There has been a tremendous growth in Labiaplasty interest. From 2011 to 2015 in the United States, there was a 400% increase, followed by an additional 39% increase in 2016 when close to 13,000 labiaplasties were performed by board certified plastic surgeons. There has been a similar increase in other English-speaking countries like Australia and the UK.1 Labiaplasty is not a fad operation of the young; the average patient is in her late 30’s and noticed changes over time and after childbirth. There have been theories that the increase in demand has been related to hair patterns such as Brazilian waxing, online pornography, media images and marketing. However, evidence suggests patients with an interest in getting the procedure are no more likely to watch porn that those that don’t, yet many have turned to online images for research purposes.
Plastic surgeons have become the go-to specialty for this designer operation. The American College of Gynecology dropped the ball for these patients with their position paper in 2007 which suggested vaginal rejuvenation and cosmetic vaginal procedures as “untenable”. Not until 2016 was there a slight relaxation of their stance for the treatment of teenagers with persistent physical concerns. The Gynecology Establishment has missed the last decade’s opportunity to train their fellows in safe, aesthetic labiaplasty. Reitsma et al.3 found that gynecologists are more likely than plastic surgeons to discourage patients from having the procedure. Interestingly, in an era of women taking charge of their own sexuality, it is male surgeons who are more likely to provide the service.
A number of studies have documented the high success with a lower than 5% complication rate.2 In the US, uncommonly high satisfaction was found to be 97%, in France 96% and in Australia the majority of patients were very satisfied.1 When surveyed, 93% of post-labiaplasty patients have reported improved self-esteem and 71% described enhanced sex lives. There is an old adage that states sex is one-part friction and nine parts fantasy. It seems reducing the friction in this case can improve the fantasy. The data shows that instead of decreased sensation, two-thirds of women have improved feeling, as labial irritation goes down.1, 4
So why are women undergoing Labiaplasty? 94% of women surveyed at the time of their labiaplasty consultation felt self-conscious over appearance, 72% reported physical discomfort wearing tight clothing, and 64% felt their labia had a negative impact on intimacy. Surveys have shown that it is a combination or multifactorial concern to patients over both feeling andappearance, the average patient having three to four complaints. Ranked in order are:
Labiaplasty Survey Results
Mean Age =+ SD, Years
Previous Child Bearing
Tugging During Intercourse 74%
Uncomfortable wearing tight clothing 72%
Uncomfortable twisting of labia 58%
Visible labia in exercise clothing 54%
Pain during intercourse 48%
Exposure in bathing suit 40%
Self-conscience over appearance 94%
Negative self-esteem 66%
Less attractive to partner 64%
Negative Impact on Intimacy %66
Restrictive of clothing choice 56%
TIMING OF SYMPTOMS
Increasing age 52%
After Childbirth 32%
At Puberty 22%
As long as you can remember 18%
After weight gain 2%
So what are the problems with this procedure if there is so much success? Dissatisfaction or lower satisfaction is related to those who experience complications such as over resections, scalloping, asymmetry and separation – all of which decrease with surgeon experience. Another problem arises when patients do not fully appreciate what results a Labiaplasty can provide.4 Clitoral unhooding for instance reduces clitoral show through the labia majora but does not improve the female orgasm.
In conclusion, Labiaplasty is an exciting growth area in plastic surgery with high success, patient satisfaction and minimal complication. When picking a surgeon, you want an interested, experienced board certified plastic surgeon who will listen to your concerns. Dr. Davison has contributed to the literature5, has been actively performing and teaching Labiaplasty at DAVinci Plastic Surgery since 2006, and would be happy to consult on this delicate matter.
Click here to read Dr. Davison’s article “Labiaplasty and Labia Minora Reduction” on Medscape
Sharp G, Tiggemann M, Mattiske J. A Retrospective Study of the Psychological Outcomes of Labiaplasty. Aesthet Surg J. 2017; 37(3): 324-331.
Sorice SC, Li AY, Furnas HJ. Why Women Request Labiaplasty. Plast Reconstr Surg. 2017; 139: 856-863.
Reitsma W, Mourits MJ, Koning M, Pascal A, van der Lei B. No (wo)man is an island: The influence of physicians’ personal predisposition to labia minora appearance on their clinical decision making. A cross-sectional survey. J Sex Med. 2011; 8: 2377-2385.
Goodman MP. Commentary on: A Retrospective Study of the Psychological Outcomes of Labiaplasty. Aesthet Surg J. 2017; 37(3): 332-336.
Davison SP, West JE, Baker CL. Labiaplasty and Labia Minora Reduction. http://reference.medscape.com/article/1372175-overview Published 8 Sept 2016. Accessed 22 May 2017.