Natal female seeks labia and clitoral hood reduction

Dr. Reed, I am 27 year old cis (natal born) woman with nuisance labia and floppy clitoral hood.  Can you make the labia more delicate.  I think it’s not just the minora but labia majora as well. Nancy

Dear Nancy,

Yes, we do labiaplasty or labial reduction for women such as you.  Please see our web-site

2/1 - Genetic female labiaplasty, Pre-op

Before photo excessive labia majora and minora and clitoral hood   

2/2 - Post-op after labiaplasty, clitoral recession.

After photo,  Labiaplasty and clitoral hood reduction

(below from Wikipedia)

Labiaplasty (also known as labioplastylabia minora reduction, and labial reduction) is a plastic surgery procedure for altering the labia minora (inner labia) and the labia majora (outer labia), the folds of skin surrounding the human vulva. There are two main categories of women seeking cosmetic genital surgery: those with congenital conditions such as intersex, and those with no underlying condition who experience physical discomfort or wish to alter the appearance of their genitals because they believe they do not fall within a normal range.

The size, color, and shape of labia vary significantly, and may change as a result of childbirth, aging and other events. Conditions addressed by labiaplasty include congenital defects and abnormalities such as vaginal atresia(absent vaginal passage), Müllerian agenesis (malformed uterus and fallopian tubes), intersex conditions (male and female sexual characteristics in a person); and tearing and stretching of the labia minora caused by childbirth, accident and age. In a male-to-female sexual reassignment vaginoplasty for the creation of a neovagina, labiaplasty creates labia where once there were none.

A 2008 study in the Journal of Sexual Medicine reported that 32 per cent of women who underwent the procedure did so to correct a functional impairment; 31 per cent to correct a functional impairment and for aesthetic reasons; and 37 per cent for aesthetic reasons alone. According to a 2011 review, also in the Journal of Sexual Medicine, overall patient satisfaction is in the 90–95 percent range. Risks include permanent scarring, infections, bleeding, irritation, and nerve damage leading to increased or decreased sensitivity. A change in requirements of publicly funded Australian plastic surgery requiring women to be told about natural variation in labias led to a 28% reduction in the numbers of surgeries performed. Unlike public hospitals, cosmetic surgeons in private practise are not required to follow these rules, and critics say that “unscrupulous” providers are charging to perform the procedure on women who wouldn’t want it if they had more information.

Images of vulvae are absent from the popular media and advertising and don’t appear in some anatomy textbooks, while community opposition to sex education limits the access that young women have to information about natural variation in labias. Many women have limited knowledge of vulval anatomy, and are unable to say what a “normal” vulva looks like.  At the same time, many pornographic images of women’s genitals are digitally manipulated, changing the size and shape of the labia to fit with the censorship standards in different countries. The Observer wrote in 2011 that some medical researchers raised concerns about the procedure and its increasing prevalence rates, with some speculating that exposure to pornography images on the Internet may lead to body dissatisfaction in some women. However, the researchers noted that research evidence for this speculation was lacking.

The external genitalia of a woman are collectively known as the vulva. This comprises the labia majora (outer labia), the labia minora (inner labia), the clitoris, the urethra, and the vagina. The labia majora extend from the mons pubis to the perineum.

The size, shape, and color of women’s inner labia vary greatly. One is usually larger than the other. They may be hidden by the outer labia, or may be visible, and may become larger with sexual arousal, sometimes two to three times their usual diameter.

This photo depicts a typical healthy vulva, with “enlarged” labia minora and “excess tissue” in the clitoral hood region. The 20 year-old nulliparous patient complained of an inability to wear tight clothing, as well as discomfort with intercourse, due to pulling and stretching of the labia minora.

The size of the labia can change because of childbirth. Genital piercing can increase labial size and asymmetry, because of the weight of the ornaments. In the course of treating identical twin sisters, S.P. Davison et al reported that the labia were the same size in each woman, which indicated genetic determination. In or around 2004, researchers from the Department of Gynaeology, Elizabeth Garret Anderson Hospital, London, measured the labia of 50 women between the ages of 18 and 50, with a mean age of 35.6:

Measurements Mean [Standard deviation]
Clitoral length (mm) 5.0 – 35.0 19.1 [8.7]
Clitoral glans width (mm) 3.0 – 10.0 5.5 [1.7]
Clitoris to urethra (mm) 16.0 – 45.0 28.5 [7.1]
Labia majora length (cm) 7.0 – 12.0 9.3 [1.3]
Labia minora length (mm) 20 – 100 60.6 [17.2]
Labia minora width (mm) 7.0 – 50.0 21.8 [9.4]
Perineum length (mm) 15.0 – 55.0 31.3 [8.5]
Vaginal length (cm) 6.5 – 12.5 9.6 [1.5]
Tanner Stage (n) IV 4.0
Tanner Stage (n) V 46
Color of the genital areacompared to the surrounding skin (n) Same color 9.0
Color of the genital areacompared to the surrounding skin (n) Darker color 41
Rugosity of the labia (n) Smooth (unwrinkled) 14
Rugosity of the labia (n) Moderately wrinkled 34
Rugosity of the labia (n) Markedly wrinkled 2.0


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