labiaplasty scotland

Labiaplasty - all you need to know

Enhance Your Feminine Confidence with Labiaplasty Surgery in Edinburgh, Scotland

A labiaplasty or labia minora reduction decreases the size of the labia minora, or ‘inner lips’ of the vagina. If you feel self conscious or uncomfortable about the size, shape, or symmetry of your labia, our experienced plastic surgeons can help.

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Overview

LABIAPLASTY

TYPE OF ANAESTHETIC

  • Local or general anaesthetic

LENGTH OF SURGERY

  • 1 hour

HOSPITAL STAY

  • Day case – walk-in walkout

RECOVERY

  • Swelling for up to 10-14 days
    7-10 days off work
    3-4 weeks before strenuous exercise

Procedure and benefits

You may be self-conscious about the appearance of your labia minora, and this may have been the case for some time.

Your labia may have enlarged after childbirth or with the natural ageing process.

You may experience discomfort with certain sporting activities or when wearing tighter clothing.

The cosmetic appearance of your labia minora is affecting your sexual confidence.

Benefits of Surgery

Increased comfort and confidence during physical activities, such as exercise and sexual intercourse

Relief from discomfort and irritation caused by large or asymmetrical labia

Improved aesthetic appearance and symmetry of the vulva

Enhanced sexual pleasure and satisfaction

Boosted self-esteem and body image

What is normal, and why the controversy?

Labia minoras come in all shapes and sizes, and there is no definition of “normal” or “abnormal”.

Labiaplasty is incorrectly called “designer vagina” surgery. We have a useful section exploring perceived concerns around this surgery. Please see the section on common issues surrounding labiaplasty below.

The procedure itself

Labia minora reduction is a surgical procedure. Most of the sensitive labial tissue is left behind, and the extra, loose skin is removed. We use the wedge excision method, which avoids leaving scars over the outer edge of the labia.

Surgery is carried out under local or general anaesthetic as a day procedure. There is discomfort for a few days after the surgery, and swelling is expected to last around 7-10 days.

We do not post before and after images of labiaplasty on our website. You will be shown several before and after images during your consultation.

Your care

Please be assured that we will treat you with a level of professionalism, discretion and sensitivity expected of UK-trained consultant plastic surgeons practising at reputable, accredited private hospitals in Edinburgh.

We all have expertise in gynaecological reconstructive plastic surgery. Please take the time to read more about the process below…

labia minora reduction scotland

Common issues surrounding the procedure

Why do women have surgery?

Several reports have shown a significant increase in the number of women seeking labiaplasty procedures in the NHS and the private sector. In the United States, there was a 49% increase in demand for labiaplasty from 2013 to 2014; similar trends have been documented in other Western countries, including the UK and Australia.

Labiaplasty most commonly involves reducing the size of the labia minora to achieve minimal or no protrusion of the labia minora beyond the labia majora. It may also be performed to correct asymmetry.

The procedure remains controversial for some, and we will discuss some of the main issues surrounding labiaplasty.

Research shows that cosmetic concerns are the primary motivation for women seeking to undergo labiaplasty, followed by physical issues of both a sexual and non-sexual nature. For example, a study of 163 labiaplasty patients in 2000 showed that cosmetic dissatisfaction with labia (87%), discomfort when wearing clothing (64%) or when participating in sports (26%), and painful sexual intercourse (43%) were the main reasons for having surgery. A more recent study of 35 women showed that 71% had concerns with appearance, 69% with physical (non-sexual), 60% with sexual function and 45% with psychological symptoms such as self-esteem.

Designer vaginas or Designer vulvas?

Some refer to labiaplasty as designer vagina surgery. The labia form part of the external genitalia, and anatomically speaking, the labia minora are part of the vulva and not the vagina. So the term designer vagina should not be used to encompass labiaplasty.

Is it a form of female genital mutilation?

FGM is defined by the World Health Organisation (WHO) as procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. Some commentators have used this to describe labiaplasty in consenting adults as a form of FGM.

This definition fails to take on board the fact that the procedures listed by the WHO refer to ones which include partial or total removal of the clitoris or deliberate narrowing of the vaginal opening designed to prevent sexual intercourse. Most such procedures are carried out on unconsenting children against their will. Labiaplasty does not fall into this category.

A fourth category cited by the WHO includes: all other harmful procedures to the female genitalia for non-medical purposes. The critical term here is “harmful”. Labiaplasty has one of the highest satisfaction rates among all cosmetic surgery procedures. The risks of the surgery are well known, and a reputable surgeon will inform prospective patients of these risks. All cosmetic surgery procedures carry a risk of adverse outcomes. To say that labiaplasty falls under this fourth category by the WHO is like arguing that all cosmetic procedures are harmful.

What is the influence of pornography?

