Labia Minora Hypertrophy
Labiaplasty is the process of reducing the labia minora or the inner lips, which are the skin folds on both sides of the vaginal entrance, by adhering to the principles of aesthetic surgery and providing symmetry. The labia minora covers the vaginal entrance and is considered one of the structures that provide sexual pleasure in women. Size, color and structure may differ from person to person, and structural changes can be observed with hormonal stimuli, especially during adolescence.
Why should labiaplasty be done?
Adolescent girls and women are increasingly seeking medical and surgical interventions today due to concerns about the appearance of their external genitalia. Dissatisfaction with the size and shape of the labia minora (small lips) is the leading reason for this demand, although differences between individuals are mostly consistent with normal anatomy.
Interest in surgical correction of the appearance of the external genitalia may be associated with an increase in the trend of hair removal, exposure to idealized images of genital anatomy through digital apps or websites, and increased awareness of cosmetic vaginal surgery.
However, if the external genitalia is larger than normal or asymmetrical in size, it can make daily life difficult. Hypertrophy of the labia minora (larger than normal inner labia) can cause irritation, chronic infection, poor hygiene or pain. In addition, the patient may complain that the larger than normal genitals interfere with walking, sitting, sexual activity, and activities such as sports (for example, running, cycling, horseback riding or swimming). Patients may describe their discomfort by the fact that there is a “bulge” in their underwear, reporting that they need to “fold” the labia and push them into the vagina to reduce the protrusion.
Concern about the appearance of the labia minora can cause significant emotional and psychological distress. Adolescents are a particularly vulnerable group, given the physical and emotional changes that accompany puberty. For example, adolescents may notice the size of their genitals or think there is a problem if they need to change their clothes in front of their peers.
How can it be understood that the inner lips are large (hypertrophy of the labia)?
Labia minora (inner lip) hypertrophy is usually when the inner lips are larger or wider than the labia majora (outer lip). However, there is no complete consensus on this definition. During the clinical examination, the labia minora is grasped by its free edge and extended to its full width and its width (length) is measured. If the labia minora are longer than 5 cm, this is considered labial hypertrophy. However, some researchers report that small lips should be shorter than 3 cm. On the other hand, some doctors argue that surgical correction should be offered to patients who present with any complaint, regardless of the measurements.
How is labiaplasty done?
The purpose of labiaplasty is to remove excess tissue and create symmetrically reduced inner lips. The procedure can be performed safely under local or general anesthesia; I do the procedure under general anesthesia in my practice.
This procedure can also be applied to girls under the age of 18 if it is deemed medically appropriate. However, the emotional maturity level of the patient should also be evaluated while determining the appropriate age for the surgical procedure. Decisions regarding surgical treatment of adolescents require the involvement of a parent or guardian.
Before surgical incision, the labia is gently extended laterally so that the area can be marked; Care should be taken not to overstretch the tissue, as excessive tissue removal and excessive reduction of the lips may result in post-surgical problems.
Which surgical techniques are most commonly used for labiaplasty?
Commonly used techniques for labiaplasty:
Excess tissue is excised and the remaining tissue is repaired using individual stitches. Although this procedure is used quite frequently, it can cause chronic irritation and discomfort at the suture line. Also, the natural contour of the labia minora may be compromised. If this technique is used, it is possible to damage the clitoris and surrounding vessels and nerves.
A different technique has been described that attempts to preserve the natural contour of the small lips and reduce the amount of exposed scar tissue. In this technique, a V-shaped section is carefully cut out and then repaired with individual stitches. This technique provides a more natural look. I more often apply this technique to my patients.
What are the complications (problems) related to labiaplasty?
Possible complications of labiaplasty include infection, bleeding and wound dehiscence, but these complications are rare.