Long labia and/or bulky labia cause discomfort, may be a frequent distraction,  and/or may show through   tight fitting or minimal wear.

Normal labial anatomy varies widely.  Excess labia may be irregularly shaped.  There may be more on one side or the other.  Excess may be concentrated in one part of the labia, either the front, the center, or much less commonly toward the back.

In planning labiaplasty, differences between right and left sides are  considered.  If one side is larger or longer to begin with, that side will be reduced more than the smaller side for symmetry.

If excess is distributed along the entire length of the labia from front to back,  the trim technique may be most appropriate.  If excess skin is localized to one area, then modified wedge labiaplasty is preferred.

Labiaplasty is individually designed and accomplished based on the presenting appearance, her complaints, and the result she desires.  Our very first part of the procedure is careful marking of labiaplasty skin to be removed with agreement between patient and doctor.  Then, complete anesthesia is achieved so labiaplasty is comfortable.  Although anxiety and fear surround labiaplasty for many women, it is usually an easy procedure.  Disability following labiaplasty lasts one week or longer.  

Expert labiaplasty surgery requires skilled reduction and artistic, feminine re-shaping of the labia minora (“nymphae”).  The nymphae are soft, pliable, erectile, sensitive ridges of skin.  They partially cover and emerge from the glans clitoris in front, surround the urethral opening (“meatus”) and the vaginal introitus (entrance) centrally, and then become smaller toward the back, to reunite again as the “posterior fourchette.”  Labia minora skin folds have an outer dry side and distal edge with a roughened (rugated) surface and an inner side that becomes pink and moist toward its base.  The outer dry side is pink, or pigmented like surrounding skin.  Skin on the edge is often more darkly pigmented, and inner labial skin is more thin, delicate, and specialized, with glands for lubrication.  In front, labia minora divides into two folds, including the prepuce of the clitoris (clitoral hood) and the inner frenula, which unite in the midline at the clitoral base.  The back third of the labia minora (toward the posterior fourchette and perineum) gradually becomes more thin and shortened, sometimes to disappear completely into skin of the labia majora.

Labia minora skin folds protect sensitive and delicate central structures (clitoris, urethral opening, and vaginal entrance), maintain moisture of vestibular surfaces, and prevent fecal contamination of the genito-urinary tract.   Excess labia beyond what is needed for protection is unnecessary, and can be uncomfortable.  Surgical trimming, re-shaping, and re-arranging labial excess doesn’t interfere with sexual, reproductive, or excretory functions.  Innervation of remaining labial surfaces remains unchanged, provided surgical technique accommodates sensory function.  Vaginal and clitoral mediated orgasm is unaffected by labiaplasty and other superficial procedures of labia minora, labia majora, and clitoral hood.  Circulation of genital skin is abundant, which facilitates complication free healing.