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Use this time to explore your unique anatomy and learn more about your body. Think of your outer lips like a horseshoe flipped upside down — a round curve that meets evenly at the end.

When this happens, it usually leaves the inner lips exposed. They may or may not protrude below your labia majora. More often than not, the inner lips are longer than and stick out from the outer lips.

This difference in length may be more subtle, with the inner lips just barely peeking out, or more pronounced.

Prominent outer lips sit much lower on your vulva. The skin may be thick and puffy or thin and a bit loose — or somewhere in between. These are a form of prominent inner lips.

They can dangle up to an inch or more! They may even hang outside of your underwear. You may notice a bit of extra skin or additional folds. These are a form of prominent outer lips.

This may give your inner lips a little more exposure. Your outer lips are flat and rest up against your pubic bone, but are separated slightly, showing your labia minora.

With this type, your inner and outer lips are usually the same size. They can usually be seen from the top to the bottom of your outer lips.

What we do know stems from two small studies, one done in and one in For example, neither study:. But they do help establish that each labia may be longer or shorter, or thicker or thinner, than its counterpart.

Regardless of what the average size may be, if your labia minora or majora are especially sensitive or prone to pain and discomfort , you may be experiencing symptoms of labial hypertrophy.

This is the medical term for enlarged labia. Labial hypertrophy can make cleansing difficult or uncomfortable, and may ultimately lead to infection.

If this sounds familiar, see your doctor. They can assess your symptoms and advise you on next steps. Some people may have pink or purplish labia, while others may have reddish or brown labia.

This is because of increased blood flow to the area. See your doctor if:. These could be a sign of yeast infection or other irritation. Your vaginal area is distinct in more ways than just labia appearance.

Most people develop pubic hair as a response to rising testosterone levels during puberty. You can have thick hair, thin hair, a lot of hair, a little hair, hair just on your pubic bone or all over your vulva, and, yes, the carpets may not match the drapes.

All of this is absolutely normal. Some vaginal discharge is normal. Sometimes, changes in color and texture are a sign of an underlying condition.

See your doctor if your discharge:. These are typically signs of infection, such as yeast vaginitis, bacterial vaginosis , chlamydia , or gonorrhea.

All vaginas have a slight odor. Your smell will depend on a variety of factors, including your diet and hormones. Bumps caused by ingrown hairs , pimples , swollen veins , or harmless cysts typically fade after a week or so.

See your doctor if the bump persists or is accompanied by itching, burning, or other unusual symptoms.

It could be caused by a sexually transmitted infection or other underlying condition. Absolute hemostasis prior to closure is essential to avoid hematoma formation.

A Preoperative labia majora reduction markings on a year-old woman with ptotic labia majora and moderately large, asymmetric labia minora. B Immediately postoperative photograph after bilateral labia majora and labia minora edge excision reduction and left clitoral hood fold excision.

A Preoperative photograph of a year-old woman with redundant labia majora. B Postoperative photograph obtained 3 months after bilateral labia majora reduction using the described technique note the absence of visible scars.

Although many recommend general anesthesia, 2 , 14 I perform virtually all labiaplasty procedures, including combined majora and minora reductions, using local anesthesia, with mild oral sedation mg of diazepam.

Topical anesthetic ointment or cream is applied at the same time oral sedation is administered. Approximately half of women undergoing minora procedures will not experience injection pain if 45 minutes elapse between topical anesthetic application and injection.

Anesthetic buffering with sodium bicarbonate, if utilized, will further reduce infiltration discomfort. One dose of a cephalosporin oral antibiotic or clindamycin for Beta-lactam allergic patients is taken 2 hours preoperatively.

Procedures are performed with the patient supine, in frog leg position. Lithotomy position, although commonly recommended by many authors for labiaplasty procedures, 2 , 14 should be avoided in my opinion, as external genital anatomy can be distorted.

All surgical markings must be made before local anesthetic injection. Deviation from markings should be avoided.

Tissue distortion should be avoided. Adequate time should be allowed for vasoconstriction to occur. Twenty minutes is ideal for maximum effect, but a minimum of 10 minutes is suggested.

In combined labiaplasty procedures, the majora should be done first. For labia minora edge excision techniques, use of a traction suture placed in the most prominent portion of the labium is helpful.

Clitoral hood folds, if present, should be excised first, followed by minora excision. Resection of redundant labial tissue posterior to the introitus may occasionally be difficult with the patient in frog leg position.

It can be facilitated, if necessary, by placing gauze pads between the buttocks posterior to the anus to separate them and increase visualization of the posterior perineum.

