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Labiaplasty addresses labial hypertrophy, or labia minora that are disproportionate to the labia majora. Women may be born with protruding or asymmetrical labia minora, or the labia minora may lengthen later in life as a result of childbirth or inflammation from recurrent infections or dermatitis. There is no official definition of labial hypertrophy. The proposed definition classifies mild to moderate labial hypertrophy as the extension of labia minora 1 to 3 centimeters beyond the labia majora, and severe labial hypertrophy as 3 centimeters beyond the labia majora.
Some patients may have physical symptoms like discomfort during exercise or intercourse. For others, this is solely an aesthetic procedure. The vulva naturally occurs in various shapes and sizes, and the potential loss of sensation should be weighed carefully against the desire for perceived attractiveness. - Amputation is the simplest and most common technique for labiaplasty. The area to be removed is secured with a clamp for several minutes so the blood flow in the remaining labial fold can stay as stable as possible. The excess tissue is then cut off, and the incision stitched. While this is the easiest of the labiaplasty procedures, it can cause nerve damage and the edge of the labia may look unnatural.
- Central wedge resection involves taking a section of tissue from the middle of the labia, allowing the surgeon to preserve the nerve endings and appearance of the edge of the labia. This technique is the basis of de-epithelialization, which removes tissue from the same part of the labia, but removes only the epithelial layers, as opposed to all of the tissue. This preserves the labia's edge and most of the sensitive nerve endings throughout the labial structure. This may be done either with a scalpel or a laser. The laser will cause less bleeding, but may cause epidermal cysts.
- A labiaplasty patient may also have thickened skin over the clitoris. If so, a clitoral unhooding may be performed. The hood of the clitoris is released, pulled back, and attached farther back on the pubic bone. This will tighten the labia minora, and a patient with mild labia hypertrophy may not need any additional procedures.
