Labiaplasty

What is labiaplasty?

Labiaplasty, within the scope of this article, is an operation to reduce the labia minora, the inner lips, or to change their shape. The inner lips are external genital structures around the entrance to the vagina; they are not the vaginal canal itself.¹

The size, colour, edge and symmetry of the labia can vary from person to person. No single normal measurement can be defined for their appearance.² The inner lips being visible beyond the outer lips does not on its own establish a need for surgery.³

"Genital aesthetic surgery" is a broad name used for different procedures. Labiaplasty and vaginoplasty are not the same operation; narrowing of the vaginal canal is not described here.⁴ The aim is not for everyone to reach the same genital appearance.

Who is it suitable for?

Friction, catching on clothing, discomfort during exercise, difficulty with hygiene or pain during intercourse can be assessed among functional complaints. Whether these complaints genuinely arise from the labial tissue is separated at examination.⁴

A request can also be made for appearance alone, without a functional complaint. In this practice, surgery can be carried out for aesthetic purposes where the person is suitable; the decision is made by assessing the person's own wish, their expectation and the limits of the operation together. A request about appearance and a medical necessity are not the same assessment.

The American College of Obstetricians and Gynecologists states that procedures intended to alter appearance or sexual function without a medical indication are not medically indicated, that there is insufficient evidence on their safety and effectiveness, and that they can carry substantial risks.⁵ That warning is addressed not in order to judge a person's wish, but so that the decision is made in the knowledge of the evidence and the risks.

In this practice the lower age limit is 18. No assessment is carried out under the age of 18. Where a request is made during adolescence, it is reassessed at the age of 18.

What does the examination assess?

Which activity brings on the complaint, how long it lasts, any skin or infection problems, previous procedures and the nature of any pain during intercourse are assessed. Removing tissue is not the answer to every pain or itch.⁴ The change wanted and the limits of the operation are clarified at examination.

Whether the expectation belongs to the person themselves, and whether it can be met by surgery, is addressed. Where body dysmorphic disorder is suspected or there is marked psychological distress, an appropriate assessment is requested before a decision on surgery.⁵ A person with normal anatomy wanting a change does not on its own establish such a diagnosis.⁴

Plans for pregnancy and childbirth are part of the assessment as well. Childbirth can stretch the labia again and change the appearance achieved; where childbirth is planned in the near future, the timing is therefore assessed separately.⁶

How is the operation planned?

How do edge excision and the wedge technique differ?

In edge excision, excess tissue along the free edge of the inner lip is removed and the remaining edge is sutured. In the wedge technique a portion of tissue is removed as a wedge, and closure preserves part of the natural edge.¹ These are not the same incision pattern. The distribution of tissue, the features of the edge and the change wanted are assessed together; the name of a technique does not on its own determine suitability.⁴

The amount to be removed is not determined by an aim of smallness alone. Removing too much tissue can lead to problems such as traction, pain or dryness around the entrance.¹ The limit of the tissue to be removed is explained before surgery.

Does the clitoral hood need a procedure?

The clitoral hood is the fold of skin over the clitoris; although it is related to the inner lips, it is assessed separately.⁴ In this practice it can be addressed in the same session. That is not an obligatory step added to every labiaplasty. The decision on an added procedure and its limits are determined separately.

How is the timing of the operation decided?

In this practice, surgery is avoided during menstruation; the timing is planned according to the menstrual cycle. Where a pregnancy or childbirth is planned, the suitability of postponing is assessed with the person. Childbirth being able to change the result does not mean that everyone must leave surgery until after childbirth.⁶

Are non-surgical procedures directed at the same aim?

Procedures offered under the name of laser or radiofrequency "vaginal rejuvenation" are not the same procedure as the surgical removal of tissue from the inner lips.⁴

The American College of Obstetricians and Gynecologists reports that the United States Food and Drug Administration (FDA) issued a warning against these devices in July 2018: it asked that energy-based devices not be used for cosmetic vaginal procedures or vaginal "rejuvenation" outside standardised research protocols, citing serious adverse events such as vaginal burns, scarring, pain during intercourse and recurring pain.⁵ According to the same document, the FDA has not approved any energy-based medical device for this purpose.⁵ That warning concerns a particular intended use; it does not mean that all uses of lasers or surgical tools are prohibited. These procedures cannot be presented as a proven equivalent of labiaplasty.⁵

How do you prepare for surgery?

