FAQ's - Frequently Asked Questions What is the normal size of the labia minora? There is no so called “normal size”. Like a nose, every labia of every size is considered normal. No person can dictate what a normal sized labia should be. However, there have been some unscientific surveys that state most women would prefer their labia minora not protrude past the length of the labia majora. Most patients prefer the labia minora to be at the level of the labia majora or lower. What type of symptoms do patients have with enlarged labia? Many patients complain of pain, discomfort or irritation during physical activity, sexual intercourse, or wearing certain types of clothing. Should I have labia reduction surgery? No physician, sexual partner or spouse should tell you to have labia reduction surgery. Only the individual considering surgery can make that decision. She must remember that this is an irreversible procedure. So once performed the labia can never be replaced. Only you can make the decision to go to surgery after the physician discusses with you the risks, benefits and alternatives to the procedure. This surgery is a quality of life issue and is not life threatening and is not considered a medical condition. What technique do you use and why? We use a contouring technique which allows me to shape the labia like one is shaping a vase from a block of clay. The reduction is not in a straight line it is done in what is called a curvilinear fashion, a gradual curve from the clitoral hood towards the perineal area near the anus. We usually reduce the labia to or just below the level of edge of the labia majora. This technique does NOT leave a noticeable scar despite what a few surgeons might say. It gives the labia an easy relaxed reduction without an abrupt flat look from someone who just amputates. This contouring affect also allows me to remove the darkened edges of the labia. Why remove normal natural looking darkened edges? The idea that darkened edges are normal is a misnomer. Having a saggy butt is normal for an 80 y/o, but it’s not youthful. Most patients develop a darkening appearance due to hormonal changes. This occurs most frequently with pregnancy and getting older. Pink labia are associated with a more youthful appearance and thus most patients actually prefer lighter colored labia. If a patient is adamant about keeping the darkened edges I have no problem upholding their request by doing a “wedge reduction”, a type of procedure for labia reduction. This procedure will maintain the darkened edges of the labia yet will reduce the size of the labia. The draw back of using a wedge resection is that it will reduce the size but it is difficult to get an even contouring of the labia throughout its length. How much time is required to actually do the surgery? The labia reduction surgery usually takes about 1 one to 2 hours. This may seem like a long time for a small area but this is a result of slow meticulous work in order to make our patients as happy with their surgical outcome. Do you use a laser to do your contouring? We use a variety of instruments including a laser electric micro tip cutting devise, plastic surgery scissors, and scalpels. We use whatever instruments we believe will give me the best results. We personally have not seen any difference in healing or pain associated with one or the other. How long do the sutures last? The sutures are made of a delayed absorbable material called Vicryl. These sutures usually dissolve in 6 weeks, however we have seen them last anywhere from 3-12 weeks. At which point they dissolve and the ends of the sutures fall off. How much pain is involved with the surgery? Though there are no generalized statements about the pain you will feel, most patients don’t have much discomfort after the first day. Most patients say they have more of a soreness, but not much pain. Many of my patients do not even use narcotics and will only use anti-inflammatories such as Motrin/Ibuprofen. Patients will have swelling up to 6-8 weeks postoperatively, but by using cold compresses during the first 48 hours most of the swelling is gone by 3 days. Where is surgery performed? We perform these surgeries in a hospital operating room or in a much more private outpatient surgical center. Though on rare occasion patients will request I do it in the office. I explain to them that to get my best results I prefer to do the surgery in a surgical suite is an operating room. What type of anesthesia is used? Patients have the choice of general and epidural anesthesia. With general anesthesia most patients are not incubated with a tube in their trachea or windpipe. Instead a simple mask is used to allow the patient to sleep during surgery. The reason why we do not use local anesthesia is the injection of the fluid into the tissue makes the tissue swell dramatically. If the tissue is swollen it is very difficult to artistically shape the labia because now you are no longer operating on the original labia. What you are operating on is a swollen version of the labia thus making it quite difficult to shape the labia with great confidence. Why don't you use local anethesia and do the surgery in the office We perform these surgeries in a hospital operating room or in a much more private outpatient surgical center. Though on rare occasion patients will request I do it in the office. I explain to them that to get my best results I prefer to do the surgery in a surgical suite is an operating room. What if I am unhappy with the results? Will I be charged for a revision? Though no surgeon can make a guarantee of 100% satisfaction, we will do everything possible to give you your desired results. Our revision rate is approximately 2%. This is a low revision rate. Most patients just need a little nip on one side or the other. If a patient needs to go back to surgery, we do not charge a new surgeon’s fee for the surgery. However, the patient will be required to pay for the use of the operating room and anesthesiologist. BACK TO LAST PAGE