From celebrities to neighbors, more people seem to be opening up about having a little work done. It is becoming more common to hear someone talk about their Botox injections or see lip-enhanced selfies on social media, and with this growing awareness of cosmetic surgery, the target areas seem to be expanding as well. For the first time, this year the American Society of Plastic Surgeons (ASPS) has included information in their annual statistics about a relatively new procedure that is rapidly gaining popularity: labiaplasty.

What is labiaplasty?

Labiaplasty is a procedure that adjusts the size of the labia majora or labia minora so that they are more in proportion. This may involve surgery, reducing the size of the labia minora so it does not protrude as far past the labia majora. However, there are also less-invasive procedures which inject either fat or hyaluronic acid into the labia majora. This second option often replaces tissue volume lost after childbirth or with menopause, increasing the size of the labia majora so the labia minora is less prominent. Injections of hyaluronic acid have the added benefit of restoring moisture to the vaginal area, reversing the dryness that often comes with age.

Why do women choose labiaplasty?

There are many reasons why women may choose to have a labiaplasty procedure, from medical to aesthetic:

Congenital Abnormalities

Some people are born with malformed genitals or are intersex. In these cases, doctors may perform labiaplasty to correct the structural defect or make adjustments to reduce the additional sexual characteristics. Doctors may also perform labiaplasty as part of gender reassignment surgery.

Reducing Discomfort

Some women may have labia minora that extend far beyond their labia majora. In these cases, the women may experience chafing as their labia rub against clothing. This chafing can be intensified by removing hair which would otherwise help cushion and protect the area. By reducing the size of their labia minora, the women are hoping to protect these sensitive areas as the clothing instead rubs against their less-sensitive labia majora.

Misconceptions About the Effect on Sex

Some women believe a smaller labia minora will increase sexual pleasure. However, there is no evidence this is the case.

Aesthetic Reasons

Much of the recent increase in labiaplasty requests seems to be for aesthetic reasons. Women may believe their labia look abnormal or a sexual partner may have commented negatively on the size of their labia minora. They believe a labiaplasty procedure will help them to look more "normal" and "attractive."

Anti-aging Volume Restoration

Approaching and during menopause, and after childbirth, hormonal changes may cause the labia to lose tissue volume and become less elastic. This can cause the labia majora to appear loose and thinner, and a smaller labia majora can cause the labia minora to look larger in comparison. Fat or hyaluronic acid injections can help restore the original volume for a more youthful appearance.


Although it has nothing to do with surgical labiaplasty, women may opt for hyaluronic acid injections for rehydration. Skin can become dry with age, leading to irritation, and some women may want to restore a more hydrated feeling.

How popular are labiaplasty procedures?

Although labiaplasty is not new, the ASPS has included it in their annual statistics for the first time in their 2017 report. According to the report, doctors in the U.S. performed 9,138 procedures in 2015 and 12,666 procedures in 2016. That is a 39% increase in procedures in just a year. Anecdotally, some plastic surgeons report that while they used to get the occasional labiaplasty request from women with large labia minora, they are getting labiaplasty requests much more frequently in recent years from women who are in the normal range of labia minora sizes. The recent jump in popularity of the procedure is likely a sign of future growth as awareness of labiaplasty grows.

In a previous study, in 2000, researchers analyzed the reasons 163 women opted for labiaplasty surgery. 87% of those women opted for the procedure for aesthetic reasons and 64% chose surgery to correct discomfort from clothing. A 2008 study discovered that about a third of women opted for labiaplasty for discomfort, about a third for aesthetic reasons, and about a third for a combination of the two reasons.

Why is labiaplasty controversial?

As the popularity of labiaplasty has grown, so has the controversy surrounding this procedure. While any procedure a woman chooses to make herself feel more beautiful is a positive thing, some worry that these women are getting the wrong idea about what a normal labia looks like. Some have asserted that women are looking at images of other women online and in the media who may have had their labia digitally altered, or who may disproportionately be women with smaller labia minora because that is more aesthetically-pleasing. The concern is that women are getting a warped idea of what constitutes normal-looking labia, and may believe that theirs looks abnormal. The truth is there is a huge range of labia minora sizes and most women seeking labiaplasties actually have completely normal labia.

Concerned with the huge increase in women requesting labiaplasties, Australia introduced regulations requiring doctors to provide information to their patients before the procedure, if the surgery was publicly-funded. The doctors are to provide these women with information about how a normal labia looks and the wide range of labia appearances in the population. After receiving this information, 28% of women who had requested the surgery changed their mind. This seems to suggest that the women had been insecure about whether their labia appeared normal, and the educational materials helped make them feel more comfortable about their own body's appearance.

Some doctors also express concerns about the lack of knowledge about the procedure. While medical complications like bleeding, infection, and poor healing are uncommon, the big concern is the lack of long-term data. The labia changes during menopause, and some doctors are concerned about how these changes affect a surgically-altered labia and vice-versa.

The Less-Invasive Labiaplasty Option

While labiaplasty surgery is an invasive, and permanent, procedure, many women are choosing the less-invasive option of dermal filler injections. Similar to facial injections, these non-surgical labiaplasty or "labial puff" procedures use hyaluronic acid to add volume to the labia majora. Hyaluronic acid tends to hold moisture within the skin, so along with adding volume, the substance can also help rehydrate the area. This can not only help reduce dryness but also make the labia minora appear smaller with the restoration of volume, and size, to the labia majora. After childbirth, before menopause, and during menopause, these injections can help restore a more youthful look and feel to the labia.

One such labia injectable is called Desirial®, made by Vivacy of France who are also known for their Stylage® facial fillers. This labia filler contains cross-linked sodium hyaluronate along with mannitol, an antioxidant which can help prevent the sodium hyaluronate from degrading as quickly. Doctors can choose from Desirial®, suitable for use after childbirth or during perimenopause, or Desirial® Plus, a more intensive treatment suitable for use after childbirth, during perimenopause, or during menopause. The results of a Desirial® treatment can last for about a year or two, and at that time the doctor and patient can reevaluate the patient's needs, unlike permanent labiaplasty surgery.

Vivacy estimates about 80% of women are affected by vaginal dryness as they enter menopause and about 50% of women continue to experience this dryness as they complete menopause. Add these statistics to the growing concerns about labia appearance and the increase in labial irritation with hair removal, and Desirial® could very well grow to become one of the most popular treatments at cosmetic surgery clinics across the U.S. and beyond. More women are requesting information about labiaplasty from their plastic surgeons: be prepared to offer them a non-surgical labiaplasty option by ordering Desirial® or Desirial® Plus today. For more information about these products or to place an order, visit today.