July 07, 2026 | Uncategorized
She had her list written on the back of a parking receipt.
I see that more than you would think with this particular consultation. The patient has done her homework, she has the questions ready, but she is nervous to read them aloud, so she has them on paper where she does not have to meet my eyes to ask. By the third question, the receipt is back in her purse and we are just talking. That is the whole goal.
Labiaplasty (surgery to reduce the inner labia, the labia minora) comes up far more often than my patients assume going in, and nearly always in that slightly hushed voice. The worries cluster around the same handful of things. Will it hurt. Will it change sensation. Will the scars show. Am I even a candidate. I handle it the way I handle every consultation, practically and without a flicker of judgment. The answers below come from real visits, anonymized.
“Is This Cosmetic, or Can It Help With Discomfort?”
For a lot of patients it is honestly both at once, and both reasons are legitimate.
Extra tissue can rub under certain clothing, get in the way during activity, and for some women it drives recurrent irritation on top of all that. So if it bothers you physically and you are also unhappy with how it looks, you are not choosing between two reasons to be taken seriously. You have two. Some of my patients come in purely for comfort. Some come in purely for the look. Plenty land somewhere between the two, and that is completely normal.
“How Do You Actually Do It?”
I trim the excess so everything reads smooth, and I deliberately leave a margin behind. The goal is never to remove every last millimeter.
Now the part I make sure lands before we go any further. Trim the labia in isolation and the clitoral hood (the little fold of skin over the clitoris) can start to look like it protrudes, simply because it is no longer in proportion with what surrounds it. Not a flattering outcome. That is why I usually recommend easing the hood down a touch at the same time, so the whole area sits flush and balanced rather than mismatched. If you started with very little tissue, a small amount may still show afterward. Far less than before, though.
“Will It Change My Sensation?”
By a wide margin this is the question I get most, and the answer usually settles people right down.
Yes, I am removing tissue, and yes, I cut through small nerves to do it. But the nerve stays on the surface right at the cut, which is why loss of sensation is not something my patients come back reporting. You keep what you had. And with a little less tissue crowding the clitoris afterward, full sensation often climbs rather than fades.
“What Kind of Anesthesia, and How Long Does It Take?”
IV sedation handles it, the same kind you would get for a colonoscopy. We start the IV, bring you into a deep sleep, and then I numb the whole area with local before doing the procedure. You will not feel any of it and you will not remember it. General is on the table if you would prefer, but for this it is more than you need. The procedure itself is quick, under forty-five minutes start to finish.
“What Is Recovery Like?”
Pretty simple, honestly. Here is the timeline I give patients.
| Recovery Point | What to Expect |
|---|---|
| Pain | Most people do not report much; you may be a little sore |
| Comfort aid | Exparel numbs the area for about three days |
| Spotting | A little, for a couple of days |
| Return to work | About five days, if you avoid strenuous activity and stay under fifteen pounds |
| Exercise | Four weeks |
| Intercourse | Four weeks while everything heals |
| Final result | Visible right away, but final look settles by four to six weeks as swelling resolves |
“Will I Get a Keloid Scar There?”
In all my years I have never once seen a keloid form in this area. Keloids turn up on ankles, shoulders, ears, and the chest, spots that live under tension or constant movement. The genital region is different material, more mucosa than skin, and it is not stretched the way those places are, so it is simply not where keloids grow. If that fear has been holding you back, you can set it down.
“What If It Is Not Perfect, or Asymmetric?”
Early on you may spot some unevenness, but that is nearly always swelling talking, since one side tends to puff up more than the other for a while. Underneath it, like breasts, the two sides were never identical to begin with. I make them as even as the anatomy honestly allows, and I will not call a case finished until I am satisfied with it. If a touch-up is ever needed down the line, my revision policy means you pay for the operating room and anesthesia time, not for the revision itself.
Why I Approach It This Way
I am a double board-certified plastic surgeon, certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, with a plastic surgery fellowship from the Mayo Clinic. The two things that matter most with this procedure are an honest conversation about what is realistic for your anatomy and a result that feels comfortable and looks natural. I will tell you plainly whether removing more is possible in your case or not.
For my broader take on why this conversation should never be awkward, see the companion essay on drworldwide.com. For skin and recovery support, including the Med Spa and laser options, the team at Southwest Plastic Surgery can walk you through it.
Ready to Talk?
If this is something you have wondered about, you can ask me directly and privately. Bring your list, on the back of a receipt if you like. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
