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The external genitalia of a woman are collectively known as the vulva. This comprises the labia majora outer labia , the labia minora inner labia , the clitoris , the urethra , and the vagina.

The labia majora extend from the mons pubis to the perineum. The size, shape, and color of women's inner labia vary greatly. They may be hidden by the outer labia, or may be visible, and may become larger with sexual arousal, sometimes two to three times their usual diameter.

The size of the labia can change because of childbirth. Genital piercing can increase labial size and asymmetry, because of the weight of the ornaments.

In the course of treating identical twin sisters, S. Davison et al reported that the labia were the same size in each woman, which indicated genetic determination.

Labia reduction surgery is relatively contraindicated for the woman who has active gynecological disease, such as an infection or a malignancy ; the woman who is a tobacco smoker and is unwilling to quit, either temporarily or permanently, in order to optimize her wound-healing capability; and the woman who is unrealistic in her aesthetic goals.

The latter should either be counselled or excluded from labioplastic surgery. Davison et al write that it should not be performed when the patient is menstruating to reduce potential hormonal effects and the increased risk of infection.

In sexual reassignment surgery, in the case of the male-to-female transgender patient, labiaplasty is usually the second stage of a two-stage vaginoplasty operation, where labiaplastic techniques are applied to create labia minora and a clitoral hood.

In this procedure, the labiaplasty is usually performed some months after the first stage of vaginoplasty.

Labial reduction can be performed under local anaesthesia , conscious sedation , or general anaesthesia , either as a discrete, single surgery, or in conjunction with another, gynecologic or cosmetic, surgery procedure.

The original labiaplasty technique was simple resection of tissues at the free edge of the labia minora.

One resection-technique variation features a clamp placed across the area of labial tissue to be resected, in order to establish hemostatis stopped blood-flow , and the surgeon resects the tissues, and then sutures the cut labium minus or labia minora.

This procedure is used by most surgeons because it is easiest to perform. The technical disadvantages of the labial-edge resection technique are the loss of the natural rugosity wrinkles of the labia minora free edges, thus, aesthetically, it produces an unnatural appearance to the vulva, and also presents a greater risk of damaging the pertinent nerve endings.

Moreover, there also exists the possibility of everting turning outwards the inner lining of the labia, which then makes visible the normally hidden internal, pink labial tissues.

The advantages of edge-resection include removal of the hyper-pigmented darkened irregular labial edges with a linear scar.

Another disadvantage of the trim or "amputation" method, is that it is unable to excise redundant tissues of the clitoral hood, when present.

In addition, the trim method does not address the clitoral hood. Clitoral hood deformities are common with this approach, again requiring additional corrective surgery.

Some women complain of a "small penis" when the trim procedure is performed, owing to the un-addressed clitoral hood tissue and completely removed amputated labia minor.

Labial reduction by means of a central wedge-resection involves cutting and removing a partial-thickness wedge of tissue from the thickest portion of the labium minus.

If performed as a full-thickness resection, there exists the potential risk of damaging the pertinent labial nerves, which can result in painful neuromas , and numbness.

A partial thickness removal of mucosa and skin, leaving the submucosa intact, decreases the risk of this complication. Giraldo et al. The benefit of this technique is that an extended wedge can be brought upwards towards the prepuce to treat a prominent clitoral hood without a separate incision.

Labial reduction by means of the de-epithelialization of the tissues involves cutting the epithelium of a central area on the medial and lateral aspects of each labium minus small lip , either with a scalpel or with a medical laser.

This labiaplasty technique reduces the vertical excess tissue, whilst preserving the natural rugosity corrugated free-edge of the labia minora, and thus preserves the sensory and erectile characteristics of the labia.

Yet, the technical disadvantage of de-epithelialization is that the width of the individual labium might increase if a large area of labial tissue must be de-epithelialized to achieve the labial reduction.

Labial reduction occasionally includes the resection of the clitoral prepuce clitoral hood when the thickness of its skin interferes with the woman's sexual response or is aesthetically displeasing.

The surgical unhooding of the clitoris involves a V—to—Y advancement of the soft tissues, which is achieved by suturing the clitoral hood to the pubic bone in the midline to avoid the pudendal nerves ; thus, uncovering the clitoris further tightens the labia minora.

Labial reduction by means of laser resection of the labia minora involves the de-epithelialization of the labia. The technical disadvantage of laser labiaplasty is that the removal of excess labial epidermis risks causing the occurrence of epidermal inclusion cysts.

Labial reduction by de-epithelialization cuts and removes the unwanted tissue and preserves the natural rugosity wrinkled free-edge of the labia minora , and preserves the capabilities for tumescence and sensation.

Yet, when the patient presents with much labial tissue, a combination procedure of de-epithelialization and clamp-resection is usually more effective for achieving the aesthetic outcome established by the patient and her surgeon.

In the case of a woman with labial webbing redundant folding between the labia minora and the labia majora, the de-epithelialization labiaplasty includes an additional resection technique — such as the five-flap Z-plasty "jumping man plasty" — to establish a regular and symmetric shape for the reduced labia minora.