 

newspaper article about link between porn and cosmetic surgery

 

There have been many ill-informed opinions on the reasons for the increased demand for labiaplasty. For example, an article published in the Observer Newspaper in 2011 blamed the increase in labiaplasty surgery on pornography. Many other commentators have expressed similar concerns. While the increased availability of pornography and its idealised portrayal of women’s external genitalia may have affected women’s perceptions of their labia, it is essential to look at the available evidence.

A recent study published in the Aesthetic Surgery Journal in 2006 by Sharp and co-workers looked at factors that Influence the decision to undergo labiaplasty. They compared a group of 35 women seeking to undergo labiaplasty to a control group of 30 women who were not. The two groups did not differ in their exposure to female genitals on television and in their exposure to pornography. However, the authors showed more exposure to media images of female genitals in the labiaplasty group, specifically via the Internet and genital cosmetic surgery advertising. The authors conclude that – the issue with mainstream media being women’s primary source of information regarding female genital appearance is that the mainstream only displays a narrow range of labial appearances. For women who are already concerned about their genital appearance, seeing images of female genitals on the Internet (some of which have been air-brushed) may confirm to them that they are “abnormal” and require surgery to become “normal”.

Increased awareness of cosmetic surgery and reality TV shows such as Embarrassing Bodies has contributed to an increased acceptance of cosmetic surgery procedures. While the increased availability of pornography may have an influence, the evidence is lacking and does not explain the whole picture.

What is the labial pride movement?

The labial pride movement is a feminist movement to raise awareness of the regular appearance of the vulva and to defy the trend towards cosmetic surgery on the female genitals.

 

labial pride movement

 

The London-based feminist group UK Feminista organised “the muff march” through Harley Street, an area synonymous with its private medical providers, in December 2011. Over 320 women paraded the street with slogans like: “Keep your mitts off our bits!”, “There’s nothing finer than my vagina!” and “Harley Street puts my chuff in a huff”.

Other groups have encouraged women to release images of their vulvas by posting photo submissions of anonymous vulvas on their websites. For example, visit the labia library — the aim being to establish a sphere for women to get realistic impressions of normal vulvas. Others have criticised such campaigns for giving a false impression that protruding labia are the anatomical norm and small inner labia are the adaptation to beauty standards.

“In an effort to make “real women” feel better about themselves, some labia-proud ladies are taking shots at girls whose labia look like the imaginary “Barbie” ideal. It turns out some girls are born like that. Labia, like boobs or entire bodies, come in all shapes, sizes, colours and textures. Shaming one to make another type feel better is bad news. Think of it in terms of thin women who are often shamed or shunned in support of body image advocacy for larger girls.” Jessica Sager 2013

Are my labia normal?

We inform all of our prospective patients that there is no definition of what is normal regarding labia minoras. Labia come in all shapes, sizes and colours.

 

variation in labiaplasty anatomy diagram

 

The artist Jamie McCartney has focused on female genital anxiety through his work ‘The Great Wall of Vagina‘. The Great Wall of Vagina comprises 400 plaster casts of women’s genitals arranged in ten panels. It is a provocative response to the exponential rise in cosmetic labial surgery. By confronting the viewer and revealing the diversity of female genital appearance, McCartney opposes any notion of a singularly “perfect” aesthetic, thereby forcing society to rethink its relationship with the vulva.

For any woman considering labial surgery, it is well worth reflecting on this quote,

“Vulvas and labia are as different as faces, and many people, particularly women, don’t seem to know that. McCartney hopes this sculpture will help to combat the exponential rise, seen in recent years, of cosmetic labial surgeries. This new fashion for creating ‘perfect’ vaginas sets a worrying trend for future generations of women.”

Cosmetic surgery can be defined as “the intentional alteration of physical features to enhance the appearance“. With some procedures, there are functional benefits such as relief of physical symptoms, which many labiaplasty patients display. The argument that labiaplasty involves removing or destroying normal tissue is invalid in this context. Other common plastic surgery procedures, such as breast surgery and facial rejuvenation, essentially involve the alteration/ removal of “normal” tissue. Yet, there is not the same controversy involved with these procedures.

What is a “Barbie” Labiaplasty?

Dr Alinsod, a gynaecologist from California, developed the “Barbie” labiaplasty. He describes the procedure as a more aggressive reduction of the labia minora to the point of complete excision. According to his website, this is the most popular technique of labial surgery Dr Alinsod performs, and the appearance most wanted on the West Coast.

This procedure is essentially a complete amputation of the labia minora and is achieved using the “trim” method of labiaplasty. While there is no definition of what is normal for labia minora size, what is not in doubt is that it is normal to have some labia minora!

We would never completely amputate the labia minora, and the technique we use (“wedge” method) makes it impossible to remove too much tissue as it would not be possible to close the edges of the wounds together.

