Very heavy people may either loose weight on their own or undergo surgical bypass procedure or banding prodedure to loose weight. Loss of weight may be massive. Many people after this weight loss undergo body lifting procedures so that the extra skin can be removed and the tissues that are sagging lifted. Breasts are lifted, abdomen reduced in size of skin and girth, upper arm skin can be excised and thighs can be lifted as well. Many undergo buttock lift or even circumferential tummy tuck. However, most people do not discuss the fact that in women the extra weight also makes the labia fat and heavy. After the weight loss when all other parts are addressed the labia and vaginal regions are forgotten and remain still very loose and stretched out. It is time that these areas are also addressed as they are part of the body and a very important part indeed. Labiaplasty and vaginal tightening in these patients is a wonderful procedure which makes the pelvic region match the rest of the now remodeled body. Labiaplasty in these individuals may need to be reduced both in vertical and horizontal dimention. Vaginoplasty may also need to be done. labia majora may need to be addressed as is the mons pubis which may be still very saggy covering all the private parts especially the clitoris. I strongly suggest to all those people out there who did undergo bariatric surgery to look for a qualified doctor in your area to address the labia and vagina and evaluate those areas for reduction and tightening if indeed it needs to be done. Again one must find a very qualified plastic surgeon who does these procedures and has experience.