Labiaplasty: Everything You Need to Know

Surgery to change the external appearance of the vagina

A labiaplasty is an operation in which the size and/or shape of the labia, the lips of the vulva, are surgically modified for either cosmetic reasons or to reduce physical discomfort. A type of vaginal rejuvenation surgery, this procedure is usually elective and is not normally done for a medical purpose.

This procedure may also be a part of gender-affirming surgery, which includes a number of procedures that are done to align a person's physical gender with their gender identity.

Woman talking with her doctor
Sean Justice / Getty Images

What Is Labiaplasty?

The labia majora are the outer skin folds that are naturally covered with hair after puberty. The labia minora sit directly within the labia majora and are smaller, hairless folds of skin. Both are visible without an invasive medical examination.

A labiaplasty can involve reducing or increasing the size of any part of these folds by:

  • Cutting away a portion of the labia
  • Restructuring a section of the labia
  • Injecting a material into the labia to fill it out (temporary)

Excess tissue may be resected with surgical cutting tools or radiofrequency, which uses the energy of heat. Clitoral hood reduction is often performed at the same time as labiaplasty.

When done as part of comprehensive gender-affirming process, labia are created from existing genital tissue. Labiaplasty may be preceded and/or followed by other surgeries, as well as hormone therapies.

This procedure is performed by a plastic surgeon and can be done with local anesthesia with or without monitored anesthesia sedation while you are awake.

While it is rarely done under general anesthesia, you may have this type if you are having a labiaplasty as part of a more extensive procedure such as vaginoplasty (creation of a vagina) and/or orchiectomy (removal of testicles).

Contraindications

If you have a vaginal infection or a bladder infection, you will need to postpone the surgery until the infection resolves.

Previous vaginal surgery or previous surgery near the labia may lead to scar tissue that could make you prone to complications from a labiaplasty. If you have such scarring, you and your doctor will have to discuss the risks and benefits of the surgery to determine if it is right for you.

Some factors may interfere with healing or alter the potential benefits of this surgery, and the procedure may not be advised for you if you are not prepared for/willing to accept these circumstances.

For example:

  • You have to be prepared to abstain from strenuous exercise and sexual activity for approximately four to six weeks after the surgery.
  • If you become pregnant and have a vaginal delivery after a labiaplasty, your labia may change appearance, altering the results of the surgery.

Legal Restrictions

According to the American College of Obstetrics and Gynecology (ACOG):

  • Labiaplasty in patients younger than age 18 is a violation of federal criminal law except in cases when a physician believes the surgery "is necessary to the health of the patient."
  • Some states have laws against labiaplasty in certain cases (minors and adults).

Potential Risks

This procedure can cause complications that are normally associated with surgery and anesthesia. Additionally, labiaplasty can also result in specific problems that can emerge after the operation.

Risks include:

  • Swelling
  • Infection
  • Bleeding
  • Scarring
  • Persistent pain
  • Pain when urinating or having a bowel movement
  • Pain with sex
  • An outcome that is different from what you wanted

Sometimes complications can be managed with medical or surgical treatment, but these problems can cause prolonged distress.

Purpose of Labiaplasty

Labiaplasty is usually considered a type of genital cosmetic surgery that is done at a patient's request and not as a means of medical treatment.

The reasons people seek a labiaplasty are very personal. They can include:

  • Symmetry: You might consider this surgery if you want to reshape the uneven sides of your labia. However, experts describe labial asymmetry as normal and do not recommend surgical correction unless the variation is causing a negative impact.
  • Protrusion: The labia minora may be larger than the labia majora or protrude out of the larger lips for another reason. Causes of such protrusion include atrophy (thinning) of the labia majora, which can occur due to menopause or other hormone changes, and labia minora hypertrophy, a rare condition in which the labia minora is unusually large.
  • Other concerns with appearance: Some may want to alter how the labia look underneath clothes like swimsuits or tight pants or when they are nude. Concerns about the appearance of the labia can arise at any time in a person's life due to the natural development of the labia or after physical changes occur, such as due to childbirth.
  • Discomfort/pain: Some adults and adolescents experience tenderness, irritation, or bleeding of the labia minora during sex or athletic activity if the labia minora extends out of the labia majora. This can happen because the labia minora is composed of thin tissue that is usually protected by the labia majora.