Are women satisfied after a labiaplasty?

Several studies have reported high satisfaction rates among women who have had labiaplasty. These studies have been published by plastic surgeons, gynaecologists, and psychologists.

A recent study by Goodman and colleagues published in 2016 supported earlier findings that body, genital, and sexual dissatisfaction shown by labiaplasty patients improved with time following surgery. Over time, rates of genital, body, and sexual satisfaction among study participants became equal to or better than rates for the control group.

A sizeable multicentre study looking at 258 women with female genital cosmetic surgery found that 91.6% of patients were satisfied with the results of their operation after a 6-42 month follow-up. Significant subjective enhancement in sexual functioning was noted, and complications were acceptable and not of significant consequence.

Trends in shaving/ tighter clothing

Recent trends in shaving the pubic area have also been postulated to have made women more aware of labia minora, which may be protruding. Likewise, the trend in tighter clothing, such as skinny jeans, may also increase possible discomfort.

What to expect

You will be up and about straight after your surgery, but it will be a week or two before you are entirely up to speed.

Your mood may fluctuate after surgery – this is normal. A small amount of blood staining on the inside of your dressings is typical during the first few days.

Discomfort/ Pain

Discomfort is typical in the first few days and is to be expected.

Bruising/ swelling

Swelling is to be expected and can be quite severe. It may get worse before it gets better and usually has improved significantly by 7-10 days.

Appearance

Your labia minora will look very different immediately after surgery than it will look after a few weeks. This is mainly due to swelling.

Most of the swelling will subside in 1-2 weeks. A small amount of swelling may persist for up to 3 months.

Scars may be red and inflamed for the first few weeks. In time, these usually soften and fade.

Long term outcomes

  • There is a very high satisfaction rate with labiaplasty, and revision rates are very low (less than 1 in 30 patients).
quaba aftercare activities

What are the risks?

Surgery can be carried out either under local anaesthetic or general anaesthetic. Most patients opt for local anaesthesia as the recovery is quicker. Local anaesthesia involves injections to numb the area, and most patients tolerate this well.

The risks of labiaplasty include:

Bleeding

Minor spotting is expected after the procedure. Rarely bleeding may occur that causes pain and swelling and may require a return to theatre to stop the bleeding/ remove the clot that has formed.

Swelling

Is expected over the first few days and varies significantly between patients. Usually settles by ten days.

Infection

Relatively uncommon and may require treatment with antibiotics.

Delayed wound healing

Again, uncommon but can result in the wound opening and not healing correctly. This can cause notching at the rim of the labia or a hole through the middle of it.

Scars

All scars are permanent. The scars using the “wedge technique” are relatively hidden and tend to settle well. Rarely scars can be sensitive and painful, but this usually improves with time.

Undercorrection

Not removing enough tissue.

Overcorrection

Removing too much tissue.

Asymmetry

Minor degrees of asymmetry are expected – this is normal.

Revision

A small number of patients (less than 5%) may require further surgery to correct residual problems.

Labiaplasty Aftercare

If you have had a labiaplasty with us or are considering it, please find detailed instructions and advice on aftercare following your procedure.

Explore Labiaplasty Aftercare
Labiaplasty Aftercare

Labiaplasty – from start to finish, amazing

From start to finish dr. Quaba was amazing. I completely trust him. The care I received was just incredible. Dr quaba made himself available at the weekends to answer any questions. I couldn’t be happier with the results.

crawfordN

Realself Sep 2022

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Body dysmorphia

Body dysmorphic disorder (BDD) is a mental health condition in which someone can’t help thinking about one or more perceived issues or faults in their appearance. Other people may think that their concerns are minor or they may fail to see them at all.

People with BDD, continuously focus on their appearance and body image, repeatedly checking the mirror, grooming or seeking reassurance, sometimes for many hours each day. The perceived flaw likely causes significant distress and impacts on a person’s ability to function in their daily life.

People affected with BDD often seek out cosmetic procedures to try to “fix” their perceived flaw. Afterwards, they may feel temporary satisfaction or a reduction in their symptoms, but often the anxiety returns, or they may move on to focus on other perceived problems related to their appearance.

Some patients may have features of body dysmorphia. Such patients are not likely to be offered surgery.

If you are considering surgery, it is worth trying the self-assessment tool below known as the Cosmetic Procedure Screening Questionnaire (COPS).

The questionnaire was developed by David Veale, Nell Ellison, Tom Werner, Rupa Dodhia, Marc Serfaty and Alex Clarke (2012) Development of a cosmetic procedure screening questionnaire (COPS) for Body Dysmorphic Disorder. Journal of Plastic Reconstructive and Aesthetic Surgery, 65 (4), 530-532.

TAKE THE COPS QUESTIONNAIRE