Smoking and nicotine: Smoking is a risk factor for wound healing problems after surgery. Direct surgical data on nicotine products other than cigarettes are scarcer. The practice reference of the American Society of Plastic Surgeons notes a lack of clinical data on e-cigarette use and surgical risk, but states that because nicotine is known to reduce blood flow, e-cigarettes and other nicotine products are regarded as a potential risk factor.⁷ Stopping smoking, vaping and other nicotine-containing products at least 1 month before the operation, and not using them after surgery until healing is complete, is therefore advised. The studies below concern smoking cessation; their results do not establish the same reduction in risk for every nicotine product. A review pooling 6 randomised and 15 observational studies showed that every week of abstinence added benefit, and that studies with at least 4 weeks of abstinence produced markedly better results than shorter ones.⁸ A study appraising systematic reviews together reported that cessation interventions beginning at least 4 weeks before surgery and combining multiple behavioural support sessions with pharmacotherapy reduced complications. The same study notes that interventions with only one component, even when started more than 4 weeks before surgery, raise quit rates without reducing complications.⁹ Shorter intervals are not useless either: in a meta-analysis of 55 studies covering adults undergoing a range of operations, the risk of pulmonary complications was 27 per cent lower in relative terms among those who stopped at least 2 weeks before surgery, and 29 per cent lower among those who stopped at least 4 weeks before, compared with those who continued smoking.¹⁰ The benefit therefore grows as the interval lengthens; being late does not make stopping pointless. The interval applied and the nicotine policy can vary from surgeon to surgeon.

Coexisting illness: Diabetes and blood pressure are expected to be under control before surgery. Where there is an active infection in the body, surgery is postponed.

Medication: Blood thinners and some herbal products can increase bleeding. Every medicine and supplement you take needs to be declared. Prescribed medication should not be stopped on your own decision.

Tests and anaesthetic assessment: The tests required are determined by general health and by the anaesthetic assessment.¹¹ Any previous problem with anaesthesia or drug allergy should be declared. The instructions given about fasting and about how to take medication on the day of surgery are followed.

Home and transport: Someone is arranged to accompany you home on discharge.¹¹ The timing of check-ups, the help you may need in the first days and the plan for time off work are organised beforehand. Follow the surgical team's guidance on preparing the operation area; do not shave or prepare the incision area at home on your own initiative.

What is recovery like?

In this practice the operation is carried out under general or local anaesthesia. 1-1.5 hours are planned for the operation and 1 night for the hospital stay. Sutures that dissolve on their own are generally used; these do not need removing. The first check-up takes place within the first week.

7-10 days are expected for bruising to settle and 1-2 weeks for marked oedema to subside. Residual slight swelling can last 1-3 months; the shape is assessed within 1-3 months. Swelling settling, the sutures dissolving and a return to all activities are not the same thing. At check-ups the state of the wound and the complaints are considered together with the timetable.

1-2 weeks are expected for a return to work, and 4-6 weeks for a return to sport and a full return to daily life. No fixed interval is given for a return to sexual activity; that decision varies with healing, with the procedure carried out and with the person. The plan for return given to each person is determined by the check-up findings.¹²

What to pay attention to after surgery

The following is a general framework. Where the instructions you were given differ, your surgeon's instructions apply.

Dressings: A pressure dressing is applied on the first day. For the subsequent arrangement of dressings, how they are changed and how the area is checked, the surgical team's instructions are followed. The arrangement for dressings and washing is determined by the procedure carried out.¹¹

Cleaning the area: After using the toilet, the area is wiped in turn with a moist gauze swab, a dry gauze swab and then povidone iodine; a clean pad is then placed in the underwear. The area is cleaned from front to back.

Sleeping: Rest with the head elevated. Your surgeon decides how long that position and the avoidance of physical strain are continued. A sleeping position that puts no pressure on the incision is preferred. Returning to sleeping on the side or front is assessed according to the state of the incision and the swelling.

Showering, wound and dressings: When you may shower depends on the dressing used. If there is a skin incision, once allowed you can shower without rubbing the wound and pat the area dry gently. Baths, swimming pools and the sea wait until the wound has closed completely.

Clothing and sitting: Loose underwear and clothing that does not rub the area are preferred.³ There can be discomfort when sitting in the early period.³ The arrangement for sitting is adjusted to the complaints and to the care plan given; the same period of sitting is not advised for everyone.

