Are you contemplating a labial reduction and remodeling (aka Labiaplasty)? How much will it cost you? Do you have health insurance and if so, will your insurance pay for your surgery? Where will it be performed, in the Hospital or Surgical Center? Or the surgeon’s office? Plastic Surgeons do not like to talk about fees online, but here are the honest facts.

Mostly, you get what you pay for in genital plastic surgery, as in most everything else. Cheap labiaplasty (“LP”) generally = cheap results. The “…kiss of death” as it relates to the dreaded outcome of “botch” or “mutilation” is a LP performed by a general Ob/Gyn in the hospital, under general anesthesia, and paid for by insurance. First, why are cut-rate LPs so risky, and then the “straight skinny” about fees.

The Danger…

Be sophisticated! Do your homework. Any surgeon who does not have his or her own website that has special and specific pages with education on LP, and lots more than 2-3 of “Before & After” pics of their own cases is a not a surgeon trained in aesthetic labial reduction LP. Only labial removal (not aesthetic reduction) is taught in all Ob/Gyn residency programs. Only a Plastic Surgeon trained in LP, or a Gynecologist who can prove to you that they have taken specialized training course(s) and can call themselves a “Cosmetic Gyn” should be allowed to operate on such an important and special place.

Will Insurance pay?

I have a wealth of medical-legal experience, frequently serving as both a Plaintiff’s and Defense’s “expert reviewer” and “Expert Witness” in professional liability (“Malpractice”) cases, when a woman is suing her surgeon for an entirely unacceptable outcome, usually related to an “amputation” or a dreadfully unaesthetic outcome related to poor choice of suture material and technique, performed in a manner used in standard gynecological, but not “plastic,” surgery. One thing ties together these many cases from around the country: all were performed by either a “general Og/Gyn” referred by the patient’s PCP, or the patient’s own general gynecologist. And virtually all were performed “…under insurance.” An important point to remember: for insurance to pay for a labiaplasty it cannot be considered to be “cosmetic.” Insurance does not pay for cosmetic procedures. Please understand: even if your reason for your LP is mostly “functional,” you would rather that it looks good, is not significantly “off-balance,” and is not lopsided because your surgeon has no idea on how to aesthetically reduce excess clitoral hood skin. But insurance will pay (a pittance!) for “labial removal” for reasons of tumor, viral growths, or ongoing functional problems with pain and disability related to excessive labial size. Insurance non-payment for cosmesis + lack of training in either general plastic surgery technique and suture choice by a general Gyn not specially trained in Cosmetic LP frequently equals botch and disaster.

So, what then will your “average” LP cost if performed by someone who knows what they are doing (a Cosmetic Gynecologist and some Plastic Surgeons)? These specialists have taken the time, energy, and financial outlay to become specially trained and savvy in the art of labial remodeling, and simply will not accept the low fees (usually in the $300-$600 range) insurance pays for a “…just cut it off…” LP. Even if for mostly “functional” reasons (chafing, getting in the way, etc…) if it is your labia, you would hope your surgeon has the requisite training and experience adequate for the task at hand.

Hidden Costs

Additionally, one must be very careful when evaluating fees, as many surgeons are quite slippery when it comes to fee structure, advertising a relatively low surgical fee but failing to disclose that additional fees for facility, anesthesia and “supplies” often apply, leaving the “out-the-door” fee almost double what you were quoted as the surgical fee. As a consumer, remember to calculate the bottom line, out-the-door fee! Many surgeons operate in hospitals or surgical centers, who will charge you their own fees. Frequently, surgical fees do not include anesthesia, or special surgical supplies. And what about your post-operative supplies (dressings, ointments, anesthetic spray, etc. etc. Do you need to spend 30 minutes up & down the aisles of CVS or Walgreens or does your surgeon supply these and, if so, is there an additional charge?

Again. Please remember that I am talking about TOTAL, “out-the-door” fees here; this is exactly what you should be asking for when requesting a quote re: LP cost. Remember to have any anesthesia and facility fees included in your quote. Ask for a written quote from your surgeon. Some surgeons have a standard fee for all labiaplasty, some bill by complexity. Some have a separate and sometimes steep fee for clitoral hood reduction; some surgeons build hood reductions into their overall fee. It pays to check.

Here then are our “out-the-door” fees which include all intra-op supplies plus all of the at-home supplies you will need for a successful recovery:

Unilateral (1-sided) labiaplasty (trim or wedge): $3500-4000

Bilateral labiaplasty (trim or wedge): $4500-7000, depending on complexity

Add reduction clitoral hood: + $500; occasionally + $1000 if extremely complex

Add reduction posterior commissure (the very bottom of labia, sometimes connecting left & right labum under vaginal opening): + $500

“Clitoral unhooding” release of clitoral glans trapped by fused upper labia: $1500

Availability of your surgeon after your procedure (“…Who’s on call?!”)

Last, but certainly not least, involves post-op care. How will you communicate with your surgeon? Directly, or via a complicated many branched “phone tree,” leaving you to indirectly communicate with

a “midlevel” physician’s assistant or NP or the “on-call” doc who may not intimately know either you or your procedure. Ideal is the ability to “person-to-person” communicate with your surgeon best via their cell phone, giving you the opportunity to send personal photographs often so helpful in figuring out what best to do in an often confusing situation.

Other questions regarding fees or financing?. Call or text (916) 634-5038, or email [email protected]. We do not have a “phone tree,” or Muzak while you are on a 15 minute “hold..!”

–Michael P Goodman MD
“Caring For Women”
Sacramento California