Labiaplasty is the commonly performed outer surgical vaginal rejuvenation procedure.It is carried for those who have experienced physical discomfort or pain due to enlarged or elongated labia lips, due to chafing, pulling, or rubbing against clothing/ in intercourse. Even fat grafting is used to give puffy look to labia majora if they are sagging due to aging, called labia augmentation

Labiaplasty:
The outer and inner lips of the vulva are known as the labia majora and the labia minora, respectively. Through this method, the contours of the labia majora or labia minora are changed. It may cover reconstruction, augmentation or reduction of labia majora or minora.
In labiaplasty, one of the most popular vaginal rejuvenation procedures, the extra tissue of the labia majora and minora are trimmed away. The results are meant to relieve the discomfort of longer labia lips, reducing their length to prevent tugging and pulling, and/or to improve the appearance of the genitalia.

Surgical Techniques of Labiaplasty

There are various methodologies used to perform labiaplasty, however the most common are wedge resection and curvilinear resection.

1. Wedge Resection labiaplasty
   It is the safest and most effective method of reducing the labia minora. It spares nerve and arterial supply to the labia minora. Though reduction can be performed with scalpel or scissors, the low temperature Radio frequency cautery gives better results in terms of fast healing and recovery. Our cosmetic gynecologist performs labiaplasty most commonly by this technique as it gives natural irregular margins of labia minora and edges remain pigmented.
   Before surgery length of labia minora is assessed and vulval anatomy is assessed and labia looked for any asymmetry or pigmentation.
   This may be accompanied with clitoral hood reduction or labia majora reduction.
   
   
2. Curvilinear Resection Labiaplasty

This procedure is performed with radiofrequency cautery and is performed for patients who wish to have a marked reduction in the size of their labia minora and don’t wish for pigmentation at the edges or natural jagged appearance of labia minora. This procedure leaves a long horizontal scar versus a small midline scar with wedge resection and is intended for aggressive reduction of labia minora.

Labia Majora Reduction

Childbirth or aging causes sagging appearance of labia majora and causes discomfort to women due to rubbing against clothing or appearing puffy in tight fitting clothes or causing discomfort in intercourse. Similarly, abnormally large labia since birth may cause such difficulties.
Reduction of labia majora requires linear incision in the folds between minora and majora and extended laterally so as to remove any excess fat content. The margins are then closed without tension and so scar is hidden between the labial folds.Careful closure is of utmost importance with proper hemostasis as chances of hematoma formation and infection is high.

Labia Augmentation with Fat Transfer:

Shriveled labia majora gives a non-appealing look to one’s genitalia and may be the cause of diminished self esteem.
The goal of labia augmentation is to create a more youthful and rejuvenated looking vagina by enhancing the labia majora. There are two methods commonly used in “labia puffing,” which are labia augmentation with fat transfer, or labia augmentation with hyaluronic fillers. In labia augmentation with fat transfer, fat is harvested from another area of the body, usually the stomach or thighs, through liposuction. The fat is then processed and injected evenly across the labia to combat sagging skin and wrinkling.
Pre and post procedure medical photographs are a must to compare the outcome of the procedure.

Contraindications to Labiaplasty
Active HPV infection
Acute Herpes infection

Labiaplasty requires much skill as chances of hematoma and infection is high in this area of vulva, if improper technique is used; so you need to select a labiaplasty surgeon with excellence in the field beyond par.