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Great Sexpectations: Changing the perspective on labiaplasty

Great Sexpectations: Changing the perspective on labiaplasty

Published By Mike

With Dr Mike Shenouda, Cosmetic Surgeon, Geniale Drummoyne

Lady parts come in all shapes and sizes - and the demand for labiaplasty is high, with the procedure one of the fastest growing in cosmetic surgery.*1

As a physician who performs intimate cosmetic procedures on a daily basis, I’d like to dispel a few of the common myths about labiaplasty.

 Myth 1. It’s largely a cosmetic procedure

A labiaplasty is a labia reduction surgery to help reduce symptoms of:

- Chafing, pain and discomfort when wearing tight clothes

- Pain and discomfort during sex or during exercise 

- Increased vaginal odour due to bacteria on excess skin

- Psychological distress caused by an overly large labia appearance      

Outside of addressing physical symptoms, the procedure also aims to improve the appearance of labia so it doesn’t “hang” or protrude and so there is less prominence in the appearance of the female genitalia. 

Many women report an improved quality of life after labiaplasty, according to a recent study of 11,000 labiaplasty patients, from the American Society of Plastic Surgeons.*2

 Myth 2. It’s not morally acceptable  

There is still a huge misconception that labiaplasty is some kind of genital mutilation. 

But this is not the case at all. 

Some women are born with a large labia.

Other women experience labia enlargement after childbirth, and also around menopause when less estrogen may cause the tissues of the vulva and lining of the vagina to become thinner, drier and less elastic and the aging labia may atrophy and stretch.

Outside of pain and discomfort, a large labia frequently causes significant psychological distress. 

I have operated on women in many cases where the labia was in excess of 8cm in standing position.

And in one report from the Royal Australian College of General Practitioners, patients delayed their Pap Smear due to embarrassment about their labia during the examination.*3 

Redesigning the labia in these cases can be life-changing in terms of pain and body image.    

As this is an emerging area of medicine, I am delighted to provide a service where women can now feel comfortable in seeking new options that were simply not there a few decades ago. 

Myth 3. It’s declining in popularity

The truth is that labiaplasty is growing rapidly.

In 2016, The American Society of Plastic Surgeons said there was a 45% increase on labiaplasty procedures in a single year*4, making it the fastest-growing cosmetic procedure in the world. 

Similarly in Australia, the trend is growing.

However, it is also important to distinguish exactly who is suitable for the procedure and who isn’t. 

In some cases, there is a real physical or psychological need to have the procedure, whether it’s due to childbirth, genetics or ageing. 

Other women simply feel very self-conscious about the length of their lips, to the point where it impacts their relationships and desire for intimacy. 

On the other hand, quite often I counsel younger women especially where the labia size is in the “normal” or close to the normal range that the labiaplasty is not warranted unless there is significant discomfort or pain or they cannot insert tampons.

I must say the sexual bar has been set high by extreme waxing trends, Brazilian waxing, and the exponential growth of pornography on the website. 

Comparing yourself to others and wanting to have a procedure for “an extra less cm of perfection” is not a good reason to have a labiaplasty. 

 Myth 4. The labia never changes – what you are born with is there forever. 

The shape and appearance of the vulva actually does change over the years and the most obvious changes are linked to hormonal periods including puberty (becomes larger and thicker), in pregnancy (another increase in length and thickness) and around the menopause (skin atrophies, sags and thins) which can lead to an increased risk of dermatitis in the labia and vulva on older females. 

A large labia further increases this risk. During this time, cells are readier to shear off with friction or mild trauma with intercourse.  

 Myth 5. Labiaplasty is generally covered by Medicare

Most labiaplasty hospital fees are not covered by Medicare or Private health care rebates (occasionally people will be covered where the issue is a medical issue or deformity).

Patients will need to check with their insurer if these costs are covered. 

In order to qualify for a hospital rebate from Medicare, you must meet certain Medicare criteria such as a tear after childbirth, abnormal lips, or some other structural abnormality or a labia that exceeds 8cm in standing position. 

The procedure is not covered for purely cosmetic reasons. 

The MBS codes for labiaplasty are below.

  • 35533: Vulvoplasty or labiaplasty, for repair of: (a) female genital mutilation; or (b) an anomaly associated with a major congenital anomaly of the urogynaecological tract other than a service associated with a service to which item 35536, 37836, 37050, 37842, 37851 or 43882 applies
  • 35534: Vulvoplasty or labiaplasty, in a patient aged 18 years or more, performed by a specialist in the practice of the specialist’s specialty, for a structural abnormality that is causing significant functional impairment, if the patient’s labium extends more than 8 cm below the vaginal introitus while the patient is in a standing resting position

If you think that you may be a good candidate for labiaplasty, don’t hesitate to contact us today at Geniale on 9181 3999.




 1*Labiaplasty improves quality of life in study of 11,000 patients, American Society of Plastic Surgeons 

2*Labiaplasty fastest growing procedure in the world, Society of Aesthetic Plastic Surgery, US

3*RACGP Female Genital Cosmetic Surgery, Investigating the Role of The General Practitioner, 2015 

4*Vaginal Surgery, world’s fastest growing cosmetic surgery, The Independent 

5 *Vaginal hypertrophy not linked to length but shape, Science Direct

 Disclaimer: All results are individual. Any surgical or invasive procedure carries risks.
Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.


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