The operating table may also be placed in a slight Trendelenburg position if further exposure is needed.

I perform the procedures using number 15 scalpel blades and a needle-point electrocautery. Absolute hemostasis is essential.

A single-layer closure with interrupted 4. For wedge resection techniques, a two-layer closure is suggested to reduce incision dehiscence risk.

I recommend 4. Labia majora excision defects are also closed in two layers: 4. The skin sutures are removed 1 week after surgery. Aftercare is similar for both labia majora and minora procedures: minimal ambulation, ice compacts, and narcotic analgesia for the first 2 days and topical antibiotic ointment application and sanitary pads as dressing for 1 week.

Daily tepid showers are permitted. Routine follow-up visits occur at 1 week, 2 weeks, 4 weeks, and 12 weeks. Vicryl Rapide sutures, if still present, are removed at 2 weeks.

Vaginal penetration is not permitted for 4 weeks. Labiaplasty procedures have low complication rates. Hematoma and wound dehiscence are most commonly reported.

Lista et al 2 reported a 3. Unaddressed clitoral hood redundancy and labial remnants posterior to the introitus, as indicated earlier, may also motivate revision requests.

Overzealous resection with partial or complete amputation of the labium, although rare, is perhaps the most dreaded complication observed.

Labial edge scalloping, usually minor, can occur after edge excision techniques. Scar contractures, although reported, are very rare.

Persisting postoperative dyspareunia is extremely rare. I have never observed it. This has also been the experience of others. External genital cosmetic surgical procedures are increasingly being requested by women today.

Competently performed, all labiaplasty techniques appear to yield excellent aesthetic results, with high patient satisfaction and very low complication rates.

To date, no technique has proven to be clearly superior to the others described. Plastic surgeons should develop competence in performing female external genital aesthetic surgery.

Several different operative techniques, to permit tailoring to each woman's unique genital anatomy and aesthetic desires, should be part of the skill set of all surgeons performing labiaplasties.

The author declares no potential conflicts of interest with respect to the research, authorship, and publication of this article.

The author received no financial support for the research, authorship, and publication of this article. Aesthet Surg J. The safety of aesthetic labiaplasty: a plastic surgery experience.

Google Scholar. Hunter JG. Commentary on: labioplasty: anatomy, etiology, and a new surgical approach. Cosmetic surgery of the female external genitalia.

Current Cosmetic Surgery. New York : McGraw-Hill ; ; - Google Preview. Triana L Robledo AM. Aesthetic surgery of female external genitalia.

Labia minora reduction techniques: a comprehensive literature review. Refreshing labiaplasty techniques for plastic surgeons.

Aesthet Plast Surg. Labioplasty: anatomy, etiology, and a new surgical approach. Commentary on: Postoperative clitoral hood deformity after labiaplasty.

Hamori CA. Postoperative clitoral hood deformity after labiaplasty. A large multicenter outcome study of female genital plastic surgery.

J Sex Med. Hodgkinson DJ Hait G. Aesthetic vaginal labiaplasty. Plast Reconstr Surg. Maas S Hage JJ. Functional and aesthetic labia minora reduction.

Alter GJ. A new technique for aesthetic labia minora reduction. Ann Plast Surg. Commentary on: Labia minora reduction techniques: a comprehensive literature review.

Clinical characteristics of well women seeking labial reduction surgery: a prospective study. Psychological characteristics and motivation of women seeking labiaplasty.

Psychol Med. Aesthetic labia minora and clitoral hood reduction using extended central wedge resection. A new method for aesthetic reduction of labia minora the deepithelialization reduction labiaplasty.

Felicio Yde A. Labial surgery. Considerations in female external genital aesthetic surgery techniques. Hypertrophy of the labia minora: experience with reductions.

Am J Obstet Gynecol. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

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Volume Article Contents Abstract. Corresponding Author: Dr John G. E-mail: jgh nyp. Oxford Academic. Cite Cite John G. Select Format Select format.

Permissions Icon Permissions. Abstract Aesthetic alteration of the genitalia is increasingly sought by women unhappy with the size, shape, and appearance of their vulva.

Open in new tab Download slide. A year-old woman with prominent bilateral lateral clitoral hood folds. Figure 1. Figure 2. Figure 3.

Figure 4. Figure 5. Table 1. Reduction Technique. Open in new tab. Figure 6. Figure 7. Photograph of a year-old woman with deflated, redundant labia majora.

Figure 8. Figure 9. Figure Google Scholar Crossref. Search ADS. Google Scholar PubMed. Reprints and permission: journals.