If there is one thing that we women are faced with, it is a certain pressure to change our appearance to fit the mold of what is or is not aesthetic, beautiful, acceptable, etc. The images conveyed by society, adverts, and the media as a whole, are often contradictory. You need to be slim but not skinny, shapely but with a slim waist and flat tummy, you have to take care of yourself but not wear too much makeup, you need to be natural without being artificial yet at the same time not looking neglected or sometimes… just old.
Aesthetic and reconstructive surgery is my passion, a field that is still little known and – still – struggling with some clichés. As such, it appears to be a relatively superficial and easy way of fitting the mold.
For all that, and maybe even more so as a female surgeon, what I love about my profession is ensuring that a person – man or woman – feels in harmony with themselves and not that they blend in with the crowd and ephemeral beauty trends at all costs.
In this regard, you have probably heard about a nymphoplasty, a procedure that aims to reduce the size of a woman’s genital labia minora. But why would you want to reduce the size of the labia minora of the vulva? Is aesthetic surgery going a bit too far?
Far from stereotypes of what an aesthetically acceptable vulva should look like, as there are various shapes and appearances (like the ears or nose!), it is above all to bring women psychological and functional betterment.
The anatomy of the vulva
The vulva refers to the external genital organs around the vagina, which is the internal genital organ. The vulva comprises the labia: majora and minora. The labia majora are the outer lips on which pubic hair grows and are composed of skin tissue, like the skin on the rest of the body. The labia minora are inside the labia majora and are composed of mucosa (like the lips of the mouth for example).
The labia majora and minora vary in shape, size, length, and color from woman to woman. Contrary to what we would like to believe, it is perfectly normal to have labia that are different from what we see on the Internet. There is no standard length for the labia of the vulva and they can also be asymmetrical. However, hypertrophy is possible, in other words excessively long labia. This is not the sign of a condition and, if it is not a problem for you, there is no reason to perform a nymphoplasty.
In what case can labia minora reduction be considered?
A nymphoplasty (or labiaplasty) is conceivable for purely medical reasons as the impact of the size of the labia minora can cause considerable functional discomfort. Indeed, labia that are too big can cause discomfort, sometimes even pain, during daily life or sex.
If they are particularly long, they can cause pain during sexual intercourse as they are pushed into the vagina for example. They can also be a source of irritation, even when wearing underwear or just with natural movements: walking, running, doing sports, etc. This can really disrupt your daily life.
The discomfort can become psychological and turn into a complex. Some women lose their self-confidence due to the appearance of their vulva, vis-à-vis themselves but also their partner. And I am not here to judge.
Nymphoplasty + lipofilling: combined labiaplasty
The labia majora can also lose their plumpness with time, or due to several births. They become thinner and shrink. This stretched, deflated appearance accentuates the length of the labia minora but also protects the area less.
That is why a nymphoplasty is often combined with lipofilling of the labia majora to restore balance to the volume in this intimate area while respecting the specific anatomy of each individual.
This procedure is performed in one go: I perform the labia minora reduction, respecting the anatomy and the right proportions, then inject autologous fat – taken from the patient’s body – into the labia majora. Sometimes it is possible to transfer the fat first (lipofilling): plumping the area covers the labia minora a little more, and thus only a minor reduction will be required or none at all.
The case of very young women
Some young women, even adolescents, come to my practice because they have a hang-up about their vulva as it does not fit current « beauty standards ». Although no judgment is made, I make sure I discuss it with them, especially to reassure them about the appearance of their intimate area as there are so many different shapes, sizes, and colors! I encourage them to take a look at The Great Wall of Vagina by the British artist Jamie Mc McCartney, displaying molds of over 400 women’s vulvas. This shows the great diversity, helps you to understand your body better, and realize that there is not just one type of female genitalia – often with retracted labia minora and a « smooth » vulva.