What is Labia Majora Reduction?

The labia majora is the outer portion of the vagina as seen below. The labia majora is made of skin covering fat and blood vessels. Reduction of the labia majora can be done for different reasons. Some women may notice a bulge of this area resulting in discomfort in tight clothing or bathing suits or displeasure in the overall appearance. Others may notice a sagging of the skin as a result of age and a decrease in estrogen levels or following vaginal deliveries. When the desired outcome is an overall reduction in the size of the labia majora, this is done by removing the excess fat below the skin as w ell as excess skin and plicating or bringing together the skin. This is done as an outpatient (same day) surgery in an operating room. For modification of sagging skin, typically only the excess skin is removed and this can be done in the office. For office procedures, patients are given oral medications prior to the procedure for pain control and relaxation. Addition ally, topical and injectable numbing medication is applied prior to the procedure. Some patients are interested in both a labia majora reduction and labia minora reduction or Labiaplasty. We usually proceed initially with the area that is the most bothersome. For example, if a patient is most bothered by the sagging labia majora, we proceed with labia majora reduction, allow the area to heal and then consider labiaplasty. Vaginal rejuvenation or vaginal prolapse repair can be done at the same time as labia majora reduct ion. The procedure of choice is based on the patient’s desired outcome an d the findings on her exam. The reason labia majora reduction and labiaplasty are not done in the same setting is that the incisions for the two surgeries are intricately connected. In other words, healing from a labiaplasty effects some of the labia majora tis sue and vice versa.