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Recently popularized by the media, labial shaping has become a commonly requested procedure. Many women are born with larger labia that interfere with their daily activities. As with those who request a breast reduction to alter the shape and size of disproportionately large breasts, many women are now requesting labia reduction and reshaping to improve their self-esteem and quality of life. Large labial lips can interfere with sexual intercourse and ongoing sexual relationships, as well as making it difficult or even painful to exercise, bicycle, and ride horses. They can even restrict the types of clothes a woman can wear, often making it difficult to wear jeans, swimsuits, and short shorts.

Labial reduction has been preformed for years; however, Dr. Gary Alter of the television series Dr. 90210 recently created a unique way to reduce the labia that has allowed for better shaping, sensitivity, healing, and overall results. The procedure’s popularity continues to grow as more women are electing to undergo the procedure at younger ages before having children and are letting others know of the benefits. Previously, most physicians offered a reduction that was more of an amputation of the excessive tissue. This procedure has been improved upon by focusing on the resulting shape and preserving as much of the outer lip edge and sensitivity as possible. This requires the physician to tailor the procedure to the individual and her concerns. The procedure can also be combined with other enhancements such as breast augmentation, rhinoplasty, or liposuction if one desires.

You may be a candidate for labial reduction if your inner labial lips hang below your outer labia majora, you experience pain with intercourse associated with excessive pulling on the lips, you have difficulty with labial hygiene, you are unable to wear your clothes with confidence due to the size of your labia, or you feel pain when riding a bicycle or horse. Your plastic surgeon or other qualified physician can then evaluate your labia. It is normal for one of the labia to be larger than the other, and asymmetries can be expected following the procedure as well. Your evaluation will proceed with a complete history and a physical examination of the area.

Options for treatment will then be discussed. For excessively large labia majora, liposuction or excision of the labia majora can be offered. However, if the labia majora are too small, fat transfer may be the preferred treatment. Labia minora will be assessed for size and clitoral hooding as well. In many cases, one area of the minora is excessive and a small triangle of tissue can be removed to allow for improved size and shape. This can often be combined with removal of excessive clitoral hooding by simply extending the incision between the majora and minora. Once the excess tissue is removed and meticulous hemostasis is achieved, shaping of the labia proceeds with customized closure. Other options include laser tightening and G-shots (injection of collagen into the G-spot). However, the science and predictability of these two therapies are not fully clear and await further validation.

Healing from this procedure can take up to six weeks. During this time, one must keep the area clean. The sutures are absorbable and dissolve over the first three to six weeks. An antibiotic ointment must be placed along the incision line twice a day for the first two weeks. One must maintain abstinence during the first 40 days to avoid reopening the closure and prolonging the healing process. Complications are rare; however, hematoma, prolonged bruising, opening of the sutures, and the need for additional trimming can occur. The surgery is typically performed in an accredited facility with anesthesia to make the experience safe and comfortable. You can choose to be awake or asleep for the procedure, although most patients prefer the latter.

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