Intimate Wellness Institute

What are the Vulva and the Labia?

The vulva, or outside of the vagina, is made up of three structures. The labia minora, labia majora, and clitoral hood.  The labia minora are the inner folds of skin or lips at the vaginal opening that are attached to the clitoral hood, a fold of skin covering the clitoris. The labia majora are the outer folds or protrusions of skin and fat that extend from the mons pubis region, a cushion of fat over the pubic bone,  and extend down to the perineum just under the opening of the vagina and in front of the anus.  The purpose of the vulva is to cushion the pelvic area during  sexual intercourse or sitting and to protect the opening of the vagina and clitoris.

What is Labial Hypertrophy?

Labial hypertrophy refers to enlargement, overgrowth or excess laxity of the vulva including the labia minora, labia majora and clitoral hood structures. The labia can vary in size and shape among individuals, and some degree of asymmetry or variation is completely normal. However, in cases of labial hypertrophy the labia minora, labial majora, clitoral hood or any combination of structures of the vulva become significantly enlarged leading to aesthetic concerns, physical discomfort, potential hygiene issues, and sometimes emotional distress.

Labial hypertrophy can be caused by a variety of factors including genetics, pregnancy, hormonal changes, trauma, chronic irritation, or certain medical conditions. It’s important to note that what is considered “normal” or aesthetically acceptable can vary greatly between cultures and individuals and what is bothersome or acceptable is a personal choice.  Some people with labial hypertrophy may experience discomfort during activities such as exercise, sexual intercourse, or even daily movements. 

What is Labiaplasty?

Labiaplasty refers to aesthetic procedures to improve the APPEARANCE and FUNCTION of the external vaginal and vulvar structures. Many women are born with enlarged or asymmetrical labia or experience alterations in the appearance of their external vaginal structures after childbirth, trauma or aging that they would like to change. Vaginal cosmetic surgery and many non-surgical techniques can improve the appearance of the external vaginal structures and improve sexual as well as daily function. Some women may also suffer from symptoms of discomfort or irritation from enlargement of the labia and a labiaplasty helps resolve these symptoms.

Labiaplasty and cosmetic vaginal surgery may involve the Labia Minora (inner lips), the clitoral hood, the Labia Majora (outer lips), the Mons Pubis region (area above the vagina) or the Perineal Region (between the vagina and anus). In many cases it takes a combination of treatments to these areas to achieve maximal cosmetic results. 

Why choose Dr. Guerette and IWI for your Labiaplasty?

If labial hypertrophy is impacting your quality of life and causing you to have aesthetic concerns, makes you self-conscious, have physical discomfort, or emotional distress there is no reason not to address the issue. However, decisions regarding such procedures should be carefully considered and discussed with a qualified medical professional.  

Due to the nerves and blood vessels in the area as well as the nature of the anatomy, aesthetic vaginal surgeries are some of the most intricate and precise cosmetic surgeries performed.  Cosmetic vaginal surgery requires specialized skills and experience to achieve the results you desire. Most plastic surgeons and gynecologic surgeons have little or no experience with this type of cosmetic surgery, don’t perform them regularly, and don’t appreciate the potential impact on sexual or other function to know how to consistently achieve superior aesthetic and functional results. You need to be aware of a surgeon’s training and experience.

Lead by Dr. Guerette The Intimate Wellness Institute is the most specialized, expert center for Aesthetic Gynecology and Intimate Wellness in the Mid-Atlantic.  At the Intimate Wellness Institute we understand these issues and the concerns surrounding them.  We want to make you comfortable with your decision in a caring, understanding environment.  The IWI team is expertly trained to help you through the process.  Dr. Guerette has been performing vaginal reconstruction for over 20 years and is the most experienced female pelvic reconstructive surgeon in the Mid-Atlantic region.  Many of his advancements and techniques have been presented and taught nationally and internationally and he has trained hundreds of physicians on these techniques and technologies. Dr. Guerette and IWI offer ALL surgical and non-surgical options available. 

Labia Minoraplasty / Labia Minora Reduction

Surgical Labia Minoraplasty

The labia minora are the inner lips of the vagina.  They are made of thick skin and connective tissue that acts to protect the opening of the vagina.  Sometimes the labia minora can enlarge and elongate in size causing aesthetic and functional concerns. This can happen in all women and is genetic and hormonal in nature. Common times to see these types of changes are puberty, following childbirth, other hormone shifts, weight change and/or aging.

