What Is Labiaplasty and Who Is It Considered For? Expectations and Scientific Facts

Labiaplasty (sometimes also called “labioplasty”) is a surgical procedure that changes the size or shape of the inner lips of the vulva (labia minora) or, less often, the outer lips (labia majora). According to the American College of Obstetricians and Gynecologists (ACOG), patient interest in these procedures has increased over the past decade; however, published studies and standard terminology in this area are lacking. This creates gaps in knowledge about how often the procedure is done and about its risks and benefits ¹. This article discusses labiaplasty not as a recommendation, but in terms of what you need to know before making a decision.

There is no single “normal” for the appearance of the external genitals

The appearance of the vulva varies markedly from person to person. In a study in which external genital measurements were taken in fifty women before menopause (premenopausal), a wide range of values was found for every measurement ². A recent (2026) systematic review that assessed seven separate studies together pooled data from 991 women; it showed that all of the studies reported marked differences between individuals and wide, overlapping ranges, and that there was “significant variability” in the size of the inner lips ³. This article deliberately does not give values in millimetres, because the shared conclusion of these studies is not a measurement but the variation itself ^2,3.

These findings do not define an “ideal size”; on the contrary, they show that variation itself is normal. According to the 2025 statement of the International Federation of Gynecology and Obstetrics (FIGO), the growing demand for cosmetic genital surgery largely stems from media and online content reinforcing the impression that certain appearances “do not conform to an idealised aesthetic standard” ⁴. ACOG also states that the doctor can reassure a woman who expresses concern about her appearance that the size, shape and colour of the external genitals vary markedly from woman to woman ¹.

A functional complaint and a cosmetic wish are not the same thing

According to ACOG, cosmetic procedures performed to change appearance or sexual function have no medical indication; these procedures carry significant risks, and their safety and effectiveness have not been proven. Procedures performed for a clinical indication fall outside this definition; ACOG gives the following examples: clinically diagnosed sexual dysfunction, pain during intercourse (dyspareunia), interference with sporting activities, a previous birth injury or injury from a fall (straddle injury), repair after female genital cutting, prolapse, urinary leakage and gender affirmation surgery ¹. The first question is therefore: is this a complaint that affects daily life, or a concern about appearance?

FIGO’s Committee for the Ethical Aspects of Human Reproduction and Women’s Health (the FIGO Ethics Committee for short) goes a step further. It does not consider it ethically appropriate for obstetricians and gynaecologists to recommend or perform genital surgery done purely for appearance in women who have no structural or functional disorder, or to refer patients for it. It states that women should receive counselling and be informed that these procedures are not medically indicated and carry possible risks ⁴. For this reason, labiaplasty is discussed here only as an option that is assessed for specific complaints.

How is the assessment carried out?

At the first consultation, what the concern is, how long it has been present and how it affects daily life are discussed; this is followed by a gynaecological examination. ACOG recommends that the doctor be trained to recognise sexual dysfunction, depression, anxiety and other psychiatric conditions; that, when considered necessary, an assessment for body image disorder (body dysmorphic disorder) be carried out; and that women with suspected psychological distress be referred for assessment before surgery is considered ¹. This assessment is not a judgement but a safeguard that allows the decision to be made on the right basis; understanding the source of the concern is an integral part of the decision.

In adolescents, the subject is approached with even greater care. According to ACOG’s opinion on breast and labial surgery in adolescents, counselling in this age group requires specific information about normal physical and psychosocial development, together with an assessment of physical maturity and emotional readiness; adolescents should be screened for body image disorder and, if it is suspected, referred to a mental health professional ⁵. The same opinion states that when adolescents seek treatment, the first step is often to provide information and reassurance about normal variation in anatomy, growth and development ⁵.

Risks and realistic expectations

Labiaplasty may be perceived as a minor procedure; despite this perception, ACOG points out that serious complications can occur ⁵. The same organisation states that women should be informed both about the lack of high-quality data supporting the effectiveness of the procedure and about the following possible complications: pain, bleeding, infection, scarring, adhesions, changes in sensation, painful intercourse and the need for further surgery ¹. This list is not there to frighten you, but so that the decision is made with complete information. Reliable data on how often each complication occurs are, however, limited, because the field lacks standard terminology and enough published studies ¹.

The picture is similar when it comes to effectiveness. FIGO states that there is no strong evidence to support the claim that cosmetic genital surgery is safe and effective, and that published research is limited ⁴. ACOG, for its part, asks doctors who perform these procedures to share their own experience and results openly with the patient, as with any surgical procedure ¹. So the answer to the question “How will I look and what will I feel after the procedure?” is not a general promise, but an individual and honest conversation at the examination.

Before you decide

The decision-making process requires honest answers to a few questions: Is the discomfort functional, or is it about appearance? Where is this concern coming from? Have the risks and the limits of the evidence been explained? According to FIGO, addressing ethical concerns and providing accurate information support women in making informed choices about cosmetic genital surgery ⁴. The same statement also draws attention to the lack of safety and effectiveness data for laser devices used for vaginal dryness and urinary symptoms at menopause (genitourinary syndrome of menopause, GSM) or for cosmetic purposes ⁴.

When you are looking for information about labiaplasty, the first step is not a procedure but an examination and an open conversation. This consultation considers whether the appearance is within the wide normal range and, if there is a complaint, where it comes from; surgery is considered only in specific clinical situations, after the risks and the limits of the evidence have been explained ^1,4. The authors of the measurement studies also emphasise that information about normal variation should be shared with women considering genital surgery, and that the decision should be weighed carefully together with the doctor ². Noting down your questions in advance makes the consultation more productive.

If you have symptoms, please see an obstetrics and gynaecology specialist.