Surgical reduction of the labia minora
Nymphoplasty (sometimes called labioplasty, labiaplasty or reduction of the labia minora) is a cosmetic and reconstructive surgical procedure that aims to correct the excessive size of the labia minora, which can be drooping or overdeveloped in some women.
Today, intimate surgery is becoming less and less of a taboo and more and more patients are asking for vaginal lip surgery.
Learn more about nymphoplasty or labiaplasty intimate surgery to reduce the labia minora
Whether the motivation is aesthetic (drooping labia protruding from the labia majora in a standing position that a patient wishes to make less visible – sometimes with major asymmetry) or functional (discomfort in relationships, sports, clothing, frequent infections), every case has to be fully understood and considered by the surgeon. Additionally, a cosmetic surgeon must also refuse to perform a nymphoplasty if the request seems unsuitable or if the excess size of the lips is very minor and bothers the patient more psychologically than physically.
The principle of the surgery is to remove the excess lip tissue by conventional incisions, or laser, depending on the case. Two techniques are possible, the longitudinal technique and the triangular technique, but neither is better than the other because it all depends on the shape of the lips. I always recommend general anesthesia to be more comfortable for both the patient and the surgeon. Only one day of hospitalization is required at the clinic. The postoperative recovery is marked by significant swelling for three weeks (often asymmetrical, but don’t worry) and some discomfort (more than pain) during the first few days. Some nymphoplasties can, however, be painful postoperatively in cases where the excess lip tissue goes up to the cap which borders the clitoris (an area full of nerves). The sutures are absorbable and it is safe to go back to work from the second or third day after the operation but you will have to wait a month to recommence sports or sex. The only real complication is related to a technical issue of the surgeon removing too much tissue or the scar being located too much on the internal side, i.e. towards the opening of the vagina. This can result in pain sometimes occurring during intercourse (dyspareunia) .
Intimate and taboo surgery?
It is an intimate surgery that people still talk very little about. There can be a significant psychological and physical complex, and this can particularly occur during adolescence where there are difficulties in speaking to parents. Surgery to reduce the labia minora is often a taboo procedure, little known to the general public, and the rate at which it is performed is not well known. Requests are not uncommon, however, because the complex developed can be very significant.
Doctor Vincent Masson practiced as Head of Clinic at the Saint-Louis Hospital in the plastic and reconstructive surgery department led by Professor Marc Revol. He has performed numerous reconstructive surgeries on the female genital tract following cancers, trauma and complex malformations. He has also participated in sex change procedures and regularly practices reduction surgery of the labia minora. He will listen to you and advise you in order to find a solution to your complexes, even the most intimate.
How are enlarged labia minora diagnosed?
We talk about hypertrophy of the labia minora when they measure more than 4cm with the skin stretched. However, the labia minora can be annoying even if they are less than 4 cm in size. In practice, this definition based on a measurement in cm is therefore very subjective and often does not reflect reality (i.e. patients have an excess of just 1 cm and are subsequently very embarrassed by it). The concept of developing a complex is very personal and cannot be transferred from one woman to another. Many patients actually come to see if the appearance of their labia minora is normal. Frequently, the appearance is normal or slightly excessive and does not warrant an intervention. It is therefore also Doctor Masson’s role to inform the patient about what is the normal aspect to their labia minora.
What are the consequences of enlarged labia minora?
Hypertrophy of the labia minora can lead to:
- Discomfort with clothing (wearing tight jeans, thong, swimsuit)
- discomfort when playing certain sports
- physical discomfort during intercourse (dyspareunia)
- a psychological complex
- aesthetic discomfort
- hyperpigmentation of the labia minora
- repeated infections (yeast infections)
The objectives of labiaplasty surgery
Intimate nymphoplasty surgery is a painless operation with a simple postoperative recovery that has two main objectives:
- For aesthetic purposes: reducing the size of the labia minora, correcting any asymmetry, and obtaining a harmonious and natural vulva without a visible scar. Additionally, the complex surrounding the labia minora can be removed, improving the patient’s self-image and sex life.
- With a functional aim: to remove the discomfort felt when wearing certain clothes, playing sports, and having sex.
The post-operative satisfaction rate is very high, proportional to the preexisting discomfort and the scars most of the time absolutely undetectable (natural result).
Frequently asked questions about labia minora reduction surgery
From what age can the operation be performed?
Reduction of the labia minora can be carried out at the end of puberty (the most frequent case) and without an upper age limit. The operation will not have any negative future impact on sexual intercourse, pregnancy or childbirth.
What happens before the operation?
- Two consultations with the cosmetic surgeon are mandatory.
- The reflection period between the first consultation and the nymphoplasty operation itself is 15 days minimum.
- You will be given an information document on nymphoplasty, an informed consent form and a price quote.
- Preoperative medical photographs will be taken by the surgeon.
- A consultation with the anesthesiologist takes place at least 48 hours before the operation and a blood test is performed.
- It is recommended to stop smoking at least one month before the operation and to not take any aspirin or anti-inflammatory drugs 10 days before (there is a risk of causing scarring and bleeding problems).
What surgical techniques are used?
The main principle of the intervention is to remove excess tissue from the labia minora without leaving a visible scar and without causing any functional discomfort.