A Labia Minoraplasty, also known as labia minora reduction or labia minora surgery, it is a cosmetic surgical procedure that involves altering the size, shape, and appearance of the labia minora. The goal of this procedure is to achieve aesthetic and functional improvements to the labia minora.  During the procedure excess tissue from the labia minora is removed and the remaining tissue is reshaped or contoured to achieve the desired appearance. The extent of the surgery can vary depending on your goals.

A Labia Minora Reduction is often combined with other cosmetic procedures such as labiaplasty of the majora, vaginoplasty, or mons pubis liposuction. 

The procedure can be done comfortably in the Intimate Wellness Institute’s office surgical center.  Dr. Guerette employs multiple techniques to correct hypertrophy of the labia minora.  Dr. Guerette’s proprietary technique involves using advanced incision technology such as a laser or plasma blade to reduce scarring.  A precise v-shaped incision is made to allow the tissue edges to fall together without tension.  The incision is made in a sculpted way to appear natural and not create tension.  The tissue is then reapproximated utilizing advanced, absorbable knotless suture to minimize scarring and increase post-operative comfort – as the sutures need not be removed.  This leaves a virtually undetectable scar.

Results

The results are labia minora that are flush with or inside the labia majora depending on your preference.  Dr. Guerette will consult with you and review again prior to the procedure to ensure your expectations are met. Recovery is quick and risks are minimal. The IWI team will give you detailed care instructions and be there for you during your entire recovery process.

Non-surgical Labia Minoraplasty

For women with hypertrophy of the labia minora that don’t want surgical correction or who have more minor changes they wish to improve The Intimate Wellness Institute offers ALL non-surgical therapies to reduce and rejuvenate the labia as well.  These therapies also work well to further enhance surgical labia minoraplasty and other cosmetic vaginal procedures. 

Laser Labia Minoraplasty / Labia Minora Reduction

A gentle fractional resurfacing laser addresses the problem by  tightening the collagen, improving appearance and sensitivity. By utilizing different laser wavelengths and pulse modes we are able to create a dramatic improvement in the appearance of the labia minora. This same technology, using a different hand piece, is used to perform internal laser vaginal rejuvenation as well.  

Radiofrequency Labia Minoraplasty / Labia Minora Reduction

For the treatment of the labia minora, the area is heated by gentle radio waves to tighten the skin and contract the collagen and increase sensitivity. Focused thermal energy disrupts collagen fibers causing them to unravel and then contact. The natural healing process encourages fibroblasts to produce new collagen fibers and increase blood supply to the labia, clitoris, and perineum. This same technology, using a different hand piece, is used to perform internal vaginal rejuvenation as well.

Intense Pulse Light (IPL) Labia Minoraplasty / Labia Minora Reduction

IPL is cutting-edge technology that uses light energy to deeply heat the layer below the skin’s surface with an advanced sapphire quartz handpiece. The handpiece keeps the skin’s surface cool while penetrating deeper tissues with remodeling energy.  The targeted heat stimulates the body’s natural healing process, which contracts the skin, collagen and elastin. This results are tighter, smoother, more sensitive tissue.

Platelet-rich Plasma Augmentation for Labia Minoraplasty

Our bodies have a remarkable capacity to heal themselves. Regeneration of new tissue is accomplished by the natural production of stem cells. PRP involves concentrated platelets, rich in bioactive proteins, that release growth factors to stimulate cellular regeneration and accelerate tissue repair. PRP is used to address aesthetic concerns, skin conditions and sexual wellness/dysfunction. PRP is one of the most advanced and effective natural treatments for cellular repair AND rejuvenation.

What Is PRP?

PRP is in the category of regenerative autologous treatments meaning it comes from your own blood and can stimulate cellular regeneration and tissue repair. Platelets are blood cells that when activated can release growth factors and other proteins.

How does PRP help rejuvenate the labia minora?

PRP uses the growth factors in your own blood to stimulate new collagen, elastin, nerve and blood vessel formation in the tissue to create firmer, smoother more youthful skin using a healthy healing process. The growth factors & proteins released by the high concentration of platelets in PRP activate stems cells and stimulate cellular repair and regeneration. Collagen production and the formation of new blood vessels occurs to further aid in tissue repair.  PRP will not change the size and shape of the labia minora by itself as it can for the labia majora but it will augment the healing process to maximize your results.  