Movement: Strain such as bending the head down, straining and heavy lifting is limited in the early period. Movements that stretch or rub the incision area are avoided. Even if you feel well, do not return to strenuous activity suddenly. Activity and rest through the day are organised according to the plan given on discharge.

Pain: There can be tenderness, tightness and pain in the labial area.¹² The painkillers given are used as instructed. Pain that markedly prevents walking or changing position is reported to the team; rather than abandoning the movement plan altogether, pain control and the need for help are assessed. No new painkiller or additional medicine is started on your own decision.

Returning to work and sport: 1-2 weeks are set aside for a return to work. Sedentary work can also put strain on the incision area; the nature of the work is assessed separately. A return to sport is planned in stages within 4-6 weeks; approval from your doctor is awaited before moving on to movements that strain the area. 4-6 weeks are expected for a full return to daily life as well. The NHS likewise advises that up to 2 weeks off work may be needed and that physical exercise should be avoided for 4-6 weeks.³ Being able to carry out a task comfortably does not mean that all activities are permitted.

Driving: A return can be assessed within 1-2 weeks. There must be no effect of medication reducing attention, no dizziness and no pain preventing movement. You need to be able to sit with a seat belt, to check your surroundings and to brake suddenly or manoeuvre comfortably. Where there is marked discomfort in the incision area while sitting, driving is not undertaken even if the timetable has run its course. Someone is arranged to accompany you home on discharge.¹¹

Sexual activity: No fixed interval is given in this article. The decision on returning varies with the course of healing, with the procedure carried out and with the person; it is considered together with the healing of the operated area and the instructions given at the check-up. The frameworks given by institutions also differ from one another: the American Society of Plastic Surgeons advises 4-6 weeks, the NHS at least 4 weeks, and The Aesthetic Society abstaining for up to 8 weeks.¹³¹² These intervals come from separate care frameworks, not from comparative research. Everyday movements becoming comfortable is not on its own permission to return; continuing pain or a wound problem is not disregarded because an interval has elapsed.¹²

Smoking: Smoking impairs wound healing after surgery as well; cigarettes and nicotine products should be avoided until healing is complete.

Findings that are normal: Bruising, swelling, tightness and altered sensation around the incision can occur.¹² What matters is that the findings are decreasing. Swelling that grows rapidly, is painful, or gathers markedly on one side should not be attributed to the healing period given alone. Where there is a new fullness, no attempt is made to press on the area to drain fluid.

How do the incision and the sutures heal?

The incision is in the tissue of the inner lip, and sutures that dissolve on their own are generally used for closure. These sutures do not need removing. The sutures dissolving and the wound being ready for every strain are not the same assessment; the plan for check-ups and care is continued.¹²

An incision scar can remain, and in some people scar tissue can cause discomfort.⁵ Pain and closure of the wound are assessed as much as appearance.¹¹ No separate scar care regimen or scar maturation timetable is advised in this article.

Risks and complications

In the meta-analysis by Géczi and colleagues, pooled rates were calculated for the most frequently reported complications. The range given in brackets after each rate below is the 95 per cent confidence interval for that outcome.

• Overall complications 8.88 per cent (5.86-13.26); 36 studies, 1,914 observations, 170 events.¹³
• Wound dehiscence 5.91 per cent (4.24-8.17).¹³
• Swelling recorded as a complication 3.95 per cent (2.44-6.33); 30 studies, 1,476 observations, 44 events.¹³
• Haematoma 3.31 per cent (2.34-4.65); 44 studies, 2,090 observations, 38 events.¹³
• Infection 3.01 per cent (1.90-4.74); 35 studies, 2,122 observations, 20 events.¹³
• Bleeding 2.15 per cent (1.41-3.25); 31 studies, 2,323 observations, 18 events.¹³

The denominators differ from one another; the rates are not added together and none of them is one person's risk. No common follow-up period is given, and the methods and age groups of the studies differ; the review does not cover adults only.¹³ The swelling figure counts swelling recorded as a complication, not every expected swelling after surgery.

Satisfaction was pooled in the same meta-analysis: the overall satisfaction rate reported for all methods is 94 per cent (93-95).¹³ That is an outcome based on people's own reports; it is not a guarantee that an expectation about appearance will be met, and it is read together with the limits of the evidence below.