Many techniques have been described but only two modern techniques are currently recognized in the international medical literature. These two techniques are practiced by Doctor Vincent Masson. The technique chosen actually depends on the level of your physical and mental discomfort and the morphology of the genitals.
The first (horizontal or longitudinal technique) consists of a resection, the outline of which follows the free edge of the lip. It makes it possible to treat not only the enlargement of the labia minora but also the extension around the clitoris if it is necessary and to reduce the frequently associated hyperpigmentation. The scar is located longitudinally on the free edge of the labia minora.
The second is the triangular technique (also known as the vertical or V technique). A wedge or triangle (sometimes double) resection is performed and allows the excess mucous membrane of the labia minora to be absorbed. The scar is not longitudinal but perpendicular to the free edge of the labia minora, towards the vagina.
Neither of these two techniques is better than the other, it all depends on the excess tissue and what will need to be surgically removed. The operation will be performed with either a conventional or electric cauterizing scalpel, or with a modern laser technique.
Anesthesia and hospitalization
Anesthesia is according to your preferences: general anesthesia, spinal anesthesia (epidural) or local anesthesia plus sedation (local anesthesia deepened by relaxing drugs administered intravenously).
In general, the intervention carried out by Dr. Masson is performed on an outpatient basis (day hospital), which means that the patient enters in the morning and leaves the same day after a few hours of monitoring. Sometimes, for social, family or personal reasons, an overnight hospital stay can be considered.
How long does the operation last?
The average duration of a Labiaplasty operation is less than 1 hour.
Post-operative recovery and follow-up
- Minimal bleeding for 2 to 3 days (like menstruation).
- Underwear protection is necessary for the first few days.
- Swelling and bruising are common.
- Moderate discomfort when walking from 24 hours to 5 days.
- Intimate washing recommended after each urination.
- It is advisable to wear loose, cotton clothing for 3 weeks.
- Resumption of sexual activity: 1 month.
- Resumption of sports: 3 weeks to 1 month.
- Rest period and time off work of 24 hours to 5 days depending on the case.
- No swimming or bathing for 3 weeks.
Pain and stitches
The postoperative recovery process of a nymphoplasty operation is generally not very painful, requiring only simple analgesics and a very short recovery period. Discomfort when walking is present for the first few days. The sutures used by Doctor Masson are very fine and dissipate in 8 to 21 days. So there are no stitches to remove.
When will I see the result?
The result is visible immediately but due to the post-operative swelling and the healing time it takes an average of 2 months for a final result with almost invisible scars and the labia minora having regained their flexibility and finesse.
What are the possible complications?
They are very rare with a nymphoplasty but, for the sake of honesty, your surgeon must inform you. Follow-up on instructions and post-operative appointments with your cosmetic surgeon are essential to avoid or detect any complications as soon as possible. Doctor Masson personally follows his patients post-operatively and listens to their questions concerning the aftermath of the operation. Complications that should be mentioned are:
- Delayed healing and dehiscence of the edges of the sutures (beware, this is often linked to smoking).
- Hematoma and greater bleeding than normal.
- Resulting imperfections (residual asymmetry, insufficient resection). In this case, a touch-up procedure will be carried out.
- Complications related to anesthesia (statistically extremely rare when an intervention which is not an emergency is performed on a healthy person).
- Phlebitis (beware, often linked to smoking).
- Sensitivity disorders, discomfort with intercourse and when wearing tight clothing longer than normal.
The price of a nymphoplasty operation, is it supported by the social security?
In certain cases of major enlargement or very significant asymmetry a nymphoplasty procedure can be covered by social security and the operation reimbursed as reconstructive surgery. But beware, this reimbursement will only be very partial because the health insurance system only covers the fees of the surgeon who operates you up to 46 euros. The price of a nymphoplasty depends on the procedures to be performed, the type of anesthesia, the clinic, the qualifications of the surgeon and his experience. A quote will be given to you by Doctor Masson. It costs from 2000 euros in practice.
Summary sheet of a labiaplasty operation
- Nymphoplasty: excess size of the labia minora
- Discomfort: during intercourse and sport, but also aesthetic and functional; when dressing, maceration, and infections.
- Intimate surgery, sometimes considered a taboo but a frequently performed intervention.
- Price: sometimes covered by social security (but with a significant excess).
Before the nymphoplasty
- Two consultations with Doctor Masson, one consultation with the anesthesiologist.
- Recommendations: stop smoking 1 month before, stop taking aspirin or anti-inflammatory drugs 10 days before.
- Signed quote and informed consent form.
- Medical photographs: systematic production of medical photographs
- Reflection period: 15 days between the 1st consultation and the nymphoplasty
- Anesthesia: general, intravenous or local sedation
- Duration of the operation: less than 1 hour
- Return home: same day, no hospitalization in most cases
After the nymphoplasty:
- Moderate pain
- Minimal bleeding for 2 to 3 days, discomfort when walking for 24 hours to 5 days, swelling for 7 days
- Intimate washing after each urination
- No sutures to remove, they are absorbable
- Rest and time off work of 24 hours to 5 days (depending on the activity)
- Swimming pool, bath, sport, sexual activities, tight clothing to be avoided for 3 weeks to 1 month
- Time until the final result: 2 months
- Natural result and almost undetectable scars over time
- Complications: rare (dehiscence of the scar linked to smoking)