In discussing labiaplasty, we quite naturally tend to talk mostly about the labia minora. This leaves the related subject of surgical rejuvenation of the labia majora often neglected. Nevertheless, this is an important enough topic to warrant some discussion here.
As is true with labiaplasty, labia majora surgery has become more popular and common in recent years. This is presumably because of the impact of the woman waxing or shaving her pubic area and genitalia. When she does these things, they allow the labial appearance and size to become more evident.
There are four frequently-cited reasons for having surgery done on the labia majora. The most common reason is the presence of a wrinkled and deflated labial skin surface. Even though this condition is frequently a normal appearance, many people interpret it as a look belonging to older women’s labia. Therefore, it’s a condition that many women hope to eliminate. In these cases, surgical rejuvenation takes a combination of skin tightening and, sometimes, a fat transfer to the labia in order to plump them (although sometimes the procedure is done without this fat transfer). The aim is to achieve smooth skin, either with or without an increase in the size of the labia majora.
The surgeon accomplishes this skin tightening by taking out a strip of excess skin from the patient’s labia majora, keeping the scar hidden in the natural groove between a labium majus and the labium minus adjacent to it. If the labia are still wrinkled after the skin tightening, the surgeon will often inject the patient’s own fat to augment labial volume and smooth out the skin.
A second reason patients seek this procedure is that they are troubled with their labia majora being too big, creating a bulge in the crotch area. This bulge limits the patient’s selection of appropriate attire. This can be improved by use of liposuction.
A third group of patients actually feel their labia majora are too small, even though their skin is unwrinkled and smooth. In this case, surgery will include labial augmentation, normally by fat transfer.
Finally, the fourth reason that women seek surgery for the labia majora is that, occasionally a patient will have labia majora asymmetry (i.e., different shaped or sized labia). One or more of the procedures outlined above is normally used; which procedure is used depends on what factors have created this asymmetry.