January 26, 2018

Q & A: Should I Have My Labia Surgically Re-Sized?

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Big ones, long ones, small ones, which one is right for me?

Q: I’ve been aware since my pre-teen years that I have rather large labia minora and have often felt very self-conscious to the point that I’d want to cut the “excess” off when I was young. I feel labiaplasty could help me. I’d like to speak with someone about this issue and find a doctor who can perform this procedure.

A: Although vulvas vary in skin color as well as the shape and size of the labia minora (inner vaginal “lips”) and clitoris, most women do not regularly experience vulvar pain or labia pinching from daily activities like walking, sitting or wearing certain kinds of clothing.

Many artists, including Judy Chicago and Betty Dodson, have glorified the vulva as a graceful, flower-like and awe-inspiring part of the body. This positive view of the vulva has been important to many women’s appreciation of a body part that is all too often portrayed as dirty, smelly or ugly — which is why some health care providers try so hard to help women accept their genitals in their natural state. And yet women’s relationship with their genitals is enormously complex, as Eve Ensler showed in her play and book “The Vagina Monologues.”

Like you, some women feel physically uncomfortable due to the length of their labia. Their labia may get pinched when they wear certain kinds of clothing, engage in various forms of exercise or try different sexual acts. Labiaplasty, which is surgical cutting and reshaping of the labia, is sometimes used to help women in these situations.

There Is No Guarantee of Improvement

A difficulty with labiaplasty is that while some popular magazines and Web sites write about (or even promote) what’s been dubbed a “designer vagina” type of surgery, the scientific literature tells a story of ever-evolving surgical techniques — but only a little research about the ways in which surgery might positively or negatively affect women’s experiences, sexual or otherwise.

The vulva is rich with nerve endings and (as with other body parts) any time cutting occurs, there is the risk of damage to the ways in which you experience sensation, making the surgical choice an important one.

If you are interested in consulting with a health care provider with expertise in vulvovaginal health you might ask for referrals from the National Vulvodynia Association or the American Society of Plastic Surgeons. Further, you may find that reading “The V Book: A Doctor’s Guide to Complete Vulvovaginal Health” by Dr. Elizabeth Stewart will provide you with a fair amount of information about vulvar health and anatomy.

Then, should you consult with a health care provider about labiaplasty, you’ll be well-informed and able to ask useful questions about how the surgery might change your vulva’s appearance and potentially its sensation.

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