Post-operative pain is minimal, and the woman is usually able to leave hospital the same day. No vaginal packing is required, although she might choose to wear a sanitary pad for comfort.

The physician informs the woman that the reduced labia are often very swollen during the early post-operative period, because of the edema caused by the anaesthetic solution injected to swell the tissues.

She is also instructed on the proper cleansing of the surgical wound site, and the application of a topical antibiotic ointment to the reduced labia, a regimen observed two to three times daily for several days after surgery.

The woman's initial, post-labiaplasty follow up appointment with the surgeon is recommended within the week after surgery.

She is advised to return to the surgeon's consultation room should she develop hematoma , an accumulation of blood outside the pertinent venous and arterial vascular system.

Depending on her progress, the woman can resume physically unstrenuous work three to four days after surgery. To allow the wounds to heal, she is instructed not to use tampons, not to wear tight clothes e.

Medical complications to a labiaplasty procedure are uncommon, yet occasional complications — bleeding, infection , labial asymmetry , poor wound-healing, undercorrection, overcorrection — do occur, and might require a revision surgery.

An over-aggressive resection might damage the nerves, causing painful neuromas. Performing a flap-technique labiaplasty occasionally presents a greater risk for necrosis of the labia minora tissues.

Labiaplasty is a controversial subject. Critics argue that a woman's decision to undergo the procedure stems from an unhealthy self-image induced by their comparison of themselves to the prepubescent-like images of women they see in commercials or pornography.

In Australia, the Royal Australian College of General Practitioners has issued guidelines on referring patients with dissatisfaction with their genitals to specialists.

Increasing numbers of women in Western countries are also using Brazilian waxing to remove pubic hair, and choosing to wear tight-fitting swimwear and clothing.

Linda Cardozo , a gynaecologist at King's College Hospital , London, told the newspaper that women were placing themselves at risk in an industry that is largely unregulated.

Although female genital mutilation — the practice of cutting off a woman's labia and sometimes clitoris, and in some cases creating a seal across her entire vulva — is illegal across the Western world, Davis argues that "when you really look carefully at the language used in some of those laws, they would also make illegal the labiaplasties that are being done by plastic surgeons in the U.

ACOG argued that it was deceptive to give the impression that the procedures were accepted and routine surgical practices. It recommended that women seeking such surgeries must be given the available surgical-safety statistics, and warned of the potential risks of infection, altered sensation caused by damaged nerves, dyspareunia painful sexual intercourse , tissue adhesions , and painful scarring.

Creighton of the University College London Institute for Women's Health wrote in the British Medical Journal in that "the few reports that exist on patients' satisfaction with labial reductions are generally positive, but assessments are short-term and lack methodological rigour.

The authors noted that "the patients consistently wanted their vulvas to be flat, with no protrusion beyond the labia majora The International Society for the Study of Women's Sexual Medicine produced a report in concluding that "vulvar plastic surgery may be warranted only after counseling if it is still the patient's preference, provided that it is conducted in a safe manner and not solely for the purpose of performing surgery".

Media related to Labiaplasty at Wikimedia Commons. From Wikipedia, the free encyclopedia. Plastic surgery procedure for altering the labia minora.

Result of labiaplasty in combination with clitoral hood reduction. Further information: Sex reassignment surgery male-to-female.

Full ablation of the inner labia by use of the trim- edge resection- technique, that results in no protuberance of labial tissue. Labiaplasty with clitoral unhooding with genital piercings.

This photo demonstrates the appearance of the labia minora and clitoral hood just after surgery in the operative theater. Note that the inner labia are less prominent than before surgery.

This photo was taken one week after an extended wedge labiaplasty with clitoral hood reduction. The inner and outer labia can be seen as edematous, with the most swelling noticed in the clitoral hood area.

Further information: Body dysmorphic disorder , Female genital mutilation , and Labia pride movement. Medicine portal. May The majora are the outer lips the ones that grow hair while the minora are the inner lips, which connect to the clitoral hood.

The majora typically at least partially envelop the labia minora. Currently, more than 12, procedures are performed by ASPS members per year, a 39 percent increase from previous years.

But before rushing to alter your lady parts, understand that almost all shapes, sizes, textures, and colors of labia are normal and healthy.

To prove our point, we talked to top gynos—and got creative in the drawing room—to share explanations and illustrations of what "normal" labia look like.

And guess what? Yours is undoubtedly on the list. Yes, it kind of resembles a fortune cookie. And when most women seek out labiaplasties, this is the look they are going for, says Karen Horton, M.

She notes that labia majora reduction surgeries are actually a thing. Would they be dysfunctional? While this shape is normal, it tends to be the one that bothers women most.

Bleeding, scarring, and uncomfortable intercourse can, in rare cases, result. If you consider that the labia majora are basically an extension of the inner thighs and buttocks, it's kind of surprising that they're a totally different color than the rest of your skin.

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