There is a popular misconception floating around the internet and social media about the “designer” or “Barbie” labiaplasty. As a double-board certified plastic surgeon in New Orleans, I perform this surgery; however, none of these are performed on patients for purely aesthetic reasons. To use these terms does a disservice to the women who encounter the very real problem of hypertrophy of the labia minora.
Hypertrophy of the labia minora — or enlargement of the inner labia tissue — can cause a host of problems for women of all ages. These problems may include daily discomfort, chafing, pain, social anxiety if the enlargement is visible in a garment, irritation during exercise, tenderness during sexual activity, and other functional concerns. It’s a very common side–effect after pregnancy, and can also occur in women as they age.
Many women are not aware that this is a solvable problem. Part of the reason they are unaware is because of terms like “designer vagina” or “Barbie vagina,” which turn the physicality and lived reality of this very real problem into something that seems tied solely to vanity, aesthetics, and sexuality. When women already feel a sense of shame or guilt for even bringing up their desire for labiaplasty or a desire to solve their problem, sensationalizing and sexualizing the solution as a “designer” vagina, “redesigned” to better appeal to the male gaze, only exacerbates the shame these women feel.
In short: if you feel discomfort, pain, irritation, or anxiety around your vulva due to extra tissue that needs to be modified, labiaplasty is an easy, accessible solution. You don’t have to live with shame around wanting to fix this very real, and very common, problem.
Who Should I Go To For a Labiaplasty?
Please keep in mind that for such a delicate and personal procedure, it’s highly important that you have this surgery performed by a board-certified plastic surgeon. Labiaplasties are performed by OB/GYNs, urological gynecologists, and cosmetic surgeons. But while a cosmetic surgeon spends 1 year in training, a plastic surgeon spends anywhere from 3-8 years. So not only do you want to go to a plastic surgeon for your labiaplasty, you want someone who is experienced.
The extent of the resection of tissue and the closure are the most important components of the labiaplasty procedure, as you do not want edges that are scalloped or too short, which can result in the opposite problem: dryness, irritation, and loss of the protective function of labia minora. Overall, you want a surgeon who takes the utmost care and pays attention to the important details.
Postpartum Mothers and their Changing Bodies
Pregnancy and motherhood can uproot our bodies and routines. In contrast with the “designer vagina” trend (which I suspect is actually just sensationalized marketing for clicks and controversy), most of the women I perform labiaplasty on are mothers in their 40s. While I have performed this surgery on adolescents who are just completing puberty, the majority of my patients have completed child bearing and are now focused on getting back to their life — but this problem is standing in the way.
“When I put on my yoga pants, it looks like a scrotum!” I hear this often from patients who are unhappy with the extra tissue around their vagina. It can often be uncomfortable and or painful from chafing and contact irritation. It can lead to frequent urinary tract infections | UTIs or pain during sexual intercourse.
During pregnancy, increased exposure to estrogen and progesterone can lead to enlargement of the labial tissue. The labia minora creates a barrier to entry into the vagina, a sort of biological protection, and with the increase in hormones during pregnancy, they naturally become bigger. If they don’t recede, labiaplasty is a perfectly safe solution.
I often perform a labiaplasty in conjunction with other restorative surgeries, like a breast lift, or abdominoplasty (a.k.a. tummy tuck). In my clinic, the last thing you have to worry about is judgment. I create a truly safe space, where you can share your concerns, and we can find the right solution for you.
Labiaplasty on Younger Women
I have performed labiaplasty on women ranging in age from 17 to 70. In patients under 18 years old, hypertrophy of the labia can be a congenital pediatric problem. While not medically threatening, it can cause a great deal of social anxiety and psychological stress. To discuss this area is a sensitive subject, but I have found that young women are comfortable talking about this problem with me because I’m a woman and a mother myself.
Commonly Asked Questions:
How safe is the procedure?
Labiaplasty surgery is a low-risk outpatient procedure, which means it is done at the clinic using local anesthesia or mild sedation. The whole process takes roughly an hour and a half. You will experience minimal pain.
How do I prepare? Do I have to shave everything?
You don’t need to do anything to prepare. It’s okay to come in your natural state.
When can I start walking?
You’ll be walking the day of surgery, but keep your activity light, with minimal sweating for a few days. Pelvic rest and exercise restrictions are in place for up to 6 weeks to allow for healing.
What does post-op care look like? Do I need to have someone help take care of me?
For post-op care, you’ll want to elevate your pelvis on pillows, use indirect ice to reduce swelling, take anti-inflammatories like Ibuprofen for pain control, use an antibiotic ointment, and apply topical anesthetic sprays. You can do all of this yourself; you do not need someone to take care of you.
Can I drive myself home from the surgery?
This depends on your medication or level of sedation. We can help you make these decisions before the procedure.
When can I go to work again?
You can return to work in 2-3 days. So, for example, if you schedule your procedure for a Friday, you should be able to return to work on Monday.
What does the procedure look and feel like?
On the day of your labiaplasty, you’ll come in, and receive whatever level of sedation we have decided upon. Next, we’ll apply a topical numbing cream, which will take about 20 minutes to set in, followed by a local injection. This will be the peak of your pain, similar to a trip to the dentist for a minor oral surgery. You should not feel anything after receiving the local injection. You may feel temperature or pressure, but nothing painful or sharp. The procedure itself will take 30 to 45 minutes. You will then be given antibiotics, padding, and underwear to go home with. You can choose to have deeper sedation with intravenous sedation or general anesthesia to alleviate any and all anxiety related to this surgery.
What if I’m having a labiaplasty along with other surgeries?
The recovery time and recovery process of your other surgeries, like abdominoplasty or breast lift, will take precedence. In other words, labiaplasty is the lesser concern.
What are the risks of labiaplasty?
The biggest risk of labiaplasty is that the closure site has contour irregularities, like scalloped edges or a compromised closure. I have had patients come to me to have contour irregularities fixed after a botched labiaplasty by someone untrained in the correct technique. I will revise the edge and re-close it. However, revising an edge means you risk shortening the labia, which can result in dryness, irritation, and additional problems. For this reason, revising a labiaplasty is often higher-risk than the initial procedure.
Another high-risk scenario is If the labia minora extends to the clitoral hood. In this case, the surgeon must be highly skilled, because you could jeopardize sexual function and pleasure. This is yet another reason that an untrained surgeon or non-plastic surgeon should never perform your labiaplasty! Only a board-certified plastic surgeon who is highly trained in anatomy and experienced in this type of procedure should perform your labiaplasty.
The truth is, most women seeking a labiaplasty are normal, postpartum women in their 40s who are trying to go to the gym or wear yoga pants without a bulge from excess tissue. Rarely is this a “designer vagina” situation. These are women like yourself who are trying to get back to their previous status for functional, not aesthetic, reasons. I’m here to help you achieve exactly that.
Please reach out to my office at 504-249-3805 if you’d like to come in to discuss how a labiaplasty can be the solution to your discomfort.
