High Rates of Physical Symptoms among Women Seeking Labiaplasty

Women seeking labiaplasty—surgery to reduce excess vaginal tissue—report a wide range of physical and functional symptoms, reports a study in the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

In the study, women nearly all women consulting with a plastic surgeon regarding labiaplasty had multiple physical symptoms in addition to concerns regarding appearance, according to the study by ASPS Member Surgeon Heather J. Furnas, MD, of Stanford University and colleagues. "Women seeking labiplasty suffer from physical and appearance-related symptoms that affect the quality of their lives," Dr. Furnas and coauthors write.

New Look at Women's Reasons for Seeking Labiaplasty

The study included 50 women who consulted with a plastic surgeon to discuss labiaplasty, including patient interviews and a symptom questionnaire. Labiaplasty typically includes surgery to reduce excess length of the inner vaginal tissues (labia minora).

The women averaged 35 years old, with a range from 17 to 51 years. Most patients said they first noticed elongation of their labia with aging and/or after childbirth. However, some said the issue developed after puberty, or was always present.

The women reported a wide range of symptoms related to elongated labia, including pain during intercourse in nearly half of patients. Many patients cited problems related to discomfort and visibility while wearing certain types of clothing, such as yoga pants or bathing suits.

"Regarding appearance, almost all patients were self-conscious and over half felt less attractive to their partner, experienced restricted clothing choice, and noted a negative impact on self-esteem and intimacy," Dr. Furnas and coauthors write. Nearly all patients experienced at least four symptoms.

Labiaplasty has been a controversial procedure, with critics claiming it is an unnecessary procedure driven mainly by exposure to media images, including pornography. Some physicians and professional associations have opposed labiaplasty, despite evidence showing that it is effective in addressing functional and appearance-related symptoms with low complication rates.

But those negative attitudes may be shifting as the number of women seeking labiaplasty continues to increase. According to ASPS statistics, US plastic surgeons performed more than 12,000 labiaplasty procedures in 2016. That rising popularity makes it especially important to understand women's motivations for seeking labiaplasty.

The researchers acknowledge some important limitations of their study, including its relatively small size and the lack of a comparison group. They also point out that none of the women were seeking insurance coverage for labiaplasty, which "lends credence to the legitimacy of the patients' complaints."

"This patient perspective is crucial in understanding why women request labiaplasty, and it will ultimately serve as a valuable tool in assessing post-procedure outcomes," Dr. Furnas and colleagues conclude. "The more physicians understand the symptomatology associated with elongated labia, the better supported patients will feel as they search for surgical relief."

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

Click here to read "Why Women Request Labiaplasty"

Article: "Why Women Request Labiaplasty" (doi: 10.1097/PRS.0000000000003181)