Labiaplasty is on the rise. Here's why women say they had the controversial plastic surgery procedure.
Emily Gavaldon says she’s never felt comfortable with her labia. Her right labia, she tells Yahoo Life, was “much larger” than her left, making her feel “ashamed” and “embarrassed” — even though her gynecologist insisted she was “perfectly fine” and that her vulva was “normal.”
“I was still upset about the appearance of my labia,” the 23-year-old Colorado native explains. “I would ‘tuck it in’ when wearing a bathing suit and never let my boyfriend look down there. Later in my late teens, it began to affect my sex life immensely. I was so scared to reveal myself to anyone.”
It wasn’t until she went to beauty school and spoke with one of her peers that she heard about labiaplasty, a plastic surgery procedure that alters the inner folds of skin that are part of the vulva called the labia minora and, less commonly, the hair-bearing outer layer called the labia majora. Gavaldon’s peer had the procedure done herself, leading Gavaldon to do her own research. She remembers thinking, “I don’t have to live with this forever?”
“Hearing how embarrassed she was of her labia made me feel somewhat better, like I wasn’t alone or the only one feeling this way,” she admits.
Gavaldon went to a plastic surgeon for a consultation. One week later, she had labiaplasty — a procedure that made her feel like a “brand new woman.” She says the pain was “manageable,” save for urinating, which was difficult, due to her stitches.
“Once I was given my before and after pictures, tears ran down my face and I couldn’t thank the doctor and staff enough. They did an amazing job,” she says.
What is labiaplasty?
Labiaplasty itself can be a fairly simple procedure that can be done with local as opposed to general anesthesia, depending on the patient’s pain tolerance, according to Dr. Gordon K. Lee, a plastic and reconstructive surgeon and professor of surgery at Stanford Medicine.
“Typically, the area is numbed with an injection of local anesthetic,” Lee tells Yahoo Life. “The extra skin is then removed. There are different techniques and ways of doing that” — namely, the trim method (extra tissue is cut and then stitched up) and the wedge method (a triangular wedge is removed, and the scar is hidden). He adds: “Patients can typically go home the same day.”
Lee notes that patients are advised not to do anything strenuous for about four to six weeks, including sexual intercourse, “because anything that would strain the stitches could obviously open the wound.” But he says that most patients can go back to an office type desk job within “a matter of a few days.”
Why do women get labiaplasty?
Labiaplasty is on the rise. Nearly 19,000 labiaplasty procedures were performed in 2021, up 36% from 2020, according to statistics from the Aesthetic Plastic Surgery National Databank. It’s a trend that the American College of Obstetricians and Gynecologists expressed concern about in 2017, especially given the rise in teens interested in the procedure.
Some blame pornography, saying that it plays a role in influencing people to have the procedure done. But several workers within porn argue that there isn’t a single idealized labia look in the industry. And a 2016 study found that only a couple of women cited how genitals appeared in pornography as the reason why they sought labiaplasty. Instead, the reasons they gave included seeing “before” pictures on surgeons’ websites, which may lead women to have labiaplasty for strictly cosmetic reasons due to the mistaken belief that there is something wrong with their genitals, as well as getting negative comments about their own labia’s appearance and physical discomfort.
The rise in tight clothing — particularly when it comes to leggings for exercising — has also become a factor when it comes to patients seeking labiaplasty, notes Lee.
“Sometimes you’re able to look in that area and see that extra tissue that is protruding, which can make people feel self-conscious,” he says. “Some people like to wear tight-fitting clothing to the gym, especially when you have people doing yoga and Pilates. That fashion trend is also driving the surgery, because as young ladies are wearing more tight-fitting clothing, that area is being more exposed.”
For Zully Azuero, a 23-year-old who lives in Chicago, it wasn’t about aesthetics. She says the physical discomfort caused by her labia was affecting her “daily life.”
“My left labia was bigger than my right one, and it would irritate me when I would sit, wear jeans or wear certain underwear,” she tells Yahoo Life, adding that she would regularly get yeast infections and UTIs. The irritation got worse, she says, in 2020, when she was sitting for long hours for an office job. Azuero first learned about labiaplasty through her gynecologist in 2022, who recommended the procedure.
