Among 50 patients consulting about labiaplasty, the most frequent physical reasons for wanting the procedure were labia tugging with intercourse and discomfort with wearing tight pants. Aesthetically, almost all were self-conscious about how their labia looked, according to a study published April 2017 in the journal Plastic and Reconstructive Surgery.
Patients in the study answered a questionnaire assessing a list of 11 physical and appearance-related symptoms associated with having an elongated labia. More than half of the patients, ranging in age from 17 to 51 years, indicated they noticed their labia had elongated with age. More than 90% had bilateral elongation, according to the study.
They found that more than 70% of those responding said they felt tugging during intercourse and found tight pants uncomfortable. More than half experienced twisting of the labia and noted labia visibility in yoga pants.
Nearly half indicated they felt pain during intercourse, and 40% noted their labia might become exposed in bathing suits.
Aesthetically, 94% of those responding were self-conscious and more than half felt less attractive to their partners, restricted in their clothing choices and admitted to negative impacts on self-esteem and intimacy. Almost every patient experienced four symptoms or more, according to the abstract.
In her discussion of the study published in the same issue, plastic surgeon Christine A. Hamori, M.D., wrote that she commended the authors for exploring issues behind a growing demand among women for surgical labia minor reduction. Demand for labiaplasty was up 23.2% since 2015, according to 2016 statistics by the American Society for Aesthetic Plastic Surgery.
Dr. Hamori wrote that instructing participants to answer all applicable questions and having them view the list of potential symptoms might have created an element of suggestive bias. An open-ended questionnaire could have eliminated that.
Nevertheless, having a better understanding about why women seek labiaplasty is important for physicians. Dr. Hamori cited research that suggests gynecologists are more likely than plastic surgeons to discourage women from having labiaplasty. That study by Reitsma et al. reflects 164 physician responses to a questionnaire looking at physicians’ willingness to refer for or perform labia minor reduction. They found that plastic surgeon respondents were significantly more open to performing such a procedure compared to gynecologists. That was even though 90% of all the doctors responding believed that a vulva with a very small labia minor represents society’s ideal.
“Understanding this patient perspective is crucial in assessing surgical outcomes. Furthermore, the better all physicians understand labia symptomatology, the better supported patients will be in seeking surgical relief,” the authors conclude.