As a feminizing genital surgery, labiaplasty is done to:

  • Create a clitoral hood and labia minora after vaginoplasty
  • Fully support gender-affirmation goals

How to Prepare

Preparing for labiaplasty involves both practical and thoughtful matters that have more complexity and nuance than many other types of surgeries.

Counseling

This surgery is considered major and permanent, and ACOG notes that patients should, "be informed about the lack of high-quality data that support the effectiveness of genital cosmetic surgical procedures and counseled about their potential complications."

To this end, your doctor may discuss not only the physical risks of labiaplasty with you, but the psychological implications of the procedure as you are deciding whether to move ahead. You might also be asked to speak with a pre-surgical educator/counselor.

Screening tests for depression or anxiety may be done to help you and your doctor consider the reason for your interest in this surgery and whether you may want more time to consider it. ACOG recommends that those who have diagnosed psychological concerns should be referred to a mental health specialist before proceeding with this surgery.

It may be unsettling to hear that this is part of the process. However, the intention is to make sure that you are going into your surgery with eyes wide open about potential results and risks.

Remember that you can and should seek out a second opinion if you are unsure about what your medical team is recommending.

Surgical Planning

Prior to your labioplasty, your doctor will ask you exactly what you want the procedure to accomplish so that the surgical plan can be tailored accordingly.

They will examine you to prepare for the details of your operation. You will also have a standard pelvic examination to identify any infections that may need treatment prior to surgery.

Your doctor will explain the location of the planned incision, the expectations you should have in terms of the size and shape of the labia, and what type of scar you may expect after your surgery.

And you may have pre-operative testing, including a complete blood count (CBC), blood chemistry tests, a urinalysis, and a chest X-ray.

Cost and Insurance

On average, a labiaplasty costs about $3,000 and might not be covered by health insurance. In cases when it might be (typically for gender affirmation only), you will likely need to meet certain prerequisites in order for all or part of the surgery to be covered. Speak with your insurance provider.

Location

You will have your surgery in an operating room that's located in a hospital or an outpatient surgical center.

What to Wear

You can wear something comfortable to your procedure appointment. You will likely need to wear an absorbent pad after your surgery, and it is best if you have underwear that is loose but still supportive of the pad.

Food and Drink

If you are having local anesthesia and/or monitored anesthesia sedation, you will not need to modify your diet prior to your surgery.

If you are going to have general anesthesia, you should stop food and drink beginning at midnight the night before your surgery.

Medications

Your doctor may give you instructions to adjust any hormone therapies that you take in the weeks before your surgery.

Additionally, you may be instructed to stop or reduce the dose of blood thinners that you take in the days before your labiaplasty.

What to Bring

When you go to your appointment, you need to make sure that you have personal identification and a form of payment for the procedure. If your health insurance is covering a portion or the whole cost of your procedure, you should have your health insurance information with you as well.

It's wise to have someone with you who can drive you home after your surgery. This is an absolute necessity if you will be having general anesthesia, but it's also helpful for anyone having a labiaplasty due to anticipated soreness.

Pre-Op Lifestyle Changes

Your doctor will let you know if you should shave your pubic area before surgery. Sometimes this isn't necessary because hair may be shaved right before surgery in the operating room.

It is not recommended to use hair removal chemicals or waxes that could make your skin fragile and prone to bleeding in the days before surgery.

What to Expect on the Day of Surgery

When you go to your surgery appointment, you will register and sign a consent form. You will go to a preoperative area and change into a surgical gown. You may have same-day tests, such as a CBC, blood chemistry panel, and urinalysis.

An intravenous (IV, in a vein) line will be placed in your arm or hand, and you will have your temperature, pulse, blood pressure, and breathing rate checked. Your oxygen saturation will be checked with a noninvasive pulse oximeter that is placed on your finger, which will stay in place during your surgery.

You may have a urinary catheter placed in your urethra either in the preoperative area or when you get to the operating room.

Before the Surgery

Your skin will be prepared for the procedure and your anesthesia will be started.

You will have a drape placed over your body and the skin of your labia will be exposed. The surgical and surrounding area will be cleansed with a cleaning solution. If needed, your pubic area will be shaved at this time.

