A recent New York Times piece revealed some eyebrow-raising information: More and more teenage girls are looking to get cosmetic surgery to reshape their labia (sometimes known as vaginal rejuvenation).
Julie Strickland, MD, MPH the chair of ACOG’s Adolescent Health Care Committee and lead author of the Committee Opinion, told Cosmopolitan.com that adolescents may be under particular stress to conform to societal conceptions of the “ideal” body, and size and shape of the labia in particular may be particularly distressing to adolescents. She advises, “Labiaplasty is not a minor procedure. And, as with any surgery, there is a risk of serious complications like pain, painful scarring, infection, etc. Also, we have no long-term data about delayed complications when these procedures are done in adolescents. Furthermore, the effects on sexual functioning are completely unknown.”
However, since more and more women are considering the procedure, Cosmopolitan.com spoke with Alyssa Dweck, MD, a gynecologist in Westchester County and the assistant clinical professor at Mt. Sinai School of Medicine, who does a lot of labiaplasties, to find out everything you need to know about labiaplasty.
1. It’s almost entirely possible that you actually do not need to get labiaplasty at all. Dr. Dweck says that girls as young as 15 will have their moms bring them in for a consultation. Women will also bring themselves in around 18 to 21, and the reason they often give for wanting the procedure is to eliminate camel toe. “These women assume all vulvas have to look the same and so if theirs doesn’t, something is wrong with theirs,” Dr. Dweck says. “To be honest, I try to talk people out of doing it because most of the time it’s not needed, and once I show them the countless ways vulvas can look and I can educate them on normal anatomy, they realize they don’t need it done.” Dr. Dweck says she also looks for signs of other issues like body dysmorphia, which is where women think they look different than they do, when determining if someone is a candidate for vaginoplasty.
2. There are many reasons someone might be a candidate for labiaplasty. Dr. Dweck says some women’s labia minora (the inner lips) are so voluminous (aka have a lot of size and volume) that they have trouble putting a tampon in, or experience inflammation or painful sex or chafing, and those can be true indications that you’re a good candidate for labiaplasty. The other indication is if someone is truly psychologically distraught by the appearance of their own labia, and that distress is not due to another psychological issue (such as body image issues they might have in general, which she says a lot of women who come in to have the procedure are struggling with). Also, sometimes there are women who have one labia that is enlarged and the other one isn’t, which could be indication that you need the treatment if it’s problematic.
3. The procedure is pretty complex but also relatively quick. Dr. Dweck says there is more than one way to do it, but she usually takes her patients to a same-day surgical unit with the intention of doing the procedure under anesthesia, then letting them recover for a few hours and then sending them home. Depending on the individual needs, there are many different types of procedures to make the labia smaller, or more symmetrical or flush with the vagina, whether that’s taking a wedge out of the labia surgically or removing the part that looks excessive. The procedure can take anywhere from 15 minutes to an hour, depending on how detailed it is or if you have to do both sides of the labia.
4. The recovery process is pretty intense and involved. Dr. Dweck says the recuperation time and process is often very underestimated by people. She usually uses dissolvable sutures during surgery so nothing has to be removed. She then tells her patients to do a sitz bath (which is like a little plastic tub you put over the toilet with warm water with epsom salts where you soak your bottom). After they do that, she also recommends that they take a hair dryer and dry the area with cool air, so moisture doesn’t remain there and lower the chance of infection. Dr. Dweck has people do that routine two or three times a day for at least a week or two. She also has them wear a tight garment so nothing gets chafed during the day and then a loose garment at night, and has them take antibiotics. After that, she also has them come in for one or two follow-up visits to make sure the area is healing well.
5. No, it’s not usually covered by insurance. Dr. Dweck says that if you have a congenital condition (such as vulvitis or pain during sex) that it truly needs to be fixed, sometimes it will be covered by insurance, but if it’s purely for cosmetic reasons, they typically will not cover it and you’ll have to pay out of pocket. One surgeon’s website suggests labiaplasty can run from $3,000 to $8,000, but of course it will vary depending on your city and the practice.