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Motivations for Labial Reduction Surgery

Motivations for Labial Reduction SurgeryJackie took a deep breath and told her gynecologist that she wasn’t happy with her labia.

“They’re not normal,” she said. “They hang down too far and my boyfriend is grossed out. And I don’t go swimming anymore because when I wear a bathing suit, you can totally tell.”

Her doctor examined the area and explained that there are lots of variations in women’s labia. Some are just bigger than others.

“Yeah, but aren’t mine too big? Don’t you think I should have that surgery?”

The surgery Jackie is referring to is labial reduction surgery or labiaplasty, a procedure that has become more popular in recent years. While some women want smaller labia, the surgery can also involve reshaping them or making one labium symmetrical with the other.

What compels women to have this delicate, intimate surgery? A recent study in Sexual Medicine investigated women’s motivations.

Dr. Sandra Zwier of the University of Amsterdam reviewed four online communities of British, Dutch, and American women who discussed reduction of the labia minora – the inner “lips” of the labia. She also examined the websites of 40 providers of labiaplasty

She found that women were more likely to discuss emotional reasons for wanting the surgery when sharing with the online communities. Some said they felt “freakish.” For example, one woman remarked, “I hate mine, hate, hate it! It's like a tongue sticking out for heaven’s sake!”

Some online community members said they felt ashamed of their labia and worried that they would be ridiculed or rejected by a sexual partner. Others noted that they would feel better with more attractive labia and that having the surgery would help them enjoy sex more on an emotional level.

Providers’ websites were more likely to report functional reasons for having labiaplasty. Some women with larger labia had pain during sex or while exercising. Others had discomfort when their labia rubbed against clothing.

Both emotional and functional reasons were recently expressed in messages left on the website of “Embarrassing Bodies,” a British television program. This reality show focuses on medical conditions that might be awkward to discuss. (This website and these messages were not part of Dr. Zwier’s research.)

My labia is very large and dangles down. Every 2 months without fail I get a cut on my labia due to constant rubbing. It is very painful when i have to go for a wee. I literally have to use plastic disposable gloves and pee on my hand. I have recently been to my doctor to speak about this cause it constantly gets me down. (Charmaine, May 1, 2014)

I'm a 14 year old girl in the U.S. My labias are fairly large and hang too ever since I was little. I'm very self-conscious about it and worry in gym while changing. (Colette, April 29, 2014)

I'm 13 and I have this problem, I get asked to send pics a lot and never once have I because I'm afraid they'll make fun of me. I tried to get the surgery not only for confidence but for pain when peeing and the lady at the hospital was very rude about it, on my way out I heard her laughing at me :( (Juliet, May 6, 2014)

Should your patients have labial reduction surgery? Before answering that question, consider their motivations. Do larger labia affect their sexual function? Their physical comfort? Their self-confidence? Do they feel that smaller labia are “normal” or “ideal”? What expectations do they have of surgery? Are they realistic?

Considering these questions, along with guidance from their gynecologist and/or therapist, can help patients with this important decision.

Print this article or view it as a PDF file here: Motivations for Labial Reduction Surgery


ABC News

Moisse, Katie

“ ‘The Doctors’ Feature Labia Reduction Surgery”

(November 21, 2011)

British Society for Paediatric & Adolescent Gynaecology

“Labial Reduction Surgery (Labiaplasty) On Adolescents”

(Position Statement. October 2013)

Embarrassing Bodies - (UK)

“Enlarged Labia”


Beasley, Deena

“U.S. gynecologists alarmed by plastic surgery trend”

(August 25, 2012)

Sexual Medicine

Zwier, Sandra, PhD

“ ‘What Motivates Her’: Motivations for Considering Labial Reduction Surgery as Recounted on Women’s Online Communities and Surgeons’ Websites”

(Full-text. First published online: January 25, 2014)


“Vaginoplasty and Labiaplasty”

(Reviewed: March 26, 2013)