrange for someone to take you home and plan on doing nothing at all for the rest of that day.

Swelling and bruising are the story of the first fortnight, and the swelling in the first three or four days is often dramatic and asymmetrical; it is not the result. Ice for the first forty-eight hours, loose cotton underwear, no tight trousers, and pouring warm water while passing urine all help. Sleep with a pillow under the hips for the first few nights.

The stitches dissolve over two to four weeks and you may notice small knots coming away, which is normal. Most women return to desk work in three to seven days and avoid standing all day for a fortnight. No gym, cycling, running, swimming or horse riding for four weeks. Nothing in the vagina and no sex for six weeks.

The tissue keeps settling long after it looks healed. Judge the final shape at three to six months, when the swelling has fully gone and the scar has softened and paled. Discomfort on sitting eases within a couple of weeks, and any sensitivity at the scar usually fades over a few months.