In most cases, the decision to undergo a labia reduction can be attributed to a combination of physical and psychological issues:

Functional reasons
(Pain, chronic skin irritation, invagination during sexual intercourse, etc.)

Aesthetic reasons
(Hesitation to get naked, negative impact on sex life, etc.)

Corrections due to previous botched surgeries
(Labia reconstruction)

We will do our best to ensure that you are given a delicate work of art that fully lives up to your wishes and expectations.
We usually aim for the labia minora to be covered by the labia majora, but other shapes and variations can also be achieved.

The “ideal” appearance

In our culture, anything that sags or hangs shapelessly is often perceived as unattractive. Since shaving public hair has become routine for most women today, the shape and appearance of the genitals are unveiled, also regrettably revealing any less appealing details.

Even though the idea of what the perfect labia should look like varies greatly from woman to woman, of course, there is one “look” of the outer female genital area that most patients consider to be ideal.

When it comes to what constitutes the “perfect shape”, the labia minora have a slightly curved contour with a firm clitoral hood. When the legs are closed, the labia minora are almost completely covered by the labia majora.

For many women, however, the labia minora hang down limply and protrude beyond the cover of the labia majora.

The main concern here is to analyze the starting situation, particularly with regard to the desired result. In which areas are the labia minora enlarged? Purely below the clitoris or also above it, in the shaft part of the clitoris? Is there clitoral protrusion or is the clitoris in a normal position, etc.?

If the labia minora are very long – a condition called labial hypertrophy – they are no longer covered by the labia majora. Labia minora are typically enlarged along their entire length, i.e. the part above the clitoris, the area adjacent to the clitoris (clitoral hood) and the part below the clitoris. An isolated hypertrophy of the lower part alone is rare.

In cases where all sections are enlarged (the most common form), all parts have to be corrected in order to achieve a balanced and aesthetically appealing result.

Attention should also be paid to the position of the clitoris itself:
In some cases, the clitoral glans can protrude to a great extent. This is referred to as clitoral protrusion. In cases where full coverage of the labia minora by the labia majora cannot be achieved with the labia reduction procedure alone, surgical correction of clitoral protrusion is advisable.

The best surgical technique for you is selected based on your desired result. This does, however, depend not only on your expectations of the result, but also on your starting situation.

The are four different options: labia reduction along their entire length, or purely below the clitoris, with or without tightening the clitoral hood, with or without correcting the position of the clitoris, etc.

Correction

Long labia minora can be corrected using various techniques, depending on the appearance and the expectations regarding the desired result:

1. Composite Reduction Labiaplasty

Correction of the labia minora above and below the clitoris, tightening and lifting of the clitoral hood, and any necessary correction of clitoral protrusion (composite reduction labiaplasty).

The area marked in dark blue is removed.

2. Correction of the labia minora above and below the clitoris, tightening of the clitoral hood, and any necessary correction of clitoral protrusion.

3. Correction of the labia minora above and below the clitoris, without targeted tightening of the clitoral hood or correction of the clitoral position.

4. Correction of the labia minora purely below the clitoris.

We differentiate between four techniques used for the reduction of the labia minora, depending on the examination findings and the starting situation (see point 6).

As labia reduction surgery is performed under local anesthesia, extensive preparation is not required. It is important that you do not take any blood-thinning medications (e.g. aspirin, etc.) 14 days prior to the surgery.

Before the surgery

If the procedure is being performed under local anesthesia, no special preparation is required. If the procedure is being performed under general anesthesia or twilight sedation, you should fast, i.e. refraining from eating, drinking, and smoking, for at least six hours prior to your surgery.
You should stop taking medications that affect coagulation, e.g. aspirin 100 mg, etc., 14 days prior to the surgery. Please completely shave your genital area before the procedure.

You will be given a delicate work of art. You need to protect it. Avoid mechanical friction as much as possible for six weeks after the procedure. Please also note the following:

After the surgery

After the surgery, you can rest at our practice.

Please do not drive home or back to your hotel yourself. Get someone to pick you up or we can call a taxi for you. Cool the area and rest. You should walk as little as possible. You may experience a mild burning or pressing sensation, especially during the first night. This is normal. However, some patients feel it more than others and, despite the pain medication prescribed by us, a few patients may experience significant discomfort. The sensation typically disappears or greatly improves after the first night. On the first postoperative day, the wound is checked and the dressing is changed at our practice.

After the third day, you can start showering again, but may only use clear water and no soap during the first week. The sutures are absorbable and do not need to be removed. Absorption of the suture may sometimes be associated with severe itching, which can be alleviated by using special creams or ointments.

The surgery will only affect your daily activities for a short time. Depending on your profession, you may be able to return to work as early as two to three days after surgery. It is very important that you try to avoid any friction and forces acting on this area for six weeks following the procedure: no sexual intercourse, jogging, cycling, horse riding, etc.! Likewise, tampons may only be used again after this period of time.

Immediately after surgery, you should wear close-fitting underwear that you can pull firmly upwards to apply some pressure on the area. This helps prevent excessive swelling and reduces the risk of postoperative bleeding. Then from the first day after surgery, you will feel more comfortable wearing loose clothing.

To optimize the healing process, you should place a compress between the labia so that they do not touch. You should do this over a period of two weeks. After this time, you should firmly squeeze the labia along their entire length between your thumb and index finger. You should do this two to three times a day over a period of four weeks. This will encourage any swelling to subside more quickly and improve scar healing. However, be careful not to rub or massage the labia.

You will be provided with the cell phone number of Prof. Gress so that you can contact him any time should you have any questions or experience an emergency.

You can see sample images under the following access: HERE

Prof. Gress has published most of his medical publications with Springer Verlag.

His textbook on correcting the outer female genital region entitled „Aesthetic and Functional Labiaplasty“ was published in 2018.

This book describes his techniques for reducing the labia minora, primarily the “composite reduction labiaplasty”, and techniques for correcting the labia majora and the mons pubis. This textbook is now the standard for colleagues in this field throughout the world.

Publications by Prof. Gress: