Aesthetic genital surgery is very successful if the guidelines are followed meticulously. As more women become aware that safe, successful operations are available, the number of these procedures performed will continue to increase.
Labia minora enlargement is usually congenital in origin. It may appear in childhood but becomes more obvious in adolescence. Occasionally, a woman will state that her labia minora increased with pregnancy, birth control pills, aging, or male hormone supplements. Ideally, the woman wants thin, straight, light-colored, non-redundant, symmetrical labia minora.
If there is enlargement or extra folds of the clitoral hood during central wedge labial reduction the outside excision on each side is often curved up to remove the sides of the hood.
Youthful labia majora (outer lips) have fullness, but overabundant fat bulging can be congenital. Obesity also causes labia majora fat and skin enlargement. After pregnancy, weight loss, or aging, the majora can lose fat but have excess skin with wrinkling. This causes the majora to hang lower with more redundancy. Excessively protuberant or low-hanging labia majora can cause an unsightly bulge in clothes, often with a central crease from the vaginal opening. Thus, the protuberance can be from either an overly fatty, full majora or a fat deficient, stretched majora with excess skin, or a combination.
If the woman desires to increase the fullness of her labia, then fat injections can be performed.
Pubic fat is often seen as a congenital deformity, which will not resolve with weight loss alone. The woman complains of an unsightly bulge or protrusion with loss of self-esteem, often leading to avoidance of wearing tight clothes or bathing suits.
The epidemic of female obesity along with massive weight loss has resulted in the common complaints of an excessive mons pubis fat deposit and descent of the pubic hair, introitus (vaginal opening), and labia majora. The large mons pubis fat deposit is often also associated with large, protuberant labia majora due to fat excess with skin stretching. Weight loss rarely results in elimination of these deformities, so surgical treatment is required.
The clitoris in the child or adult can be reduced by an outpatient procedure which removes the erectile spongy tissue of the shaft, sutures the clitoris closer to the pubic bone, and decreases the size of the glans or head of the clitoris.