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Dr Phil: Female genital cosmetic surgery (video)

Hello there I’m Dr Phil, today we are going to be talking about female cosmetic surgery of the genitals, commonly know as the ‘designer vagina’, although often it has nothing to do with the vagina at all.

The commonest operation is the vulva that is operated on. The vulva is the outside part of your genitals. It comprises of two sets of fleshy lips, the labia majora – the lips on the outside and labia minora – the lips on the inside, and of course the clitoris and the clitoral hood up there at the top. Probably because of internet porn and easy access to images of women who have no pubic hair as they’ve had it all shaved off and often they have had their vulvas trimmed to make them look younger. All women feel that they should look like this and everyone should have the same vulva, which is absolute nonsense. Naturally some women will have inner lips that hang down slightly lower than the outer lips, sometimes it is the other way round. Men don’t give a fig what your vulva looks like. A lot of men don’t spend much time down that way and when they do they are too busy trying to find the clitoris to worry what your lips look like.

So usually it is an insecurity that is pretty much unfounded. However, probably the first thing to do if you are worried about the appearance of your labia is to go and see a doctor. It could be a female doctor, possibly a male gynecologist, but someone who has seen a lot of vulvas and has seen the variety of them in all shapes and sizes who can usually reassure you that things are absolutely normal.

Just occasionally people have very protuberant labia and they opt to have a little bit shaved/trimmed off. It is quite a complex operation and you want it to be done by somebody who knows what they are doing, it might be a gynecologist or it might be a plastic surgeon. The website to look at is the British Association of Aesthetic Plastic Surgeons ( which gives you good descriptions of the operations and shows you registered specialists who do a lot of them or you may wish to go and see your GP who might recommend a local gynecologist who could do it for you. It is unlikely that you would be able to get it done on the NHS as it is a purely cosmetic procedure and as I say may not be needed anyway. Occasionally people do have a little bit of fat injected into their outer labia to plump them up a bit and make them look a bit younger. Again I think probably completely unnecessary.

The other reasonably common cosmetic procedure is the vaginoplasty where sutures are put in to actually tighten the vagina. Often after childbirth when women feel that things may be a bit looser than they were or they may worry that their partner can’t feel as much as they use to be able to, i.e. reduced sexual sensation and satisfaction. Again this often a complete myth, often both of you could be completely satisfied and it is actually a communication problem. You need to talk about it first and usually surgery isn’t needed. However, if you feel you want another opinion you need to go and see someone who does a lot of these procedures, who has seen a lot of vaginas and who can give you some advice as to whether you really need it and if you do, should ensure that you’ll get a good result. It is often good to ask for some before and after photos just to see the kind of cosmetic change that you might be striving for and what might be achievable.

The other operation which I am really not so sure about is where they take a little bit of your clitoral hood away, a hoodectomy. Your clitoris sits under a little bit of a hood and some people feel that they might get more sexual sensation if the clitoris is more exposed. That could actually make things more uncomfortable, if you are wearing tight pants for example. There is not a huge amount of evidence to suggest that it improves your sexual satisfaction so that is probably one that I would avoid.

As I say, most procedures are probably unnecessary, most of it can be sorted out with good communication and reassurance from a doctor who has seen lots of genitals. If you do decide that you want to consider having a procedure it’s really important that you go and see somebody who does lots of them and does them well. The British Association of Aesthetic Plastic Surgeons website, is a good place to start. This website, has more information and if you want to know anything more about me then would be the website.

Thank you.

Written by: Dr Phil Hammond
Edited by: Dr Phil Hammond
Last updated: Friday, October 20th 2017

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Comments on this article

Posted by Optional on 05/04/2016 at 08:30

I have a little tiny bump inside lip doesn't itch,nor getting bigger just wondering what it could b?

Posted by Mary on 19/05/2015 at 04:12

hello.. i worry about my vagina- my inner lips are big (not bigger then the outer one) and i'm scared of showing my vagina when i will be older and so- will have sex. i went to the Gynecologist but i got really scared and didn't show at the end.. should i go another time? surgery maybe?

Posted by El on 01/07/2011 at 09:16

Is there surgery that will enlarge the opening to my vagina? I have not given birth to my children vaginaly.

Posted by ANONYMUS on 30/12/2010 at 09:19