Do your labia minora seem larger than they should?
The intimate area has a significant impact on a woman's self-confidence. Changes such as enlarged labia minora can cause discomfort during physical activities, when wearing certain clothes, or during sex. If you think your labia minora are large, know that this is more common than you think — and there is treatment! Labiaplasty is the plastic surgery for the reduction of the labia minora, with a quick recovery and virtually painless. I am a plastic surgeon in Londrina, Brazil, trained by the late Professor Ivo Pitanguy in Rio de Janeiro, Brazil, and I have international specialization in labiaplasty and other forms of intimate surgery. I went to the United States to personally learn the wedge technique from its creator, Dr. Gary Alter. I have knowledge of the most current techniques indicated for your case, and I can offer excellent results in a safe and calm procedure.
Indication
Patients with excess of one or both labia minora are indicated for labiaplasty, also called labioplasty. The most common complaints include discomfort when walking, exercising, or wearing tight clothing, chronic irritation, pain during sexual intercourse, and aesthetic dissatisfaction. The excess can be upper, lower, symmetrical, asymmetrical, small, large, involve the prepuce — the skin covering the clitoris — or not, thin, thick, dark, or pink. There are various variations of the labia minora, and one of them may be bothering you. During the consultation, I clarify whether it is a case that can be improved with surgery. The indication takes into account the overall condition of the intimate area and may require concurrent treatment of other aspects, such as excess prepuce, excess mucosa in the vaginal furcula, excess labia majora, excess fat in the mons pubis, among others.
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I explain about labiaplasty in Londrina
Pre-operative
The consultation
In the consultation for labiaplasty, I listen to your concerns and evaluate your intimate area. The labia minora are analyzed regarding size, color, thickness, symmetry, and shape. During the physical examination, I also analyze the mons pubis, clitoral hood, clitoris, labia majora, and perineum to outline the most appropriate surgical plan for your case. I explain the details of the surgery and the techniques used, as well as inform you about post-operative care and answer your questions.
Exams
For your labia minora reduction surgery, I usually request the following exams:
Complete blood count;
PAT with INR + APTT;
Urea;
Creatinine;
Fasting blood glucose;
Total proteins and fractions
Vitamin D
Vitamin C
Urine I;
Electrocardiogram;
Surgical risk assessment with a cardiologist.
Anesthesia
I use a labiaplasty technique without infiltration of anesthetic solution to avoid distortions that could compromise the final result. For this reason, the labia minora reduction surgery is performed under general anesthesia most of the time, or occasionally under spinal anesthesia. The general anesthesia I perform is total intravenous anesthesia, where all medication is administered through the vein, and only oxygen passes through the tube. At the end of the surgery, the medication drip is turned off, and the patient wakes up in two to three minutes.
The surgery
I perform labiaplasty mainly using two techniques: longitudinal resection — trimming — or wedge resection — wedge excision. Both preserve the sensitivity of the labia minora, as the main innervation (perineal nerve and posterior labial nerve) is respected. The choice depends on the anatomy, complaints, and goals of each patient.
Longitudinal resection - trimming
This technique consists of removing the excess from top to bottom, leveling the labia minora with the labia majora, finishing with a continuous suture using absorbable thread in the longitudinal direction of the labia minora. The scars remain along the anterior edge of the labia minora. It is one of the oldest techniques and was the first one I used.
Advantages
Does not interfere with sensitivity;
Corrects asymmetries;
The scar is imperceptible when well executed;
It is faster and can be performed in 30 to 40 minutes;
Removes the dark and thicker part if that is the patient's desire.
Disadvantages
Does not reduce the length of the labia minora;
Some patients wish to preserve the original color pattern of the labia minora, and this technique does not allow that;
Needs to be very well executed by the surgeon to avoid leaving excess or removing too much.
Wedge resection - wedge excision
Developed in the United States by plastic surgeon and urologist Dr. Gary Alter, it consists of removing a wedge, or "pizza slice," as well as removing tissue more superiorly, laterally to the clitoris. I went to the United States to learn this technique directly from its creator to execute it perfectly.
Advantages
Also does not interfere with sensitivity;
Corrects asymmetries;
The scar is also imperceptible when well executed;
Preserves the original color and shape of the labia minora
Allows shortening of the labia minora.
Disadvantages
Does not completely remove the dark and thickened part if desired;
Takes longer to perform due to more details and more suture points - about two hours -.
Which technique to use?
Based on your desires and your physical examination, I discuss with you the most appropriate technique for your case. In some cases, I may combine elements of both techniques to achieve the best possible result.
Post-operative
Labiaplasty, in summary, is a practically painless procedure with a very smooth recovery. I recommend using silver sulfadiazine ointment for a week to prevent infection, as it is a moist area. Other recommendations include one month without physical activity and six weeks without sexual intercourse. Bleeding is minimal, and most patients resume light activities within a few days.
Suture threads
The threads I use in labiaplasty are absorbable. This means there is no need to remove them — they dissolve naturally in the following weeks, providing more comfort to the procedure.
Final result
Initially, the labia minora may be slightly swollen, and they will progressively decrease in volume. After one to two months, they will have significantly reduced swelling, but healing will not yet be complete. I consider the final result to be around six months to a year. The scars remain in the natural folds and become practically imperceptible.
