Overview of Labiaplasty Minora Reduction
How a person perceives their own body, including the appearance of their genitals, can significantly affect their self-esteem and identity, especially when beginning a new relationship. For women in particular, the appearance of their genitals can be shaped by cultural norms and personal notions of beauty, both of which are influenced by societal norms and expectations.
In recent years, more women have chosen to remove their pubic hair, leading to increased visibility of any minor irregularities and possibly making them more self-conscious in this area. Additionally, the easy availability of explicit photos or videos, coupled with the growing acceptance of openly discussing sexual practices and preferences, can make some women feel insecure about their genitals and worry that they may not meet societal expectations. As a result, these women may avoid situations where they might feel uncomfortable or exposed, such as wearing tight clothes or swimsuits or being in group showers or intimate relationships.
These concerns have led to a surge in demand for genital aesthetic surgery, with the American Society of Aesthetic Plastic Surgeons reporting a 217.2% increase in labiaplasty requests from 2012 to 2017. Aesthetic surgery of female genitals can greatly boost a woman’s confidence, especially if she perceives her genitals to be deformed. Labiaplasty (a procedure to reduce the size of the labia) and clitoral hood surgery can create a natural look with over 90% of patients reporting satisfaction. While there isn’t a universally accepted ideal appearance for genitals, some basic guidelines are followed. These include symmetrical labia minora that do not extend beyond the labia majora, a non-protruding clitoral hood without extra folds, full labia majora without excess skin or fat, and a moderately full mons pubis that doesn’t stick out in clothes.
It’s also important to note that for some women, enlarged labia minora or majora or excessive clitoral hooding can cause physical problems. They may experience irritation or discomfort during exercise, sex, or when wearing tight clothes. In extreme cases, greatly enlarged labia can interfere with sex, personal hygiene, and self-catheterization.
Anatomy and Physiology of Labiaplasty Minora Reduction
It’s crucial to have a deep knowledge of the anatomy to avoid harming the clitoris and causing loss of sensation after surgery. The labia minora, which are parts of the female genitalia, can come in a wide variety of sizes, thicknesses, and colors. Located right under the prepuce (a layer of skin that covers the clitoris), you’ll find the glans clitoris. Frenula are skin folds that extend from this area and merge with the extension of the clitoral hood, forming what we know as the labia minora.
The outer parts of the female genitalia are supplied with blood by branches from three arteries: the external superficial pudendal artery, the internal pudendal artery, and contributions from the internal circumflex artery. The external superficial pudendal artery forms a connection, known as an anastomosis, with the posterior labial artery in the labium majora. This connection distributes blood to the labia minora through multiple branches.
Why do People Need Labiaplasty Minora Reduction
The size of the labia minora, or the inner skin fold of the external part of the female genitalia, can vary significantly among women. In most cases, larger labia minora are just a part of natural, normal variations. However, some women have reported their labia growing larger after childbirth, hormone therapy, or as they age.
A reduction procedure, known as a labiaplasty, can be performed on women as young as 12-years-old if their large labia size causes symptoms. These symptoms could include lowered self-esteem, physical discomfort, or social stigma. Most of the time, women undergo labia reduction for cosmetic reasons, wanting their labia minora to look a certain way. They often desire lighter, thinner, straighter, and symmetrical labia.
A study by Felicio and others categorizes labia size into types ranging from type I (less than 2cm) to type VI (more than 6cm). As surgery to address large labia is often not deemed medically necessary, this scale is primarily used for research. A labiaplasty can be done as long as the labial tissue can be removed without harming important structures, and the procedure can be tailored to the patient’s aesthetic desires. Other accompanying procedures such as reducing the clitoral hood might be considered during a labia reduction surgery if leaving this part alone might result in undesirable physical appearance.
There are two primary methods for labia reduction. The first method, known as the trim or edge method, was reported by Hodgkinson. The second method, called the wedge method, was pioneered by Alter. The chosen technique depends on the patient’s anatomy, goals, and preferences.
When a Person Should Avoid Labiaplasty Minora Reduction
Some people should not have certain procedures for various reasons. For instance, individuals suffering from body dysmorphic disorder, a mental disorder where a person obsesses over a perceived flaw in their appearance, should not undergo the procedure. Additionally, it may not be suitable for those who anticipate the procedure to improve their sexual experiences or enhance their capacity to reach sexual climax.
Equipment used for Labiaplasty Minora Reduction
To carry out this medical procedure, the doctor will need some special tools. These include a surgical tray holding basic equipment, a ruler, and a marking pen. They’ll also use finely serrated scissors, which help to make very precise cuts. The doctor will also use what’s called absorbable sutures like Monocryl, Chromic, or Vicryl. These are special types of stitches that the body can naturally break down and absorb over time, so you won’t need to have them removed.
You’ll be positioned in what’s known as the dorsal lithotomy position. This is a common position for various medical procedures where you’ll be lying on your back with your legs elevated and bent. This position makes it easier for the doctor to perform the procedure.