What Other Benefits Can a Woman Have from PRP?

  • Decreased or completely resolved pain during sex (dyspareunia)
    Increased ability to have orgasms
     Greater arousal from clitoral stimulation
     A tighter or more elastic vaginal canal
     Younger, smoother looking skin externally (lips of the vagina)
     Decreased or resolved overactive bladder and/or urinary incontinence

Non-Surgical Labia Minoraplasty FAQs

Does non-surgical vaginal and vulvar rejuvenation have downtime ?

In most cases, no.  If more aggressive treatments are performed a couple days may be required.

Am I A Candidate For Rejuvenation Treatment?

Most healthy women who are frustrated with vaginal laxity or similar concerns may benefit from vaginal rejuvenation treatments. These are non-surgical, minimally invasive treatments. A consultation with the IWI team can help you determine which treatment is right for you and your goals. 

Are non-surgical  vulvar rejuvenation treatments painful?

For most treatments there is no pain during the procedure with the application of topical anesthesia. There may be  a mild heat sensation or prick during the treatment of vulva, lips and introitus area which is very tolerable.

When can I expect to see or feel results after non-surgical vulvar rejuvenation procedures?

Most women will start notice improvement immediately and maximum improvement in 6-8 weeks.

How often do I need non-surgical vulvar rejuvenation treatments?

The usual treatment schedule is every 2-4 weeks for 3-5 sessions. Depending on the amount of laxity in the skin some patients may need additional treatments. 

How long will my results from non-surgical vulvar treatment last?

Results of your treatment will usually last 12 months to 18 months and then require a minimal touch-up treatment to maintain improvement.

Is a non-surgical vulvar rejuvenation treatment a substitute for surgical correction?

The short answer is no.  The degree or change and permanence of the results are more significant with surgical correction.  Your choice of treatment depends of the degree of change you desire.  A consultation with Dr. Guerette and the IWI team can help you in your decision process.  We are here to help.

Labia Majoraplasty / Labia Majora Reduction

Surgical Labia Majoraplasty

The labia majora are the outer lips of the vagina and made of skin and a fat pad that acts to cushion and protect the pelvic bones and vagina.  Sometimes too much fat deposition in this area can cause the majora to bulge out excessively. This can happen in all women and is genetic and hormonal in nature. Some women may not have excess fat, but instead have excess skin in the majora causing it to protrude and sag downwards and lose its youthful appearance.   This can occur following childbirth, hormone shifts, weight change and/or aging. The fat pads atrophy over time and the skin loses tone resulting in a wrinkled loose labia majora.

A Labia Majoraplasty, also known as labia majora reduction or labia majora surgery, is a cosmetic surgical procedure that involves altering the size, shape, and appearance of the labia majora. The goal of this procedure is to achieve aesthetic and functional improvements to the labia majora and a tighter and more youthful appearance.  During the procedure, excess tissue from the labia majora is removed, and the remaining tissue is reshaped or contoured to achieve the desired appearance. The extent of the surgery can vary depending on your goals.

A Labia Majora Reduction is often combined with other cosmetic procedures such as labiaplasty of the minora, vaginoplasty, or mons pubis liposuction. Liposuction alone will not work to cosmetically reduce the size of the majora.  If only liposuction is performed, the result will be even more excessive sagging skin. 

The procedure can be done comfortably in the Intimate Wellness Institute’s office surgical center.  Dr. Guerette employs multiple techniques to correct hypertrophy of the labia majora.  In the most common technique an incision is made along the inner fold of the majora and the minora and a crescent shaped portion of the excess skin and fat are removed using advanced technology such as a laser or plasma blade to reduce scarring.  The deep tissue is then reapproximated and skin is closed in the natural crease between the labia majora and minora, leaving a virtually undetectable scar.  Dr. Guerette utilizes advanced, absorbable knotless suture to close the skin to minimize scarring and increase post-operative comfort, as the sutures need not be removed. 

If the redundancy is more lateral on the labia the scars are hidden in the inner creases of the thighs and are almost impossible to detect once fully healed. If the excess skin and fat are on the lower portion of the majora a wedge shaped technique is used to tighten the skin and hide the incision on the perineum (between the vagina and the rectum), this is often used in combination with a tightening vaginoplasty.  If there is volume loss, a small amount of fat from another area in the body, PRP, or a hyaluronic acid filler may also be injected to make the lips look fuller and more youthful. 

