Everything you should know about the Labiaplasty Procedure

Labiaplasty is the surgical correction of labia minora (small lips on the side of the genital area) or labia majora (large lips that usually cover small lips).

Some women simply do not like the look of their labia minora because they feel they are too long or one is longer or bigger than the other. In other cases, the lips can be uncomfortable during exercise or sexual intercourse or prevent the wearing of tight clothing or swimwear. A women’s labia may have enlarged to an uncomfortable size through childbirth and ageing and losing collagen. Occasionally, they may be a cause of frequent infections, itchiness, and discharge.

Should I get a labiaplasty?

All shapes and types of labia minora are normal. However, if you are unhappy, bothered and distressed with the shape of your genitals it is advisable to see a specialist and get advice.

Girls who are younger than 18 will be requested to see a psychologist before they can undergo the procedure and in most cases, the procedure is delayed until they turn 18. In some cases, Dr Novikova may request a psychological evaluation for women who are older than 18. This is to ensure that the procedure is performed for the right reasons, that expectations are met and that sound psychological support is provided.

Labiaplasty for the inner vs outer lips

The inner lips labiaplasty involves the reduction of the size or shape of the labia minora and the removal of dark skin tone tissues. These can be a cause of nuisance for many women for reasons related to physical sensation in the area, or psychological reasons such as lack of self-confidence or sexual performance if a woman dislikes the appearance of her vaginal lips. The outer lips labiaplasty involves reducing the size of or changing the look of the exterior vaginal lips by removing the excess fat and tightening or lifting any relaxed skin.

Different ways of performing the labiaplasty

Dr Novikova performs labiaplasty procedures in both Cape Town and Johannesburg under local anaesthesia in the procedure room. You will be instructed to apply a special anaesthetic cream to numb the skin over the area and take a tablet that will allow you to relax before the procedure. A local anaesthetic is injected into the area to remove any discomfort during the procedure. This part of the procedure is the only pain/discomfort you would experience during the procedure and it only lasts a minute at most.

Common types of the labiaplasty procedure are the trim or curvilinear technique (or trim technique or “barbie” labiaplasty), V- labiaplasty or central wedge resection and de-epithelization techniques.

Trim or curvilinear labiaplasty is when the edges of the labia minora are removed. This technique reduces the size of the labia minora. Women who choose the trim technique usually desire to have the darkened skin of labia minora to be removed. The end of the labia minora is excised and the lips will look pink with this technique.

V-wedge labiaplasty is done when the V-shape area in the middle of the lips is cut off and they are re-shaped with sutures. The edges have a natural look as they are not cut off and there might be a tiny scar in the middle of the area which is not visible once you heal.

It’s common for the clitoris to look bigger once the lips are reduced in size because of its proportional size. In such cases (which is 90% of labiaplasties) Dr Novikova will perform the clitoral hood reduction at the time of labiaplasty. 

At times women choose to remove excess skin, have fat filling or hyaluronic acid fillers injected into the big lips (labia majora) to improve the look. All of these procedures can be performed at the time of labiaplasty. A diathermy or laser beam is used to perform the labiaplasty. Dissolvable sutures are hidden under the skin.

Which type of labiaplasty is for me?

The technique chosen is based on the patient’s preference on the final look they desire. Your anatomy, expectations are discussed in detail and you will study before and after photos from Dr Novikova’s previous surgeries to decide on your preferred technique of labiaplasty.

Each labiaplasty is different as no one has the same anatomy and the technique is adjusted to suit the patient’s desires, concerns and anatomy. The practice nurse, scrub nurse and doctor are always available to answer your questions and provide pre-procedure and post-procedure support to make the recovery as easy as possible.

Dr Novikova is a gynaecologist and endoscopic (minimally invasive) surgeon with many years of experience in the field, she has performed many labiaplasties and is skilled in various techniques of the labiaplasty procedure. She has participated in workshops and meetings on aesthetic gynaecology and is certified by the European Society of Aesthetic Gynaecology.

For more information on the labiaplasty procedure, please see here.