(No-Hype, Honest Information on the procedures of Clitoral Hood Reduction, Vaginoplasty/”Vaginal Rejuvenation” Surgery, and Labiaplasty)
All of the mixed information in the media, plus the glossy hype and promises involving labiaplasty in California, as well as vaginal tightening advertising online and elsewhere can leave the prospective genital reconstructive patient feeling a little like a Christian Scientist with appendicitis… What to do?!?
It makes sense, and no-one gets upset, when a woman decides to enhance her appearance, function, and self-confidence by selecting a cosmetic or plastic surgery procedure on her nose, abdomen, breasts, butt, etc. However, a decision to “remodel” more intimate areas of her anatomy seems to elicit parental and puritanical responses from more straight-laced medical professionals and “retro-feminists”: who pontificate “…WHY would you want to do that…” or, “…Glory in your uniqueness (sic)…”
Women tend to consider genital remodeling of the vulva (labia; clitoral hood) or vagina for reasons of enhancement of self-confidence and sexual openness, aesthetic, and “functional” reasons such as discomfort from overly generous labia, difficulty in fitting in tight-fitting clothing, or for sexual enhancement after the “loosening” that frequently follows childbearing, by improving coital friction via vaginal tightening and improving vaginal muscular strength.
A “well-endowed” woman with large labia; a woman who has had a couple of large children and now finds herself “loose,” with declining pleasure with sexual intimacy secondary to lack of friction from vaginal laxity—this is not abnormal. BUT—just because something is “normal” (like small breast size) does not mean that it cannot be revised to provide increased comfort and pleasure for its “wearer…”
What is available, and what are the pitfalls?
Labiaplasty/Clitoral Hood Reduction Labial size and appearance, like breast size and appearance, is extremely variable, as are women’s responses to these anatomic differences. There are no exercises, creams or potions to make labia smaller; this requires a surgical approach, and surgeons certainly vary in their expertise, their approach, their esthetic, their training and experience. A ”score sheet” is an excellent way to evaluate your labiaplasty or vaginoplasty surgeon.
Several surgical techniques have been utilized for labiaplasty with or without reduction of hood size. Two seem to be the most widely utilized:
1) The “modified V-wedge” procedure removes a wedge of redundant, darkened, thickened, “floppy” labia from the mid-portion, re-approximating the remaining top and bottom labial edges with fine absorbable suture, producing an outcome that includes a smaller curtain of labia around the “opening” for a more “natural” and individualized appearance. If the hood is hypertrophied, the incision line is carried upward laterally on either side to include superficial removal of the thickened hood.
2) The “sculpted linear resection” procedure (sometimes nick-named “Barbie Doll” or “rim look”) involves resecting the enlarged labia linearly, taking off more or less dependant on individual desires, repairing the cut edges with fine absorbable suture. This can remove the majority of the labia minora, leaving a flatter, “cleaner” appearance of the opening, beveling the labia at the upper portions where they connect with the hood.
Both of these methods for labiaplasty have their advantages and pitfalls. The “V_wedge gives a more “natural,” individualized appearance, but has a slightly greater risk of separation, and may slightly diminish the size of the vaginal opening. Labiaplasty surgeons performing a linear resection must take great care to not remove too much, which can produce scarring, chafing, and pain with or without intercourse.
The most important thing is to work with a surgeon who both has considerable experience (I’d suggest a minimum of 25 cosmetic/reconstructive cases), and who is competent in both procedures (“…If all you have is a hammer, everything looks like a nail…”). Inexperienced surgeons get into trouble with both unappealing appearance, scarring, and post-operative sexual pain.
Vaginoplasty is a surgical procedure whereby the uppermost portion of the vagina is surgically “tightened” by removing wedges of vaginal tissue; this may be done either on the upper and/or bottom walls of the upper vagina, or on each side. It can also help with mild urinary incontinence (involuntary loss of small amounts of urine when exercising, coughing, etc) It frequently is combined with a perineoplasty, or reconstruction/tightening of the vaginal opening, bringing the muscles together.
“Vaginal rejuvenation” is a proprietary term meaning vaginoplasty and/or perineoplasty). Again, the important thing is to work with a surgeon well-experienced in these procedures. There definitely are potential risks from vaginoplasty (not tight enough; too tight; injury to rectum or bladder, infection, post-operative pain, etc.) so it is important to find the right surgeon!
Additionally, a vaginal tightening procedure is only as good as your perineal/vaginal muscle strength. Make sure your surgeon carefully checks this, and if it is weak, that (s)he refers you to a “pelvic floor physical therapist” to help you work on your muscular strength. Don’t accept “…just do some Kegel’s exercises…” You will need help to get it just right.
One last thing: These are procedures with sexual ramifications and overtones. You should expect your surgeon to ask you questions about sexual issues, and to be quite comfortable with the subject. If she or he is not: go elsewhere!
For more information about labiaplasty in California and other procedures for vaginal rejuvenation visit drmichaelgoodman.com.
Links: Here are some sites you may find helpful as you research your options for labiaplasty in California: