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Labia majora reduction is a technique to reduce the size of overly prominent labia majora, which sit on either side of the labia minora. The two main techniques are either liposuction or surgical excision, and the correct technique chosen depends on if there is primarily volume excess or skin excess.
Labia majora reduction is a type of labiaplasty procedure for reducing the outer vaginal lips. With the labia majora, it is important to distinguish between enlargement of the labia majora due to volume excess and enlargement due to skin excess as a result of weight loss. With excessively large majora due to volume excess, liposuction can effectively treat this. In some cases, the use of liposuction may result in skin sagging and redundant skin, especially in older patients. Where there is excessive skin as a result of volume loss, then surgical removal of skin via a wedge-shaped incision of each labia majora is ideal. The incision is placed along the length of the labia minora for optimal scar concealment.
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Preparation for Labia Majora Reduction
Patients who smoke will be advised to stop for at least two weeks before the date of their labiaplasty procedure. Smoking has detrimental effects on microcirculation and is known to slow the wound-healing process. All medications, prescribed and over-the-counter, will be reviewed. Aspirin and aspirin-containing medicines should be stopped both before and after surgery. Aspirin and NSAIDs impair the body’s natural clotting process and may cause bleeding complications after surgery. If you require pain relief after surgery, paracetamol is advised.
Whether your procedure is performed under a local or general anaesthetic, it is mandatory to have a responsible adult escort take you home in a car or taxi. You must not travel home on public transport after labia majora reduction.
Labia Majora Reduction with Liposuction
Liposuction for labia majora reduction is performed as an outpatient procedure as a day case. This means you can go home later the same day to recover in the comfort of your own home. The procedure can be performed under either a local anaesthetic or a TIVA general anaesthetic. Liposuction of the labia majora is often combined with mons pubis liposuction for optimal contouring of the female genital region. The area is first injected with a local anaesthetic to render the area fully numb. Small liposuction cannulas are then used to gently aspirate fat to the desired treatment endpoint. A compression garment should be applied over the area and worn for six weeks to ensure good healing.
Labia Majora Reduction with Surgical Excision
Similar to the liposuction method, labia majora reduction with surgical excision is performed as a day case procedure and is often combined with a labia minora reduction but can also be performed on its own. Labia majora reduction with surgical excision is more commonly performed with TIVA general anaesthetic as the procedure can be longer than for a labia minora reduction. TIVA ensures you will be comfortable throughout the procedure. The incision is made along the labia minora to ensure the resulting scar is well hidden.
Postoperative complications of a wedge excision of the labia majora are bleeding and temporary hypersensitivity for 4 to 6 weeks.