“To be honest, I always wanted it done, I just didn’t know it was a thing,” she says.
Azuero had labiaplasty as an outpatient procedure. “The recovery was difficult in the beginning,” she recalls. “The first week was the most painful. I had to refrain from physical activities for four to six weeks. I couldn’t have sexual intercourse for six weeks. It would sting when I had to use the bathroom,” adding that it was difficult to sit for long periods of time and she wasn’t able to go back to work for four days.
Still, she says, “I would totally recommend this procedure to anyone who is in the position that I once was in. It’s life changing, and I feel so much more comfortable with what I wear in my daily life.”
Like Azuero, McKayla, who lives in Indianapolis and asked that her last name be withheld, says she wanted the surgery because she was exercising every day and felt physically uncomfortable.
“I always struggled with my labia and how it was just extra long — my right one was longer than my left one,” she tells Yahoo Life. “It would always stick out, and it was just super uncomfortable. I'd have to tuck it in.”
McKayla chose to have the procedure under general anesthesia. “It was a pretty easy surgery, mainly since I was so excited to get it and get this issue resolved,” she says. “I didn’t really care how much pain it would cause, but it wasn’t very painful.”
What are the potential risks of labiaplasty?
As with any type of surgery, labiaplasty isn’t without its risks — which can include bleeding, removing too much or too little tissue, infection, scarring and loss of sensitivity — particularly when it’s not performed by an experienced, board-certified plastic surgeon.
It’s something 36-year-old San Francisco resident Jessica Pin knows firsthand. Pin was a teenager when she found photos of labia online — her first real introduction to seeing other vulvas. She realized that her labia minora hung down lower than ones in a photo she saw. It was the first time that she thought maybe she wasn’t “normal” and started seeking out other photos to find images of vulvas that looked more like hers. Instead, she says, she found several images from medical textbooks in which the labia minora were barely visible.
Pin went to her mother’s ob-gyn, who reassured her that she was perfectly “normal.” But she didn’t believe it. Pin says she didn’t realize that having the inner lips of the vulva protrude past the outer lips is actually completely normal and quite common. Around 50% of women have labia minora longer than their labia majora.
When Pin was 18, she told her father, a plastic surgeon, that she was experiencing pain from her labia minora. He set her up with an ob-gyn surgeon at a hospital, who performed a labiaplasty. However, Pin claims that her surgeon, who she says was not trained to do the procedure, “amputated” her labia minora, as well as performed a clitoral hood reduction, which removes excess skin surrounding the clitoris — all without her consent.
The surgery, Pin explains, severely impacted her sexual function, including her ability to orgasm — potential risks she was not informed of at the time. After what she went through, Pin became a full-time activist for better vulvar anatomy education and training standards for vulvar surgeries. “I don’t advocate for labiaplasty to be banned,” she says. “I advocate for informed consent and a reasonable standard of care.”
According to Lee, patients need to be informed of the risks of over-resection, which is the removal of too much tissue, which can be deforming. “Injuring the nerves to the clitoris is a complication that should not happen if performed by an experienced, American Board of Plastic Surgery board certified plastic surgeon,” he says. “This is because the nerves that go to the clitoris should not be injured during a routine labiaplasty.”
Like any surgery, “there’s still some risk,” says Lee, “and so patients have to really educate themselves and make sure this is right for them and that they will be going to somebody who knows what they’re doing.”
It’s also important for women to consider what their reasons are for having labiaplasty, says Lee. “And you want to be sure that a patient is doing it for herself, and not for someone else such as her partner.”
Most of Lee’s patients seek labiaplasty after experiencing pain or discomfort during exercise or sexual intercourse. However, for those who want the procedure strictly for aesthetic reasons, he says it’s important to understand that vulvas naturally come in a range of different shapes and sizes.
“I think that it is very helpful to know that there are many different types of normals” when it comes to vulvas, Lee says. “Not everyone’s labia looks exactly the same.”
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