A labiaplasty is a surgical procedure to reduce the size of the labia minora – the flaps of skin either side of the vaginal opening.
Most labiaplasty operations are done by private clinics as cosmetic surgery, to change the appearance of the female genitals.
Occasionally, there may be a medical need for the operation (for example, because the tissue is affected by disease), in which case it might be covered by the NHS. However, the NHS doesn't routinely provide this operation.
It's natural and normal for a woman to have noticeable skin folds around her vaginal opening and, in most cases, this shouldn't cause any problems.
Some women feel their vaginal lips should look a certain way, but it's natural for the labia minora to vary widely in appearance.
When might a labiaplasty be provided on the NHS?
A labiaplasty may be carried out on the NHS if the vaginal lips are obviously abnormal and causing the woman distress or harming her health.
For example, the NHS may provide a labiaplasty if:
- there is a lot of damage to the woman's labia after she recently gave birth
- the labia are particularly large and causing a lot of pain or discomfort (although other measures such as using emollients may be recommended first; see below)
- the labia are contributing towards a disease or infection, or they are affected by cancer
It's unusual for the NHS to provide a labiaplasty purely for cosmetic reasons.
If you feel you qualify for a labiaplasty on the NHS, see your doctor. They will examine you, and if they find a disease or abnormality you'll be referred to a specialist – usually a gynaecologist – for a full assessment.
The specialist will help you weigh up the risks and benefits of a labiaplasty operation. Labial discomfort can sometimes be relieved by avoiding harsh soaps and shower gels, and instead using emollients, so an operation may not always be necessary.
What if I want a labiaplasty for cosmetic reasons?
Some women are dissatisfied with or distressed about the appearance of their labia, even when they look perfectly normal to the health professional examining them.
If you are considering paying for a labiaplasty for cosmetic reasons, it's a good idea to speak to your doctor first.
If your doctor feels your labia are perfectly normal after examining them, they may want to have a chat with you about your reasons for wanting surgery.
The operation carries a number of risks. There's also no guarantee that you'll get the result you expected, and it won't necessarily make you feel better about your body. It might help to look at pictures of other labia, to see how they naturally vary from woman to woman.
Your doctor may recommend that you speak to a counsellor or psychologist before you commit to any surgery.
Why is a labiaplasty not recommended for under-18s?
A labiaplasty should not be performed on girls younger than 18 years unless it's strictly necessary.
This is because the labia may continue to grow and develop well beyond puberty, into early adulthood.
Girls bothered by irregular vaginal lips may find that they even out as their genitals continue to develop. If surgical changes are made too early, the tissue may continue to grow afterwards.
There is also a risk of the operation causing long-term problems for the girl, such as loss of sensitivity.
How is a labiaplasty carried out?
A labiaplasty involves shortening or reshaping the vaginal lips, a bit like shortening a hem on a dress. It is usually performed by a gynaecologist or plastic surgeon.
The unwanted tissue is cut away with a scalpel or possibly a laser, and the loose edge may be stitched up with fine, dissolvable stitches.
There is a lack of research investigating how effective this procedure is. This means there's no guarantee it will achieve a long-lasting desired effect, and there are short- and long-term risks to consider.
What are the risks of a labiaplasty?
The short-term risks of a labiaplasty include bleeding, infection and scarring of tissue.
If the desired effect isn't achieved, or there are complications, there is always a chance you will need another procedure to fix this.
There's also a risk that sex will become painful after the operation. Also, because the tissue is rich in nerve endings, you may be left with reduced sensitivity.
How many labiaplasties are performed on the NHS each year?
Most labiaplasty operations are provided privately, although a significant number are provided on the NHS.
The number of labiaplasty operations performed on the NHS has risen five-fold over the past 10 years.
The NHS performed over 2,000 labial reduction operations in 2010.
The reason for this rise in NHS labiaplasty operations is unclear. It would be wrong to assume that doctors are offering them for cosmetic reasons.
Between 2008 and 2012, 266 labial reduction operations were performed on girls aged under 14 on the NHS. The reasons for these operations are also unknown.