For pain relief, the doctor will use a local anesthetic called Marcaine. This is a strong anesthetic that numbs the area where it’s applied and works for a long time. This means you won’t feel any pain during the procedure, and the numbness can last for some time afterwards to help manage any discomfort.
Who is needed to perform Labiaplasty Minora Reduction?
During the operation, there will be a trained helper known as a scrub technician or surgical assistant to assist the main surgeon. Sometimes, another surgeon might also be there – not because they’re needed to do the operation, but to help out with detailed parts or to learn from the procedure.
Preparing for Labiaplasty Minora Reduction
Before any procedure, it’s important for the woman to have a clear understanding of what to expect. To achieve this, she should be physically examined while laying back with her legs in stirrups (a position known as the lithotomy position). By using a mirror, she can see her own genitalia and express her specific concerns and desired changes to the surgeon. This will make sure both the surgeon and patient have the same understanding of the expected results.
Pictures should be taken of her genitalia while she’s in the lithotomy position as well as standing up with her legs apart about the same width as her shoulders. This helps the surgeon to see any protrusion of the labia, or lips of the vagina, and plan the procedure accurately. Antibiotics will be given to her within 30 minutes before the first cut is made to prevent any potential infections.
This procedure can be done either in the doctor’s office with calming medication and local anesthesia, or in a surgical center under more thorough anesthesia. This depends on what the patient and surgeon agree on.
It’s often wise to have another person in the room during any intimate examination. This person, preferably someone who identifies with the same gender as the patient, is there to ensure patient comfort and safety, mainly for legal reasons. This precaution not only protects the patient but also everyone else involved in the process.
How is Labiaplasty Minora Reduction performed
There are two main methods to perform labia minora reduction: the wedge excision or the trim technique.
When the inner lips of the female genitals, called the labia minora, are uneven or protrude outward noticeably, a surgeon can correct this by using a knife, scissors, or a laser to remove the excess skin and sewing up the area for closure. The trim technique is particularly effective for significant excesses and where the patient doesn’t mind possible colour changes of the visible area. While this method is quicker and can result in a lighter colour (which some people prefer), it may also result in uneven edges, a scalloped appearance or reduced sensation, causing discomfort. There can also be issues with asymmetry and over-removal of tissue, which is hard to fix. It can also result in aesthetically unpleasing ‘dog ears’ at the top and bottom.
The wedge technique, on the other hand, maintains the natural edge of the labia. Here, the most protruding part of the labia minora is removed as a wedge or a ‘V’ shape, retaining the natural edge. The downside is that it takes longer and requires more surgical skill. Additionally, the dark pigment of the labial edge might remain.
Before the surgery, the woman is examined with her legs apart (the lithotomy position) while she and the surgeon discuss the areas for correction. This conversation is guided by mirrors or a real-time camera. The surgeon also checks the clitoral hood, the back of the vaginal opening for any problematic changes, and the shape, length and thickness of the labia minora. Then the surgeon marks the areas to be removed, taking into account the patient’s individual anatomy.
During the operation, the surgeon uses special tools, anaesthesia and precise techniques to make sure the area is tightened just right and not too much. At the end of the surgery, the labia should only slightly extend past the entrance of the vagina.
Post-operation, the patient usually comes back after three weeks to get any remaining sutures removed and to check the healing process. There will likely be significant swelling, which can take weeks to go down. Patients will need to avoid vaginal penetration for six weeks, avoid putting pressure on the stitches, and refrain from activities that could create tension on the cuts. Also, as the sutures dissolve, there might be intense itching. If the patient is not happy with the results after full healing (usually around six months), a revision surgery can be considered. If the results can be improved, the patient should be offered this option. One common complaint is that even after the surgery, the labia can still be slightly uneven.
Possible Complications of Labiaplasty Minora Reduction
Although most people recover from surgery exceptionally well, a few minor complications can occur. These complications include a slight separation of the edge of the lip-like structure (labia) or a small channel (fistula) that forms an abnormal connection, usually between two body parts. These complications occur in less than 2% of cases and can typically be fixed using a minor procedure with a local anesthetic within 4 to 6 months after the surgery.
Significant separation (major dehiscence) of the surgical wound is rare if the surgery is performed as described. Chronic discomfort in the scar tissue area or issues with sexual intercourse are extremely rare, but these can also be corrected.
Over time, the labia or scars may stretch back. However, this can be easily adjusted in a follow-up procedure. If the labia still protrude too far after the ‘V’ shaped cut has been made during the surgery, then additional procedures, which involve removing tissue from the inner (medial) and outer (lateral) areas of the labia, can be performed. However, this step is barely needed.
What Else Should I Know About Labiaplasty Minora Reduction?
Labiaplasty, a surgery for reshaping the skin around the female genitalia, can greatly enhance how the area looks and boost a woman’s self-esteem during intimate situations. However, if too much skin is removed, it can lead to serious problems that might not be fixable. To get the best possible results, two things are important: The surgeon must be very skilled and careful, and there needs to be open, clear communication between the woman and her surgeon.
