Clinical (Labial hypertrophy)

Patients seeking labiaplasty often present with reports of difficulty with hygiene (toilet paper sticking), discomfort with tight clothing, pain with bicycle riding and similar sports, labia catching in zippers, or painful intercourse due to hypertrophy of the labia minora. Perhaps the most common is the perception that the labia minora are too visible. Many women report that the labia minora protrude beyond the labia majora while in the standing position, leading to self-consciousness and difficulty with intimacy. An example of a patient presenting for evaluation can be found below (Media file 1).

Another common report is asymmetry of the labia minora. Women often present to the clinic with one lip of the labia minora larger than the other. For these women, treatment may be limited to the one side; in such cases, the goal of reduction is to match the smaller side as closely as possible.

Labiaplasty can be safely performed any time after sexual maturity, although the author prefers a minimum patient age of 18 years. This procedure can be performed before or after pregnancy. Surgery should be performed when the patient is not actively menstruating to reduce potential hormonal effects on anatomy and increased risk of postoperative infection.