Results

The results are a more youthful, tighter appearance of the labia majora without protrusion or excess skin. Recovery is quick and risks are minimal. The IWI team will give you detailed care instructions and be there for you during your entire recovery process.

Non-surgical Labia Majoraplasty

For women with hypertrophy or laxity of the labia majora that don’t want surgical correction or who have more minor changes they wish to improve The Intimate Wellness Institute offers ALL non-surgical therapies to tighten and rejuvenate the tissue as well.  These therapies also work well to further enhance surgical labial majoraplasty and other cosmetic vaginal procedures. 

Laser Vulvar Rejuvenation

A gentle fractional resurfacing laser addresses the problem of laxity by  tightening the collagen and simulating new collagen and blood vessels in the labia majora and perineum, improving appearance and sensitivity. By utilizing different laser wavelengths and pulse modes we are able to create a dramatic improvement in the appearance of vulva. This same technology, using a different hand piece, is used to perform internal laser vaginal rejuvenation as well.

Radiofrequency Treatment

For the treatment of the labia, the entire vulvar area is heated by gentle radio waves to stimulate collagen synthesis and increase blood supply for rejuvenation, tightening and heightened sensitivity. Focused thermal energy disrupts collagen fibers causing them to unravel. The natural healing process encourages fibroblasts to produce new collagen fibers and increase blood supply to the labia, clitoris, and perineum. This same technology, using a different hand piece, is used to perform internal vaginal rejuvenation as well.

Intense Pulse Light (IPL)

IPL is cutting-edge technology that uses light energy to deeply heat the layer below the skin’s surface with an advanced sapphire quartz handpiece. The handpiece keeps the skin’s surface cool while penetrating deeper tissues with remodeling energy.  The targeted heat stimulates the body’s natural healing process, which grows new collagen, elastin, blood vessels and nerves. This results is firmer, tighter, smoother, more sensitive tissue.

Platelet-rich Plasma Treatment

Our bodies have a remarkable capacity to heal themselves. Regeneration of new tissue is accomplished by the natural production of stem cells. PRP involves concentrated platelets, rich in bioactive proteins, that release growth factors to stimulate cellular regeneration and accelerate tissue repair. PRP is used to address aesthetic concerns, skin conditions and sexual wellness/dysfunction. PRP is one of the most advanced and effective natural treatments for cellular repair AND rejuvenation.

How Long Does the Procedure Take to Perform?

These injections are performed in office and take about 30 minutes from start to finish. You only need topical numbing cream to remain comfortable during the procedure and there is no preparation and minimal recovery.

When Can I Resume Sexual Activity After the PRP?

You may resume sexual activity about 4 hours after the procedure. 

Non-Surgical Labia Majoraplasty FAQs

Does non-surgical vulvar and vaginal rejuvenation have downtime ?

In most cases, no.  If more aggressive treatments are performed a couple days may be required.

Am I a Candidate For Rejuvenation Treatment?

Most healthy women who are frustrated with vaginal laxity or similar concerns may benefit from vaginal rejuvenation treatments. These non-surgical, minimally invasive treatments. A consultation with the IWI team can help you determine which treatment is right for you and your goals. 

Are non-surgical vulvar rejuvenation treatments painful?

For most treatments there is no pain during the procedure with the application of topical anesthesia. There may be  a mild heat sensation or prick during the treatment of vulva, lips and introitus area which is very tolerable.

When can I expect to see or feel results after non-surgical vulvar rejuvenation procedures?

Most women will start notice improvement immediately and maximum improvement in 6-8 weeks.

How often do I need non-surgical vulvar rejuvenation treatments?

The usual treatment schedule is every 2-4 weeks for 3-5 sessions. Depending on the amount of laxity in the skin some patients may need additional treatments. 

How long will my results from non-surgical vulvar treatment last?

Results of your treatment will usually last 12 months to 18 months and then require a minimal touch-up treatment to maintain improvement.

Is a non-surgical vulvar rejuvenation treatment a substitute for surgical correction?

The short answer is no.  The degree or change and permanence of the results are more significant with surgical correction.  Your choice of treatment depends of the degree of change you desire.  A consultation with Dr. Guerette and the IWI team can help you in your decision process.