Most cosmetic procedures—like breast augmentation, liposuction, tummy tucks and others—are fairly well understood by prospective patients these days, thanks to the Internet and media attention. Labiaplasty, however, is not on that list. There may be more misinformation floating around about labiaplasty than most other cosmetic surgery.
For one thing, it’s not necessarily easy to talk about modifying your labia, and with just a few thousand women choosing surgery annually, it’s not exactly commonplace to follow through. In addition, labiaplasty is part of a new field: female genital plastic surgery (FGPS). It’s an emerging medical specialty that touches off a significant amount of controversy.
To be very clear, labiaplasty involves reducing and reshaping the labia minora and labia majora (either or both) – the flaps of skin outside the vaginal opening. It’s done on an outpatient basis using either a laser or advanced surgical techniques. Plastic surgeons take care to preserve the natural color and feel of the delicate skin during surgery, carefully placing small sutures that dissolve over time.
Labiaplasty is just one of several forms of FGPS. Another is vaginoplasty, or tightening of the vagina.
Some negativity about labiaplasty may result from a stance the American College of Obstetricians and Gynecologists (ACOG) took a few years ago about FGPS in general. In a press release from 2007, the ACOG advised against “cosmetic vaginal procedures,” stating that these surgeries are “not medically indicated, nor is there documentation of their safety and effectiveness.”
The press release went on to allow that some procedures for “genuine medical conditions” such as “labial hypertrophy” (enlargement) may be reasonable. But this statement was somewhat buried in the ACOG’s concern about FGPS procedures being marketed to women with the promise of increased sexual satisfaction and little regard for potential risks.
There are indeed women who benefit from labia reduction: women whose labia stretched or suffered injury during childbearing, older women whose genital skin has become elongated through the passing years, or those whose genes simply gave them protruding or misshapen labia. These women suffer from some or all of the following effects: pain during sex, inability to engage in certain sports, such as bicycling, and hygiene challenges. Some find certain clothing uncomfortable, and some say you can see their labia in bathing suits and other brief or tight attire.
Some surgeons are concerned that interest in labia reduction surgery has been fueled by pornography and frank, sometimes very graphic, descriptions of female genitalia in the media and popular culture. While there certainly are patients who pursue labiaplasty for simple aesthetic improvement, Dr. David Stoker, a Los Angeles plastic surgeon, has a different observation. “Having performed the procedure for several years now, I’ve been impressed with the thought process of patients who are interested in labiaplasty,” he said. “Most consider surgery for functional, rather than cosmetic reasons.”
More data on FGPS is starting to emerge—exactly what the ACOG called for three years ago. In 2009, a group of gynecologists, gynecological urologists and plastic surgeons across eight states published an “Outcome Study” on FGPS. Among other things, they sought to characterize patients’ reasons for seeking surgery and measure satisfaction with a variety of procedures.
Of the 258 patients surveyed, 75 percent said they sought labiaplasty for functional improvement. Moreover, while women reported satisfaction with all procedures included in the study, labiaplasty (including clitoral hood reduction) had the highest rate of satisfaction of all, over 97 percent. That tracks with what Stoker has seen in his practice. He commented, “Labiaplasty patients are most often very pleased with the results. The procedure involves very few problems and offers lots of benefits.”
References:
http://www.acog.org/from_home/publications/press_releases/nr09-01-07-1.cfm
http://www.labiaplastysurgeon.com/articles/Labiaplasty-Patient-Study.pdf