Labia Majora Reduction Surgery

About Labia Majora Reduction Surgery

Labia majora reduction surgery (だいいんしんしゅくしょうじゅつ) is a gynecological plastic surgical procedure in which excess skin and subcutaneous tissue of the labia majora in the external genitalia are surgically excised and sutured to create a tighter silhouette. The labia majora tend to sag as collagen and fat decrease with age, and skin laxity also occurs due to rapid weight changes, childbirth, and hormonal fluctuations. When excess skin develops, discomfort, itching, and pain from friction with underwear and clothing may occur, and in some cases, psychological burden arises from concerns about appearance when wearing swimwear or tight bottoms. At our clinic, we use absorbable sutures and carefully perform multi-layer suturing of the submucosal and epidermal layers, achieving results that require no suture removal and have minimal scarring.

Main Causes of Labia Majora Sagging

The sagging of the labia majora involves multiple interrelated factors. The reduction of collagen fibers and decreased skin elasticity accompanying aging are the most common causes, with noticeable changes beginning in the late 30s for many individuals. Stress on the pelvic floor during pregnancy and childbirth, local edema, and subsequent weight loss create excess skin. Additionally, when body fat decreases through rapid dieting, the subcutaneous fat of the labia majora also decreases simultaneously, leaving only excess skin. In those with hypertrophied labia minora, constant friction between the labia majora and minora is reported to cause skin distension due to chronic frictional stimulation.

Surgical Flow and Procedure Method

During the pre-operative consultation, we confirm the degree of sagging, asymmetry, and your desired outcome. On the day of surgery, local anesthesia (with the addition of nitrous oxide anesthesia and/or intravenous anesthesia as needed) is used to minimize pain, and excess skin is excised according to the design. Absorbable sutures that naturally dissolve within the body are used for closure, so post-operative suture removal visits are generally not required. The operation typically takes 30-60 minutes and can be performed as outpatient (day surgery). Suturing employs multi-layer technique, suturing two or more layers of the submucosal and epidermal layers finely, distributing tension on the wound to minimize scarring. Concurrent treatment with labia minora reduction and accessory skin removal is also possible.

Literature Evidence: Safety and Patient Satisfaction in Labial Plasty

Multiple clinical studies on labial plasty (labiaplasty) have demonstrated its functional and aesthetic improvement effects. A pilot study published in Aesthetic Surgery Journal (2023) confirmed through pre-operative patient interviews that relief of functional discomfort and improvement of self-image were the primary reasons for seeking treatment, with high post-operative satisfaction (DOI: 10.1093/asj/sjad105). Additionally, a study on combined reduction methods published in Aesthetic Plastic Surgery (2022) reported that among 136 patients, there were few post-operative complications, and high improvement rates were achieved in both function and appearance (DOI: 10.1007/s00266-022-02841-7). Although these studies focus primarily on the labia minora, they serve as evidence for the safety and efficacy of the excision and suturing approach in external genital plasty in general.

Downtime and Post-operative Care

In the 1-3 days following surgery, swelling and bruising of the treated area may occur. Swelling peaks at 2-3 days post-operatively and generally subsides within 1-2 weeks. Absorbable sutures naturally dissolve over 4-8 weeks, but suture removal may be performed if the sutures are bothersome. Bathing is generally limited to showers only (avoiding the surgical site) from the day after surgery, with soaking in a bathtub, swimming, and hot springs recommended to be avoided for approximately 4 weeks post-operatively. Vigorous exercise and activities such as bicycling or motorcycle riding that cause compression or friction to the surgical site are recommended to be restricted for 2-4 weeks. Sexual activity is recommended after 4-6 weeks post-operatively. If you experience separation of the wound, excessive bleeding, or fever post-operatively, please contact us promptly.

Risks and Precautions

As with general surgical procedures, the risks of infection, hematoma, suture failure, and scar formation are not zero. In very rare cases, asymmetry may remain or the outcome may not match your desired result. Surgery is deferred during menstruation or during the acute phase of infections (candidiasis, chlamydia, etc.). Please disclose in advance if you are taking anticoagulant medications or medications that affect blood coagulation. Antibiotics are prescribed for post-operative infection prevention. At our clinic, we strive to minimize the risk of complications through thorough pre-operative consultation and appropriate surgical planning.