It may come as a surprise to you, but one of the hottest trends in plastic surgery right now is labiaplasty, a surgical procedure that’s either used to trim excessive labia minora (the “inner lips” of the female vulva) and labia majora (the “outer lips”), or to lift and fill saggy tissue of the labia majora. (This is called a “puff” procedure.) Nonsurgical vaginal rejuvenation technologies now also exist that help women deal with unwelcome internal vaginal canal changes that occur with childbirth, aging, and menopause. While these are common problems, well over half of women may be unaware of current options available to them, but that’s changing rapidly.
According to the latest statistics from the American Society for Aesthetic Plastic Surgeons (ASAPS), labiaplasty procedures spiked 49% between 2013 and 2016, and this trend is continuing, with more than 12,000 procedures performed by ASAPS members just last year. The increase in interest stems from both aesthetics and function. For instance, the internet is full of what constitutes a “desirable” appearance of the vaginal area, implying a “new norm” of more petite appearing labia minora and full, tight labia majora. Due to the popularity of Brazilian waxing, the female anatomy is now more commonly totally visible. A common complaint of patients is excessive redundancy, deflation, and hyperpigmentation of the external tissues, which is both a cosmetic concern and a functional problem for women of all ages. Young adolescents feel “abnormal” if the labia minora hang too much or are asymmetric, post-partum women experience changes of laxity and sometimes sexual dysfunction after child birth or weight loss, and menopausal women can experience dryness, tightness, itching and painful sex after aging and hormonal loss. Women’s clothing has expanded to include form-fitting streetwear like yoga pants, exercise clothing, and leggings, and excessive tissues can cause rubbing, chafing, irritation, dryness, and fullness that is uncomfortable during exercises like running, biking, horseback riding or even during intimacy.
With this cultural shift and increased media representation, the good news is that board-certified and well-trained plastic surgeons have fine-tuned surgical techniques that offer safe, effective and aesthetic results while also correcting functional issues for female patients bothered by true symptoms down below. The bad news is that with rapidly increased demand, accompanied by a lack of mandated training for the great numbers and types of practitioners offering treatments, many women fall prey to botched surgeries or spend tons of money on ineffective therapies. Good plastic surgical techniques for labia reduction and even clitoral hood reduction yield very high patient satisfaction and can make all the difference between a life of chronic anxiety and doubt and one of pleasure and self-confidence.
Meaningful nonsurgical options using CO2 laser technology now exist to effectively offer treatment of the functional conditions such as loose vaginal canal (Vaginal Relaxation Syndrome) after childbirth or weight loss and dryness, itching, vaginitis, tightness, urinary leakage (Genitourinary Syndrome of Menopause) caused by declining estrogen levels in menopausal women or those denied estrogen after hormonally treated cancers. These lasers can also be used to cosmetically treat the atrophic, loose or hyperpigmented external vulvar skin that occurs with pregnancy and aging; in some cases even eliminating the need for surgical labiaplasty. And, finally, these lasers can help treat sexual dysfunction including painful intercourse due to internal vaginal dryness or tightness, laxity due to relaxation, and orgasmic dysfunction.
In a clinical trial that I conducted last year on the use of the CO2RE Intima laser for 40 menopausal women, results showed an astounding ninety percent patient response rate after just two laser treatments, and a hundred percent response rate after the recommended three monthly treatments on symptoms of dryness, itching, painful intercourse and urinary leakage. Several of the female patient groups who can be dramatically improved with these treatments are breast cancer and hormonally treated cancer patients who may enter menopause at an earlier age and for whom hormone replacement therapy is not advised, patients with radiation-induced dryness and patients suffering from urinary incontinence or pelvic organ prolapse. Again, not all practitioners offering treatments for these cosmetic and functional issues are necessarily surgically trained or laser experts, so, as always, patients should research credentials, board certification, experience and recognition in the field before selecting a provider to ensure the best outcome.