Labial reduction surgery (vaginal reshaping)

Labial reduction is a procedure most commonly carried out to reshape or reduce the size of the labia minora (the inner folds of skin on either side of the vaginal opening). It is sometimes referred to as labiaplasty or vaginal reshaping.

Why you might have labial reduction surgery

People choose to have labial reduction surgery for a range of reasons, including physical discomfort and personal concerns about appearance.

Some may experience irritation or discomfort through activities such as exercise, sitting for long periods, wearing tight clothing or during sexual intercourse. Others may feel self-conscious about the appearance or symmetry of their labia.

It’s important to know there’s a wide range of ‘normal’ when it comes to the shape and size of the labia. Everyone is different, and there's no standard way your labia are meant to look.

Is labial reduction surgery right for you?

If the size of your labia minora is causing ongoing discomfort or affecting your daily activities, this procedure may help relieve symptoms such as chafing and irritation. Some people also choose surgery to achieve a more symmetrical appearance, which may improve confidence. However, results can vary and there’s no guarantee you’ll achieve the exact outcome you expect.

While the procedure may help reduce pain or discomfort during sex, making it more enjoyable, there’s no evidence it will improve sexual function, such as vaginal lubrication or orgasm.

Whether surgery is suitable for you will depend on your individual circumstances, general health and reasons for seeking treatment. Your consultant will discuss the potential benefits, risks and recovery to help you decide if this is the right option for you.

Alternative treatments to labial reduction surgery

Sometimes no treatment is needed. However, if you’re experiencing discomfort, there are non-surgical options that may help.

These include:

• Applying a barrier cream to reduce chafing
• Avoiding scented products around your vulva
• Using a lubricant during sex
• Wearing loose, breathable cotton underwear

If your concerns are mainly related to appearance, you may find it helpful to speak to a counsellor or psychologist before considering surgery.
Your consultant can talk you through all suitable options and support you in making a decision.

Labial reduction surgery typically involves removing unwanted tissue with a scalpel or a laser to create the desired shape and size of the labia minora. The edges of the tissue are then stitched together using fine, dissolvable stitches.

It is usually performed under a local anaesthetic, so you’ll be awake but won't feel any pain during the procedure. Sometimes it is performed under general anaesthesia, which means you’ll be asleep during the operation and won’t feel any pain.

Types of procedures

There are several techniques used in labial reduction surgery.

Trim technique

Also known as edge excision, this technique removes excess tissue along the outer edge of one or both sides of the labia minora. This can create a more symmetrical appearance and is particularly useful for removing darker or uneven edges and reducing the length of the labia.

Wedge technique

Also known as wedge excision or wedge resection, this involves removing a wedge or triangular-shaped piece of tissue from the middle of the labia minora while keeping the outer edge intact. The edges are then stitched together to create a smaller, more symmetrical shape, which can give a more natural appearance than other methods.

De-epithelialisation technique

This technique involves removing only the outer layer of skin from the labia minora, while preserving the deeper tissues, including nerves and blood vessels. This may help maintain sensation and may support faster healing.

How to prepare for surgery

Before the procedure, you’ll be sent a pre-admission form to complete. This helps your consultant understand your medical history and general health. You may also be asked to attend a pre-admission appointment with your specialist nurse a few days before surgery.

Make sure you tell your care team about any allergies and all medicines you’re taking — including herbal remedies and over-the-counter treatments. If you need any tests, such as blood tests, these will be arranged for you. Any additional costs will be discussed before further tests are carried out.

Being in good general health before surgery can support your recovery. This includes maintaining a healthy weight, eating a balanced diet and staying active. If you smoke, you'll be advised to stop, as smoking can slow healing and increase the risk of complications.

Food and drink

Unless your procedure is carried out under a local anaesthetic, you’ll need to stop eating and drinking (ie to fast) for a few hours beforehand. Your admission letter will explain exactly what to do, and it's important to follow these instructions carefully.

Washing and shaving

You should take a shower or bath in the hours before surgery to keep the area clean. Your care team may give you a special shampoo or soap to use in the days before surgery. Hair around the treatment area may need to be removed. Your operating team will usually use an electric clipper on the day of surgery if needed. Occasionally, you may be asked to use a depilatory (hair removal) cream the night before.

Who will be involved?

Your treatment will be carried out by an experienced consultant, such as a gynaecologist — a medical doctor specialising in women’s reproductive health — or a plastic surgeon who specialises in surgery to restore or reshape different parts of the body. You can choose which consultant you would like to see. Your consultant will support you throughout your treatment, from your initial consultation to your recovery after surgery.

