Labiaplasty Results Satisfy Patients Seeking Functional Improvement

A recent cross-sectional study of a retrospective cohort of women who underwent labiaplasty for labia minora hypertrophy at Cleveland Clinic found that satisfaction with the outcomes was high and the patients’ primary motivation for the procedure was comfort and function rather than appearance.

Katie Propst, MD, and Cecile Ferrando, MD, MPH, urogynecologists at Cleveland Clinic’s Women’s Health Institute, were the lead investigators in the study, which was published in the International Urogynecology Journal.

Dr. Propst says the primary takeaway of the research is the need for surgeons to work to understand what is motivating their patients to undergo labiaplasty for labial hypertrophy and to determine if there are cosmetic concerns involved. In the study, Drs. Propst and Ferrando had initially set out to determine whether there was an association between the desire for the procedure and body dysmorphic disorder (BDD), but none of the 21 women who participated met the criteria for BDD.

Motivations for seeking reductions in size of labia

Labiaplasty is a means of reducing the size of the labia minora due to hypertrophy. Women seek this reduction in the size of the labia for a variety of reasons, most commonly cosmesis. Sometimes the condition can cause discomfort and the procedure is desired to improve quality of life.

Most of the literature on labiaplasty for hypertrophy comes from plastic surgery studies, and, although these studies indicate high rates of patient satisfaction, there is a lack of quality data on clinical effectiveness. The women who participated in Drs. Propst and Ferrando’s study were urogynecology patients identified by CPT codes. Their health records were reviewed, and they were asked to complete a survey to determine their satisfaction with and motivation for the procedure. Three validated instruments were used as part of the survey – the Genital Appearance Satisfaction Scale, the Cosmetic Procedure Screening Scale and the Body Image Quality of Life Inventory. Although the women all indicated a high satisfaction with genital appearance postoperatively, 85 percent indicated that pain was their primary motivation for seeking the procedure.

“Most of our patients have functional concerns but they may also have appearance concerns,” Dr. Propst says. “If a patient only cared about how the labia looked, I would try to delve more into it to find out why she is concerned. I would talk to her about what is and isn’t normal.” She says she often does an exam with the patient during which they look at and discuss the labia together. Many women find it reassuring to know their labia are “normal” and some even change their minds about the procedure.

The question remains whether women who seek labiaplasty through a urogynecologist have different motivations from women who seek labiaplasty from a plastic surgeon. Dr. Propst says prospective studies are needed.

“Overall, there are low rates of complications and high rates of satisfaction postoperatively,” she says. “However, understanding patients’ motivations for labiaplasty is key prior to performing procedures.”