Genital Aesthetic Procedures

This page explains what surgical procedures on the external genitalia are, the medical situations in which they may be considered and what should be known before making a decision. It is not intended to encourage any procedure.

Normal variation of the genital area

The shape, size and symmetry of the external genitalia (vulva) vary greatly between individuals; the vast majority of these differences are part of normal anatomical variation. Childbirth, ageing, hormonal changes and weight fluctuation can alter the appearance of the tissues over time. A difference in appearance alone is not a disease and does not require medical intervention.

When is surgery considered?

Surgical procedures on the genital area are considered when a functional complaint has been documented by a physician, for example:

• Friction, irritation, recurrent inflammation or pain with clothing or activity due to marked length of the labia minora (labiaplasty)
• Pain and loss of function from poorly healed tears or episiotomy scars after childbirth (perineoplasty)
• Symptoms of pelvic floor weakness and organ prolapse (these fall under reconstructive, not cosmetic, surgery)

What to know before deciding

• Every surgical procedure carries risks such as bleeding, infection, wound-healing problems, altered sensation, asymmetry and pain.
• Results vary between individuals; no specific outcome regarding appearance or sexual function can be guaranteed.
• Such procedures are not performed under the age of 18, except for medical necessity, because development is not complete.
• Where concerns about body image predominate, a mental health assessment may be recommended before surgery.
• Detailed examination, information and written consent are required before any procedure.

Non-surgical options

For complaints such as irritation or dryness, non-surgical approaches are considered first: appropriate hygiene habits, moisturisers, cotton underwear, treatment of infections and pelvic floor exercises. The World Health Organization and ACOG state that there is insufficient evidence for the efficacy and safety of “genital rejuvenation” procedures that lack a medical indication.

Recovery

Swelling and tenderness lasting several weeks are usual after surgery; sexual intercourse and strenuous physical activity must be paused. The recovery period depends on the procedure and the individual and is followed by the physician.