Anesthesia will be administered:

  • You may have a sedative medication injected into your IV to make you drowsy and reduce pain if you are having monitored anesthesia sedation.
  • If you are having local anesthesia during your procedure, you will have medication that controls pain injected directly near the incision site after your skin is cleansed. If you are having it along with IV sedation, you would have your local anesthetic injected after the IV sedation starts to work.
  • If you are having general anesthesia, you will have an anesthetic medication injected into your IV to put you to sleep and a breathing tube inserted into your throat for mechanical breathing assistance during surgery.

During the Surgery

Your surgeon will begin by locating the area of tissue that will be reshaped and/or resized.

The next steps can include any of the following:

  • Trimming a small piece of tissue from the edge of one or both sides of the labia minora
  • Cutting away a portion of tissue from the inner region of the labia minora
  • Injecting hyaluronic acid into the labia majora to enlarge it
  • Removing fat from your abdomen or thigh with a needle and injecting it into the labia majora to enlarge it
  • For gender affirmation, using tissues from the penis to create the labia

Cutting and tissue excision may be done with either a surgical scalpel, special surgical scissors, or radiofrequency. Injections are administered via a syringe.

Bleeding will be controlled throughout your surgery. Your surgeon will close any open surgical incisions with absorbable suture. Your wound will be covered with surgical dressing.

Your anesthesia will be stopped. If you have had general anesthesia, your anesthesia team will remove your breathing tube and make sure that you are breathing comfortably on your own. Then you will go to the recovery area.

After the Surgery

In the recovery area, you will start becoming more alert. Your medical team will give you pain medication as needed. Your urinary catheter (if you have one) will be removed, and you will get help walking and using the toilet or a bedpan, if needed.

Your medical team will check for bleeding and will explain to you how much bleeding you should expect once you go home.

Before you are discharged, you will get instructions about wound care, bathing, pain control, activity restrictions, and your follow-up appointments.

Recovery

It takes approximately six weeks to fully recover after a labiaplasty surgery. During this time, you will see your doctor for one or more follow-up appointments. You will likely have absorbable sutures that do not need to be removed.

You will have instructions for pain control, which may include prescription pain medication or over-the-counter pain medication like Tylenol (acetaminophen). Your doctor may also give you a prescription for an oral anti-inflammatory medication and/or topical antibiotics to apply to your surgical wound.

Be sure to let your doctor know if your pain is not adequately controlled with the pain medication that is recommended to you.

Keep in mind that if you are having gender-affirming surgery, labiaplasty is only a part of this, and you can expect your surgery and post-operative healing process to be more extensive than those who get a labiaplasty alone.

Healing

Follow instructions you are given regarding wound care, bathing, and cleaning yourself after you use the toilet.

You may be instructed to wash your wound with lukewarm water, but avoid exposing it to soap or other products in the first week after your surgery. Avoid rubbing the surgical area by gently wiping or washing after urinating or having a bowel movement. Using a peri bottle can help.

You may have some bleeding, and you can wear a sanitary pad to absorb it.

Your doctor may recommend a diet or medication to prevent constipation because straining can increase pain and may stretch or break your sutures.

Expect to have some swelling. You can use ice packs on swollen areas, but don't place ice packs directly on your skin.

Swelling should begin to go down after about a week, and you might be able to stop pain medication at that time. You may still have some bleeding, but it should be decreasing. Continue to keep your wound clean and use any medications your doctor suggests.

Warning signs of post operative complications to look out for include:

  • Excessive or worsening pain
  • Increasing blood
  • Clumps of blood
  • Discolored discharge or pus
  • Opening of the wound
  • Severe pain with urination or bowel movements
  • Fever

Call your doctor if you have any of these symptoms.

Physical Activity

In the first few days, take it easy. Limit activity to just walking around your home. Pushing yourself too hard can compromise your sutures.

While you are still healing, you shouldn't exercise, run, ride a bike, swim, or begin sexual activity. You may need to stay home from work if your job involves a lot of physical activity.

Only resume such activities when your doctor gives you the OK to do so.

Long-Term Care

As you are continuing to improve, you will follow up with your doctor to ensure that healing is complete. You may be instructed to use vaginal lubrication to avoid abrasions during sexual activity if you have developed a tendency to experience dryness or tenderness after your surgery.