A consultant anaesthetist will give you the anaesthetic and monitor you throughout the procedure. You’ll also be cared for by specially trained nurses and recovery staff before, during and after the procedure.

All our consultants are highly experienced and are listed on the specialist register of the General Medical Council (GMC).

How long does the procedure take?

The operation usually takes between 1–2 hours.

Anaesthetic choices

The procedure can usually be carried out under a local anaesthetic, which means you’ll be awake but the area being operated on will be numb, so you shouldn’t feel any pain. You may also have sedation to help you feel relaxed and sleepy.

Sometimes a general anaesthetic is needed. This means you’ll be asleep during the procedure and won’t feel any pain.

Your consultant will discuss the most suitable option for you.

Pain during surgery and straight after surgery

You won’t feel any pain during the operation, as you’ll be under a local or general anaesthetic. It’s normal to experience some discomfort after surgery, but you’ll be given pain relief to help with this.

What happens straight after surgery

Once your surgery is complete, you’ll be taken to a recovery area, where you'll rest until you feel ready to go home.

Your hospital stay

Labial reduction is usually carried out as a day case, so you can go home the same day. In some cases, an overnight stay may be needed. You’ll need to arrange for someone to take you home after your procedure, as you won’t be able to drive.

Recovery time

You should be back to your usual activities around 1–2 weeks after surgery. Avoid vigorous activity for 4–6 weeks.

Short term side effects

It’s common to have some pain, swelling and bruising in the first few days after surgery. These usually improve over the next 2–3 weeks.

After the operation

You may feel tired for the first few days after surgery, so it’s important to rest. Getting up and moving gently can also help with recovery.

Swelling and bruising

It’s normal to have some swelling and bruising after the operation. You can apply an ice pack to the area for the first 24 hours to help reduce swelling and discomfort.

You may have some purple bruising around the wound, which may spread downwards. This should fade with time. Swelling usually improves over the next 2–3 weeks.

Wound care

Small blisters can sometimes appear and may leak a yellow fluid for a day or so before settling down. You can usually shower but try to keep the dressing dry. If it gets wet, contact the hospital so we can help you to change it.

Sexual activity

You should avoid sexual intercourse until the area has completely healed. This is usually around 4–6 weeks after surgery.

Pain relief

You’ll be given pain relief to help manage any pain or discomfort. You should take it regularly for the first 48 hours, then as advised by your care team.

Smoking

If you smoke, it’s important to stop. Smoking increases the risk of wound infection and can lead to poor healing. Speak to your consultant, GP or pharmacist if you need help to quit.

Driving

Avoid driving until you can perform an emergency stop comfortably and turn to look behind you without pain. You should not drive for 24 hours if you’ve had a general anaesthetic or sedation. Your consultant can advise you on this.

Time off work

You’ll need around 1–2 weeks off work to rest and recover.

What you should/shouldn’t do after surgery

After surgery, make sure to:

• Get plenty of rest
• Keep the area clean and dry
• Wear loose-fitting underwear and clothing

You should avoid the following for 4–6 weeks:

• Heavy lifting
• Tampons or menstrual cups — use sanitary towels instead
• Sexual intercourse
• Strenuous exercise

Things you can do to help with recovery

To support your recovery:

• Avoid smoking
  Attend your follow-up appointments
• Eat a healthy, balanced diet
• Keep well hydrated
• Rest for the first few days

When can you resume normal activities?

You should be able to return to your normal activities in 1–2 weeks. Wait 4–6 weeks before resuming any strenuous physical activity.

As with any surgery, labial reduction carries some risks. It can sometimes cause:

• Discomfort or reduced sensitivity during sexual intercourse
• Results that may not fully meet your expectations
• The need for further treatment due to complications or if the desired result isn’t achieved

Any type of surgery carries a small risk of:

• Allergic reaction to the anaesthetic, which can cause swelling, difficulty breathing, or feeling faint or dizzy
• Blood clots in a vein, which can cause pain, redness and swelling
• Bleeding or a collection of blood under the skin (haematoma)
• Infection — signs include increasing pain, redness, swelling, discharge from the wound, chills or a high temperature
• Numbness or reduced sensitivity around the wound site
• Scarring, although most scars fade with time

Seek urgent medical care if you develop any of the following symptoms:

• A high temperature or chills
• Bleeding or discharge from the wound
• Difficulty passing urine
• Increasing pain, redness or swelling around the wound
• Swelling in your calf, chest pain or shortness of breath

Your consultant will explain how likely these risks are and how they can be treated if they happen. They will also answer any questions you have.