Shape, symmetry and the amount of tissue removed

Asymmetry, more or less tissue remaining than expected, and an irregular edge are possible.¹¹ Traction or pain occurring after too much has been removed is not a problem of appearance alone.¹ A review examining outcomes at 1 year or more gathered 748 people from 9 studies. In that group the most frequently reported problems were asymmetry in 45 people, a need for revision surgery in 42, and scarring in 14.¹⁴ The review is not a meta-analysis: it gives no pooled estimate and no spread between studies, and asymmetry with excess tissue, and scarring with edge irregularity and over-resection, are combined outcomes within it.¹⁴ A separate rate for over-resection therefore cannot be given.

Altered sensation, pain and sexual function

Transient numbness can occur in the early period.¹² Lasting complaints, among them altered sensation, pain and pain during intercourse, should also be assessed.⁵ Complaints related to sensation are not among the most frequently reported problems in the long-term review mentioned above, and the review gives no separate rate for them either.¹⁴ Their not being frequently reported does not mean they will not develop in an individual. A change in appearance does not mean that sexual sensation or sexual life will necessarily improve.⁵

Bleeding, wound dehiscence and infection

A haematoma is a collection of blood in the tissue; it is not the same diagnosis as bleeding or the wound opening.⁴ Infection and delay in closure of the wound can require further care or intervention.¹¹ Swelling in the first days and a growing, painful fullness are not taken as the same. Increasing bleeding, worsening pain or a wound that has opened are not left to wait for a check-up.⁶

Added procedures and further surgery

Adding a procedure on the clitoral hood requires that tissue to be assessed as well; the general outcomes of labiaplasty do not determine the benefit an added procedure will give a person or its separate risk.⁴ Further surgery may be needed because of a remaining problem with shape, a scar or another complication.⁵ In the review examining outcomes at 1 year or more, a need for revision surgery was reported in 42 of 748 people; the review does not give the reasons for those operations separately and offers no pooled estimate.¹⁴

Anaesthesia and general surgical risks

Reactions related to anaesthesia and other general surgical risks are assessed together with state of health and the extent of the procedure.¹¹

Blood clots: A clot forming in the leg veins and travelling to the lungs is serious. One-sided leg pain and swelling, sudden shortness of breath or chest pain need urgent assessment.

The approach to preventing clots is decided according to the person's risk and the operation planned. The measures to be used are explained in the discharge and care plan. No blood thinner is started without being prescribed, and existing treatment is not altered on the person's own decision.

How does the result change over time?

It cannot be said that the appearance after surgery will never change in the years that follow. Pregnancy, childbirth and changes related to age can affect the tissues and the result.⁶ For someone planning to have children, the option of postponing is assessed; the same obligatory waiting period is not given to everyone.⁶

The studies in the long-term review reported favourable outcomes for appearance and function; the same source also records lasting complaints and further surgery.¹⁴ Favourable outcome data are therefore not a guarantee that every complaint will be resolved in every person, or that no further procedure will be needed.

What can be expected from the result?

The expectation should relate to the discomfort or the wish about appearance that the person has described. Copying another person's anatomy is not a criterion for the decision to operate.

In the same review, no complication after surgery was reported in 621 of 748 people, and all 7 studies reporting psychological outcomes found sustained improvement in scores for appearance and sexual satisfaction over the long term.¹⁴ These results are based on people's own reports and come from studies without a comparison group.¹⁴ Discomfort arising from the tissue and satisfaction with appearance are not the same outcome. Pain during intercourse can have different causes; it is not promised that changing the inner lips alone will resolve every sexual complaint.⁴⁵ Surgery does not necessarily resolve self-confidence or every concern about the body.³

The appearance during the first period of swelling is not the final assessment. The 1-3 month interval given by the surgeon in this practice for assessing the shape and the decision on returning to work or to sexual activity are not used in place of one another.

When should you contact a doctor?

In the situations below, the planned check-up is not waited for.

• Swelling or pain that increases rather than settling.⁶
• Marked bleeding, blood clots or the wound opening.⁶
• Fever, purulent discharge or worsening redness.⁶
• Marked pain or increasing difficulty when passing urine.⁶

The expected healing period not having elapsed does not make these findings ordinary. For a finding that needs early assessment, the next check-up date is not waited for.⁶

One-sided leg pain and swelling, sudden shortness of breath or chest pain are emergencies. Where there is a sudden breathing problem in particular, urgent assessment should not be delayed while trying to reach your doctor.

