Labiaplasty: A Guide to Cosmetic Vaginal Surgery

What Is the Difference Between Labiaplasty, Vaginoplasty, and Vaginal Rejuvenation?

With so many different cosmetic vaginal surgeries being talked about these days, it’s easy to get confused about the various surgical options and what they can accomplish. Labiaplasty is one procedure that often comes up in these conversations, and it’s important to understand what makes labiaplasty unique among these options.

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Labiaplasty Before & After
Individual results from procedures cannot be guaranteed, and may vary between patients.

What is a Labiaplasty?

Labiaplasty is a common procedure that addressed the appearance of the external labia. This can include reducing the size of the inner lips (labia minora), the outer lips (labia majora), and the clitoral hood (skin above and around the clitoris). Some patients also request excess skin to be removed from the perineal area (between the vagina and rectum) as well as loose skin around the rectum from prior hemorrhoids. Labiaplasty is easily done under local anesthesia (meaning no sedation), which means many patients can drive themselves to and from the procedure. In my office, we use a powerful numbing cream so patients barely feel the injections, and we even have TVs in the room so patients can catch up on a current TV series or rewatch a favorite movie for distraction. Most patients are back to work within a week and back to full activity within about 2 weeks, excluding sex, which is usually ok 4-6 weeks after the procedure. For many, choosing labiaplasty brings peace of mind and enhances daily comfort.

What is a Vaginoplasty?

Vaginoplasty is a more involved procedure performed under general anesthesia with the goal of tightening the vagina to improve sensation during sex and sometimes also address bladder leakage. Recovery is similar except there’s no heavy lifting or sex for 6 weeks after. Our OR uses Propofol sedation, so patients are breathing on their own during surgery but not awake or aware of anything going on. While discussing vaginoplasty, it’s worth noting that labiaplasty is sometimes performed alongside it for more comprehensive results.

Both procedures use dissolvable stitches, so no suture removal is necessary. Patient satisfaction is high with rare need for revisions, and the incisions usually heal without visible scarring. Patients report improved confidence and comfort as well as improved sexual satisfaction.

Am I a candidate for Vaginoplasty after childbirth?

Patients often come into the office and ask if they need vaginal tightening. I explain that it’s something they tell me, not something I tell them. If they have urinary leakage or if sex doesn’t feel satisfying anymore then I will do an exam to feel for the edges of the pelvic floor muscle and the strength of the muscles. Thankfully very few patients have been dissatisfied after vaginal tightening, but after evaluating my own results, I eventually realized the few who were unhappy had poor muscle strength. I can put the muscle edges back together, but I can’t make them stronger. This is why for patients with weak pelvic floor muscles, I will recommend pelvic floor therapy if it is covered by a patient’s insurance. If it isn’t, there are muscle stimulating units for purchase (even on Amazon) to help strengthen muscles to either help patients avoid surgery or ensure that surgery is worthwhile. Additionally, labioplasty may be considered by some patients for external cosmetic improvement following childbirth.

How to Prepare for Your Consultation

What is Vaginal Rejuvenation?

Vaginal rejuvenation can refer to a few different things. Labiaplasty as one option can remove excess skin to change the appearance of the labia or reduce discomfort from pinching during sex or exercise. This can be done in the office under local anesthesia without the need for sedation or general anesthesia. Vaginoplasty is a more involved surgical procedure done in the operating room. During vaginoplasty, muscles that have separated during childbirth or from aging or other trauma are repaired. This can be done between the vagina and the rectum, wich can improve sensations during sex. It can also between the vagina and bladder, which can help with urinary leakage.

Non-surgical optionsfor rejuvenation include PRP or Femtouch laser. PRP (platelet rich plasma) is a fluid rich in platelets obtained from drawing a patient’s own blood and processing it to concentrate the platelets, which contain a lot of growth factors. This can be injected near the clitoris and G spot to improve sensation or into the labia majora to plump and smooth the skin. There is surprisingly minimal discomfort during the injections and no formal downtime. Injections take about 30 minutes due to processing the platelets and should be done every 6 weeks for three treatments and then as needed to maintain results. In certain cases, labiaplasty offers a surgical way to address cosmetic or comfort concerns not managed by these therapies.

Femtouch is a CO2 (carbon dioxide) laser that is performed inside the vagina to stimulate collagen. It is excellent for improving vaginal moisture and reducing tissue atrophy (thinning) for post menopausal women. It is also useful for addressing urinary leakage. Treatment takes 15 minutes and is recommended every 6 weeks for 3 sessions, with follow up treatments as needed after that. No downtime is in place for exercise, but it’s recommended to avoid intercourse for 3-4 days. Likewise, patients considering surgical options like labiaplasty should consult their doctor for personalized recommendations.

Can Vaginal Rejuvenation Improve Urinary Leakage?

There are two types of vaginal rejuvenation to improve urinary leakage. Surgical tightening of the wall between the vagina and bladder is a permanent fix, but this requires surgery under general anesthesia with a 6 week recovery. Non-surgical treatment with the Femtouch laser is also effective with less downtime (just a few days avoiding intercourse), but it requires 3 treatments 6 weeks apart and then maintenance treatments every few months as needed. Meanwhile, labiaplasty is not intended for urinary leakage but can address external tissue concerns.

Are Labiaplasty and Vaginoplasty Surgeries Worth It?

Labiaplasty and Vaginoplasty have low complication rates and high patient satisfaction. Most patients are very happy with their results and many say they wish they had done it sooner. Ultimately, deciding whether labiaplasty is worth it is a very personal choice, but many patients are pleased with the outcome.

What Is the Difference Between Labiaplasty and Vaginoplasty?