Associated intimate surgeries
It is very common to associate other intimate surgeries with labiaplasty. This is because treatment of the intimate area deserves to be comprehensive to achieve the highest degree of intimate aesthetics. I specialize in various modalities of intimate surgery and have the knowledge, experience, and skill to offer you a complete and individualized treatment.
The most commonly performed intimate surgeries with labiaplasty are:
The skin around the clitoris, also known as clitoral hood, may be excessive. During the evaluation for labiaplasty, it is very important to assess this area, as an excess of clitoral hood can make the clitoris very prominent, making the result of labiaplasty less aesthetic. The wedge technique usually includes the reduction of the skin along the clitoral hood. For patients who will undergo the trimming technique, I evaluate and remove the excess clitoral hood if present. This excess can be removed with longitudinal incisions parallel to the clitoris, as in the wedge technique, or through a crescent-shaped removal just above the clitoris, increasing its exposure, similar to male circumcision — phimosis.
To understand the name of this surgery, it is enough to know that the labia majora are also called labia majora. Often, the problem of enlarged labia minora is associated with laxity of the labia majora. It is possible to reduce the labia majora in conjunction with labiaplasty, and the resulting scar is imperceptible, in the fold between the labia majora and labia minora on each side. But be careful: as Dr. Christine A. Hamori always reminds, during this association I first reduce the labia majora, as labia majoraplasty usually decreases the projection of the labia minora, making labiaplasty a bit more conservative.
The little fat in the pubic area can be very bothersome. During the consultation for labiaplasty, many patients request the reduction of this fat through liposuction. Through two small incisions hidden by the bikini, it is possible to effectively remove fat and reduce the volume that used to protrude in swimsuits and gym clothes.
Non-surgical treatments
There are other treatments for the intimate area that do not involve surgery and can be performed complementarily to labiaplasty. These treatments depend on each case and may involve, for example:
Laser;
Lightening creams;
Filler with hyaluronic acid.
I evaluate your case and recommend the necessary aesthetic treatment modalities.
Frequently Asked Questions about Labiaplasty
Is labiaplasty painful?
I perform labiaplasty under total intravenous general anesthesia, so the patient feels absolutely nothing during the procedure. In my experience, postoperative discomfort is minimal — most of my patients report much less pain than they expected. I prescribe painkillers that effectively manage any discomfort in the first few days.
What is the difference between the wedge technique and the trimming technique?
In my practice, I use both techniques according to each patient's needs. The trimming technique removes excess tissue along the edge of the labia minora, allowing for the removal of the darkened and thicker part. The wedge technique removes a wedge-shaped section in a "V" shape, preserving the natural edge and original color. I went to the United States to learn the wedge technique directly from its creator, Dr. Gary Alter, and I personally assess which approach will yield the best result for each case.
Does labiaplasty affect the sensitivity of the labia minora?
No. The techniques I use preserve the main innervation of the labia minora — the perineal nerve and the posterior labial nerve. In my experience, no patient has reported loss of sensitivity after surgery. This is one of my greatest concerns during surgical planning.
When can I return to normal activities after labiaplasty?
I recommend that my patients resume light activities within a few days. For intense physical activity, I advise waiting a month, and for sexual relations, six weeks. Each case is evaluated individually during follow-up consultations.
Does labiaplasty leave a visible scar?
In my experience, the scars are practically imperceptible. In both the trimming and wedge techniques, I position the incisions in the natural folds of the labia minora. With complete healing, around six months to a year, the marks become almost invisible.
Is it possible to combine labiaplasty with other intimate surgeries?
Yes, and this is very common in my practice. I often combine labiaplasty with preputioplasty, labia majora reduction, or liposuction of the mons pubis. I specialize in various modalities of intimate surgery and assess the entire region to provide a complete and harmonious result.
What type of anesthesia is used for labiaplasty?
I use total intravenous general anesthesia in most cases. In this technique, all medication is administered through the vein, and only oxygen passes through the tube. At the end of the surgery, the drip is turned off, and the patient wakes up in two to three minutes. Occasionally, I may use spinal anesthesia. I choose not to infiltrate local anesthetic solution to avoid distortions that could compromise the result.
Do the stitches from labiaplasty need to be removed?
No. I exclusively use absorbable sutures for labiaplasty, which dissolve naturally in the weeks following the surgery. This ensures more comfort for my patients, without the need for a return visit to remove stitches.
How long does it take to see the final result of labiaplasty?
In the first few days, it is normal to experience swelling in the labia minora. In my experience, after one to two months, there is already a significant reduction in edema, but I consider the final result to be between six months and a year, when healing is fully complete.
Who is a candidate for labiaplasty?
I recommend labiaplasty for patients who have excess skin in one or both labia minora and who experience discomfort while walking, exercising, wearing tight clothing, or who have aesthetic dissatisfaction. During the consultation, I carefully assess the anatomy — size, color, thickness, symmetry — and discuss expectations to determine if surgery is the best option.
Get your labiaplasty done with a specialized plastic surgeon!
Contact the Zamarian Clinic in Londrina, Brazil, and schedule your consultation for labia minora reduction. I am a plastic surgeon specialized in labiaplasty and other modalities of intimate surgery, with excellent results. I treat each patient with total respect, discretion, and professionalism.