Some individuals may have dysuria (discomfort with urination) after labiaplasty due to exposure of the labia to the urine, which can be acidic. This should improve over time as your skin adjusts. However, you should discuss dysuria with your doctor because it can be the sign of a urinary tract infection.

Possible Future Surgeries

Generally, labiaplasty surgery is a one-time procedure that doesn't involve multiple surgeries. However, if you have complications, you may need additional surgical intervention to repair any problems that arise.

If you have had an injection-based procedure, you may decide to have "touch-ups" after the effect of the filler material wears off, which can be about six to 12 months.

Lifestyle Adjustments

Over time, you shouldn't have to adjust your activities or lifestyle after you recover from your labiaplasty. You should be able to have sexual intercourse, exercise, and move around without any special restrictions or limitations once your doctor says it is safe to do so.

A Word From Verywell

A labiaplasty is a procedure that is gaining popularity. Generally, it is done for cosmetic reasons. If you are thinking about having this procedure, consider your options and objectives carefully as you decide if proceeding is right for you.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Chen ML, Reyblat P, Poh MM, Chi AC. Overview of surgical techniques in gender-affirming genital surgery. Transl Androl Urol. 2019 Jun;8(3):191-208. doi: 10.21037/tau.2019.06.19. PMID: 31380226; PMCID: PMC6626317.

  2. Hersant B, Jabbour S, Noel W, Benadiba L, La Padula S, SidAhmed-Mezi M, Meningaud JP. Labia Majora Augmentation Combined With Minimal Labia Minora Resection: A Safe and Global Approach to the External Female Genitalia. Ann Plast Surg. 2018 Apr;80(4):323-327. doi: 10.1097/SAP.0000000000001435. PMID: 29461295.

  3. Dayan E, Ramirez H, Theodorou S. Radiofrequency Treatment of Labia Minora and Majora: A Minimally Invasive Approach to Vulva Restoration. Plast Reconstr Surg Glob Open. 2020 Apr 22;8(4):e2418. doi: 10.1097/GOX.0000000000002418. PMID: 32440388; PMCID: PMC7209841.

  4. American College of Obstetricians and Gynecologists. Committee on Gynecologic Practice. Elective Female Genital Cosmetic Surgery. Committee Opinion. Number 795. January 2020.

  5. Furnas HJ. Trim Labiaplasty. Plast Reconstr Surg Glob Open. 2017;5(5):e1349. doi:10.1097/GOX.0000000000001349

  6. Elective Female Genital Cosmetic Surgery: ACOG Committee Opinion Summary, Number 795. Obstet Gynecol. 2020 Jan;135(1):249-250. doi: 10.1097/AOG.0000000000003617

  7. Wilkie G, Bartz D. Vaginal Rejuvenation: A Review of Female Genital Cosmetic Surgery. Obstet Gynecol Surv. 2018 May;73(5):287-292. doi: 10.1097/OGX.0000000000000559

  8. Gulia C, Zangari A, Briganti V, Bateni ZH, Porrello A, Piergentili R. Labia minora hypertrophy: causes, impact on women's health, and treatment options. Int Urogynecol J. 2017 Oct;28(10):1453-1461. doi: 10.1007/s00192-016-3253-8. Epub 2017 Jan 18. PMID: 28101640.

  9. Hamoud Y, Cosson M, Collinet P, Phalippou J, Rubod C, Giraudet G. Easy way to perform a labia minora reduction. J Gynecol Obstet Hum Reprod. 2020 Aug 1:101884. doi: 10.1016/j.jogoh.2020.101884. Epub ahead of print. PMID: 32745640.

  10. American Society of Plastic Surgeons. What Is Labiaplasty? Updated 2020.

  11. Jabbour S, Kechichian E, Hersant B, Levan P, El Hachem L, Noel W, Nasr M. Labia Majora Augmentation: A Systematic Review of the Literature. Aesthet Surg J. 2017 Oct 16;37(10):1157-1164. doi: 10.1093/asj/sjx056. PMID: 28449124.

  12. Johns Hopkins Medicine. The Center for Transgender Health. Gender Affirmation Surgical Services.