Why Patients Request Labiaplasty

Over the past five years, labiaplasty has been exploding in popularity, yet the procedure is controversial. Many articles emphasize the impact that media exposure has on women, influencing them to seek labiaplasty, despite their normal genital anatomy.(1)  Several of the presenting author's own patients have described being shamed by their gynecologists for asking about labiaplasty, despite the negative impact of their elongated labia on their quality of life. The multifactorial reasons for having labiaplasty are not yet accepted by many physicians. 

To investigate patient motivation for requesting a labiaplasty, a questionnaire was given to 44 consecutive patients consulting about labiaplasty in a two-plastic-surgeon practice. The patients' average age was 33.23, with a range of 17 – 51.

Symptoms listed were those commonly cited by patients in the previous 15-year labiaplasty experience of authors HF and FC. Of the 44 patients studied:

• 57% experienced uncomfortable twisting of the labia in tight jeans.
• 68% found tight pants uncomfortable to wear.
• 73% experienced tugging during intercourse.
• 50% experienced pain during intercourse.
• 41% said their labia could become exposed in bathing suits.
• 52% said their labia were visible in yoga pants.

Regarding the appearance of the labia:

• 93% were self-conscious.
• 61% felt less attractive to their partner.
• 64% experienced a negative impact on their self-esteem.
• 43% experienced a negative impact on intimacy.
• 55% experienced restriction in choice of clothing.

Half (52%) noticed their labia become elongated as they got older, and nearly all (93%), had bilateral elongation. Of the 57% who gave birth, 60% noticed elongation after childbirth.

The motivation for labiaplasty is multifactorial. While nearly all patients surveyed were self-conscious about the appearance, nearly all (95.45%) also had at least one of the physical symptoms listed, with over two thirds experiencing three or more. 

The more physicians understand both the physical and emotional symptomatology associated with elongated labia, the better supported patients will feel in their search for relief.