What is labia majora reduction surgery? The difference between surgery to remove sagging skin and treatment to add volume

Labia majora reduction surgery is a procedure that removes excess, sagging skin of the labia majora and reshapes the outer appearance of the intimate area[1][2]. However, if the concern is not due to 'excess' but rather to 'atrophy and deflation,' a volume-adding treatment may be more suitable than cutting.[3]. Distinguishing which is the underlying cause is the first point of decision.

What can labia majora reduction surgery achieve?

What it can do is remove excess, sagging skin and reduce the enlargement or sagging of the labia majora.[1]. Current reports indicate that labia majora rejuvenation treatment centers on surgery that removes excess skin.[2].

It is sometimes performed together with surgery on the labia minora. In a review of labia minora surgery, labia majora reduction was performed in 33 cases among simultaneous procedures.[4]. This shows that some practitioners consider the balance between outer and inner structures together.

When is cutting not recommended?

When the labia majora are atrophied and the labia minora appear protruding, cutting surgery may not be appropriate.[3]. In this case, adding volume to the labia majora is thought to make it easier to balance the overall appearance.[3].

Volume-adding methods include fat transfer and hyaluronic acid injection.[1][3]. In a study of 72 people who received hyaluronic acid injection into the labia majora, 97% reported 'improvement' at 12 weeks.[3].

However, this study lacked a comparison group, so caution is needed to confirm effectiveness.[3]. Before deciding to 'cut because it is large,' it is important to have a professional assess whether the tissue is sagging or atrophied.

What are the surgical risks?

Important to understand are bleeding and blood clots (hematoma). Surgery to remove excess labia majora skin has reported postoperative heavy bleeding and hematomas requiring additional surgery.[1].

In a review of 53 studies, combined surgery involving the labia majora was estimated to have a wound-opening rate of approximately 8%.[5]. This calculates to about 8 per 100 people, but the range across studies is wide, so the exact figure is unclear.[5].

After surgery, it is reassuring to confirm rest periods in advance and the contact information for reporting any bleeding. Also ask before the procedure when swelling and pain are expected to subside.

How reliable are high satisfaction ratings?

Although satisfaction is high, it is safer not to decide based on that alone. Satisfaction with intimate area surgery overall is reported at 94%.[5].

On the other hand, reviews of labia minora surgery recommend not using satisfaction as the only measure of effectiveness.[4]. It is more reliable to consider complication rates and how much the concern has improved.[4].

Research focusing solely on labia majora reduction is still limited. Understanding that most figures include procedures such as labia minora surgery will help minimize gaps between expectations and outcomes.

What should be confirmed in a consultation to determine if it is right for you?

What you should confirm is whether the skin is excess, whether volume has decreased, and the balance with the labia minora. This will determine whether to proceed with cutting surgery, volume-adding treatment, or whether to also refine the labia minora at the same time.

Also ask which areas will be treated and by how much, where scars will remain, and how bleeding will be managed if it occurs. Since anatomy varies greatly among individuals, it is most reliable to have an in-person examination and discuss options with your physician before deciding.