Labiaplasty: 'We all deserve to feel happy in our skin'

According to the International Society of Plastic Surgeons, labiaplasty is the fastest growing cosmetic surgery procedure.

Sadaf Ahsan 5 minute read October 19, 2021
watercolour woman with bioculars

What a labia "should" look like is non-existent — everyone's is different, there is no right size, shape or symmetry. GETTY

There are many terms for labiaplasty, including vaginal rejuvenation, vagina sculpting, even, hilariously enough, the “Toronto trim” if you’re a bougie local, but what it actually is often lost in translation.

In simplest terms, a labiaplasty is a plastic surgery procedure that changes the size or shape of the labia minora and/or the labia majora. The labia, latin for lips, are fleshy folds of tissue around a female’s genitals. According to the Merck Manual, literally meaning large lips, the labia majora enclose and protect the other external genital organs and contain sweat and sebaceous glands, which produce lubricating secretions. The labia minora can be very small and are just inside the labia majora, surrounding the openings to the vagina and urethra.

During a labiaplasty, the long labia minora tissue that protrudes past the labia majora is trimmed, while enough natural tissue to protect and maintain sensation, natural movement and sexual function is left. Delicate dissolving sutures are used, while the entire procedure is performed under anesthesia. It’s also mostly painless, taking just about 30 minutes, meaning patients are able to go home the same day and can even drive themselves back — speed bumps and all.

And while labiaplasty might sound scary, the risks are relatively low. Trimming skin actually leads to minimal risk, though like with any surgical procedure, there is a small chance of infection, wound healing issues, hematoma, and changes in sensitivity. Labiaplasty does, however, have a slightly higher risk of healing issues at the incision sites as the area is moist and hard to keep sterile, but because of the tissue type, these often heal well without any noticeable scarring. Pain medication is typically recommended for several days afterward.

For the most part, it is an elective and cosmetic procedure, and that’s where the reasons behind it can get a little thorny. Because what a labia “should” look like is non-existent — everyone’s is different, there is no right size, shape or symmetry. So it often comes down to the aesthetic a person desires for themselves.

In some cases, it can be necessary, such as when the labia might be pulled into the vagina during sex and causes pain, or if wearing a certain material or exercising causes irritation. For some, the labia also elongates after childbirth or due to age, so the procedure can be a go-to for older women.

Women are gaining a better understanding of what the procedure has to offer and feeling less shy about researching it

In fact, while it may seem unlikely (and that’s largely due to anything related to a vagina still being taboo), labiaplasty has become incredibly common in recent years.

According to the American Society of Plastic Surgeons (ASPS), those seeking labiaplasties have grown since the organization began keeping track in 2015, while the 2016 ASPS statistics report showed a 39 per cent increase in the number performed that year. On average, 10,000 to 12,000 of these procedures are performed annually. In fact, according to the International Society of Plastic Surgeons, labiaplasty is the fastest growing cosmetic surgery procedure.

“It is certainly becoming more requested and I think some of that popularity relates to increasing transparency and discussion across online forums and platforms as well as education through social media,” says Toronto plastic surgeon Dr. Jacqueline Rose Makerewich, plastic and reconstructive surgery at the Toronto Cosmetic Surgery Institute. “Our clinic has certainly seen an increase in demand over the last five years. Women are gaining a better understanding of what the procedure has to offer and feeling less shy about researching it.”

Which is for good reason as there’s plenty of judgment surrounding elective cosmetic procedures, specifically this one. The criticism often suggests women are being influenced by pornography, and feel a pressure to have “the perfect vagina.” While that may be true for some, it also takes away a certain agency and brings shame to anyone opting for it, including to those for whom it is necessary.

“I have this discussion with every single patient,” says Makerewich. “It is very important to understand that just like any other body part there really is no normal shape or size for the labia minora. Women come in different shapes and sizes, and so the decision to make a change to the labia minora is very individual and very personal.”

One of Makerewich’s patients, who chose to be anonymous, shared that she opted for a labiaplasty because of the discomfort she felt in her day to day life, during everything from bike rides with her children to sex to fitted clothing that led to friction — all of which also caused “emotional dissatisfaction and insecurities.”

“Growing up, I really didn’t know if it was normal or not to have the excess skin there,” she says. “I think what triggered my curiosity was after experiencing my first ever Brazilian wax. The service provider had asked me to hold my labia and pull it aside. It had me thinking, ‘I wonder if everyone who gets this service has to do the same?’”

After going home and doing her research, she discovered labiaplasty, and decided it was the right option for her. She found the pain to be “minimal and manageable,” and was up and about shortly after the surgery.

“I am now much more comfortable in my own body and no longer feel insecure to wear and physically do the things that would have once bothered me [when ‘it’ was] in the way,” she says. “The only thing I regret is not doing it sooner. We all deserve to feel happy in our skin.”

She’s not the only one who feels that way.

A 2014 study in the International Urogynecology Journal found that 91 per cent of people who had the procedure felt “more satisfied” with their genital appearance afterwards and found that “labiaplasty is effective in improving genital appearance and sexual satisfaction.”

“A labiaplasty is a procedure that improves quality of life, and that is incredibly valuable,” says Makerewich. “It is safe, it does not detract from function, and there are many personal and functional reasons why women choose to undergo this procedure. Women should have the freedom to make personal decisions about their bodies without judgement.”

Just know one thing: there is no such thing as a weird or abnormal looking labia. What works for you is what works for you.