About the numbers in this article

The age limit, anaesthesia, the duration of the operation and the hospital stay, the use of sutures, the timetable for bruising, swelling and assessment of the shape, and the intervals for returning to work, to driving and to sport are the clinical framework approved by the surgeon. No fixed interval is given for a return to sexual activity; the intervals named by institution are those institutions' care advice, not this practice's approved value. The timing according to the menstrual cycle is likewise a clinical decision, not a research finding.

Research percentages are calculated from particular outcome definitions and sets of studies. The pooled rates in the risk section come from one meta-analysis and are given with their confidence intervals; the denominators differ between outcomes and none of them is one person's risk.¹³ The counts in the long-term review are given out of 748 people gathered from 9 studies; that review is not a meta-analysis and offers no pooled estimate or spread between studies.¹⁴ The satisfaction figures in both sources are likewise based on people's own reports.¹³¹⁴ A confidence interval is not the range of risk a person will experience. A number not being given for a risk in this article does not mean that the risk does not exist.

The data in the smoking cessation paragraph cover a range of operations.⁸⁹ In the results reported from Tang, the relative risk was 0.73 with a 95 per cent confidence interval of 0.60-0.89 for those who stopped at least 2 weeks before, and 0.71 with a 95 per cent confidence interval of 0.61-0.82 for those who stopped at least 4 weeks before.¹⁰ The 27 per cent and 29 per cent relative reductions in the shared paragraph are not an absolute complication rate specific to labiaplasty.

References

1. American Society of Plastic Surgeons. Labiaplasty. Accessed 13 September 2026. Institutional text ↩ ↩² ↩³ ↩⁴ ↩⁵

2. Lloyd J, Crouch NS, Minto CL, Liao LM, Creighton SM. Female genital appearance: "normality" unfolds. BJOG. 2005;112(5):643-646. doi:10.1111/j.1471-0528.2004.00517.x ↩

3. NHS. Labiaplasty (vulval surgery). Last reviewed 27 September 2023. Accessed 13 September 2026. Institutional text ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

4. Furnas HJ, Canales FL, Pedreira RA, Comer C, Lin SJ, Banwell PE. The Safe Practice of Female Genital Plastic Surgery. Plast Reconstr Surg Glob Open. 2021;9(7):e3660. doi:10.1097/GOX.0000000000003660 ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰

5. American College of Obstetricians and Gynecologists. Elective Female Genital Cosmetic Surgery: ACOG Committee Opinion, Number 795. Obstet Gynecol. 2020;135(1):e36-e42. doi:10.1097/AOG.0000000000003616 ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰

6. Cleveland Clinic. Labiaplasty. Last updated 15 June 2023. Accessed 13 September 2026. Institutional text ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰

7. American Society of Plastic Surgeons. Managing the risks of smoking in plastic surgery patients. Practice reference, 9 October 2024. Accessed 8 September 2026. plasticsurgery.org ↩

8. Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8. doi:10.1016/j.amjmed.2010.09.013 ↩ ↩²

9. Fiddes RA, McCaffrey N. Preoperative smoking-cessation interventions to prevent postoperative complications: a quality assessment and overview of systematic review evidence. Anesth Analg. 2025;140(6):1377-1387. doi:10.1213/ANE.0000000000007187 ↩ ↩²

10. Tang E, Rodriguez RM, Srivastava A, et al. Impact of short duration smoking cessation on post-operative complications: a systematic review and meta-analysis. J Clin Anesth. 2025;106:111967. doi:10.1016/j.jclinane.2025.111967 ↩ ↩²

11. Australian Society of Plastic Surgeons. Labiaplasty. Accessed 13 September 2026. Institutional text ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸

12. The Aesthetic Society. Labiaplasty: Aftercare & Recovery. Accessed 13 September 2026. Institutional text ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

13. Géczi AM, Varga T, Vajna R, et al. Comprehensive Assessment of Labiaplasty Techniques and Tools, Satisfaction Rates, and Risk Factors: A Systematic Review and Meta-analysis. Aesthet Surg J. 2024;44(11):NP798-NP808. doi:10.1093/asj/sjae143 ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰

14. McGrattan M, Majeed A, Hanna SA. Long-term Functional and Aesthetic Outcomes of Labiaplasty: A Review of the Literature. Aesthet Surg J. 2025;45(2):180-185. doi:10.1093/asj/sjae211 ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