labia minora

The labia minora are too big, too small, asymmetrical, too colourful. A specific treatment for each condition

Reduction of small lips


Labia minora that are too large or asymmetrical.

Surgical technique

Laser-assisted reduction, possibly conservative, respecting sensitivity and vascularization


20/40 minutes, under local anesthesia or with sedation, day hospital


Poor (infections, delayed healing)

Postoperative pain

Poor if you use common painkillers


2/4 weeks

Too large labia minora reduced without incisions


Labia minora too large (but not too much)


Optical reduction for augmentation of the labia majora with lipofilling or hyaluronic acid


10/20 minutes, local anesthesia, outpatient


Very scarce


0-2 days

Secondary labiaplasty: results to be corrected

The correction of anomalies of the labia minora represents numerically the most performed procedure in gynaecology. Defects can be classified into:
a- Excess anomalies (hypertrophy of the labia minora)
b- Anomalies due to defects (excessive reduction of the labia minora)
a- Overdeveloped labia minora can be symmetrical or asymmetrical (i.e. one lip is larger than the other); they can be associated with excess of the clitoral foreskin or with real excessive exposure of the clitoris due to significant volume. Sometimes the hypertrophy of the labia minora is made more evident by poorly developed labia majora which cause an optic protrusion.
Reduction methods: there are many, the expert surgeon has in his hands the possibility of choosing the least invasive and most anatomical-friendly technique. In fact, a nervous vascular bundle runs through the small lip which innervates and supplies nourishment to the small lips. Anatomical respect for this structure is a key point for obtaining an aesthetically and functionally correct result. As far as possible, direct reduction of the crest of the labium minor should be avoided because the majority of the nerve endings are located here.
The artistic sense: It is important that the surgeon has a strong sense of overall harmony. The labia minora must be evaluated in context and not in isolation. The labia majora, for example, represent the frame into which the labia minora fit, the adiposity of the pubic area of ​​the inner thighs must also be taken into consideration.
The patients’ wishes must be listened to, discussed and fulfilled as far as possible. Exposure, shape, color must be discussed in front of the image of the vulva photographed and displayed on the screen. Sometimes wishes cannot be fulfilled and it is better to come to an agreement on the possible outcome rather than disregarding expectations.
Drawing: I love drawing and I find that showing the technique, the incision and reduction lines, the possible modifications of the labia majora is a great help in understanding what I do. The procedure: in most cases the procedure is carried out under local anesthesia with sedation, i.e. it does not require general anesthesia. Depending on the case, the operation lasts from 30 minutes to an hour and a half and requires hospitalization in a day hospital.

Non-surgical reduction of the labia minora

The non-surgical reduction of the labia minora that I presented for the first time in 2012 at the Congress of the French Society of Plastic Surgery (Optical Non Surgical Labial Reduction) consists in the augmentation of the labia majora enough to determine an optical reduction of the protrusion of the labia minora. The technique is ideal in cases of modestly hypertrophic labia minora and particularly emptied labia majora. The big advantage is that there is no incision of the labia minora. The evolution of the method has led to improvements in the technique to the point of flattening the labia minora by implanting adipose tissue in the base of the labia minora itself.

Secondary labiaplasty: results to be corrected

Not all donuts come with a hole. In some cases, an unexpected complication or a poorly designed or poorly performed procedure can lead to an unfavorable outcome. Complications can be caused by a problem of 1) size, 2) shape, 3) color, 4) sensitivity.
1) Size issues. The labrum minor may have been reduced too little or too much. Correcting a lip that is too small is infinitely simpler than correcting an amputated lip. Secondary reduction, although more difficult than primary reduction, nevertheless leads to excellent results. The correction of an excessively reduced labia minora is much more complex and relies on the use of labial and preputial residues. Excellent results are obtained by total reconstruction of the minor labrum using the associated flap and graft technique. Unfortunately, this technique, in addition to being complex, is burdened by a long postoperative period, however it is capable of restoring substantial volume and shape to amputated labia minora. In some cases the increase in labial residues with hyaluronic acid leads to a good result by mitigating the severity of the excision.
2) Form defects. The shape defects are generally attributable to excision of the labia minora without considering the harmony of the vulva, for example the reduction of the labia minora in the absence which does not consider the continuity with the clitoral foreskin almost always leads to the exaltation of the volume of the clitoris itself with the appearance of false hypertrophy. Secondary correction consists in harmonizing the various vulvar elements with often minimal corrections which however lead to a largely satisfactory result.
3) Coloring defects. Nature almost always gives color uniformity, even in cases of hyperchromia this is harmonious. For example, it involves the small lip from bottom to top for a very specific thickness and is interrupted in an equally uniform way. Some procedures for reducing the labia minora, especially wedge excisions in olive complexions, can lead to unnatural and violent color combinations. Each case must be evaluated in its detail and complexity in order to find the most suitable correction to depigment or shift the pigmentation.
4) Sensitivity defects. It may happen that following labiaplasty surgery there is a reduction in sensitivity or an alteration thereof. This can happen if the vasculonervous bundle has not been respected or an anomalous cicatricial process has occurred which has resulted in the entrapment of the nervous structures. Massage and time help alleviate the uncomfortable condition. The use of adipose tissue (lipofilling) is often extremely useful as it is able to bring regenerative cellularity to damaged tissues between trapped nerve fibers and often thin skin.

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