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Prof. asoc. Dr. Stefan Gress

Labia Reconstruction

Professor Gress is one of the top specialists internationally


How to find the right doctor?

How is the procedure performed?

Genital surgery and interventions
have surged in popularity in recent years,
especially labia minora reduction surgery.

So, you think it is all over and you have put everything behind you. But the result has turned out a lot different than you expected, different from what was discussed or even promised. Perhaps it’s much worse than before, or even mutilated.

Sadly, it has to be said that the biggest risk of labia reduction surgery relates to the incompetence and inexperience of the surgeon. These operations are frequently offered casually, even though the surgeon has not mastered the surgical standards and techniques. A labia reduction is often described as a “quick fix” in the sense of “it won’t take us long to do that too”. And the result lives up to this.

Labia minora reduction has been the most common procedure on the spectrum of female intimate surgery at our clinic for many years, followed by vaginoplasties. We have the most experience in this field worldwide. Despite the routine nature and safety of this operation, a labia reduction surgery takes around two to two-and-a-half hours for us to complete. You are quite within your rights to be suspicious if you are told elsewhere that it would be much faster…

There are a whole host of factors that can go wrong and impair the result. That is why the reconstruction, in other words the restoration of the labia minora, is no routine procedure. It is a very individual procedure that not only corrects previous mistakes but also gives you the desired result that you had hoped for when you first decided to undergo a labia reduction!

An unsuccessful operation always brings considerable disappointment and sometimes even traumatic effects and severe mental stress. It is now even worse than before. You probably regret deciding to go ahead with the procedure in the first place.
You may be experiencing pain, sensory disturbances, a deflected urinary stream, exposure of the vaginal opening with recurring inflammation of the vagina, burning, itching, skin irritation, etc.
Whilst some problems can be resolved or improved through reconstructive surgery, others cannot or are extremely difficult. It is often the case that this cannot be achieved in one surgery alone.
Here are the most common errors

1. “Microphallus” / small penis deformity
This is the most common error. The labia minora have only been reduced below the clitoris. There is still an overhang in the area adjacent to or above the clitoris. This then resembles a microphallus.
Prospects of corrective surgery: mostly successful

2. Overcorrection
The labia minora may shrink a little more once the swelling has gone down after the operation. This should be taken into consideration before the procedure. In an ideal scenario, they have a height of about 1 cm (measured from the base) but can be more or even less, if desired.
Prospects of corrective surgery: dependent on the remaining length of the labia minora

3. Undercorrection
The removal of too little tissue is not so much of a problem as further reduction is always possible. Although this is annoying, it is not usually a problem. In most cases, undercorrection affects the area above the clitoris. In this case, reductions are usually not performed due to the fact that this could impair sensation. However, since the sensation of the clitoris comes from within the deeper tissue, there are no restrictions on sensation.

4. Frayed wound edges
This is primarily due to a poor suture technique and the use of suture threads that are too thick.

5. Gaps
Surgical techniques, such as the wedge resection, often leave conspicuous scars; the wound edges are sometimes under so much tension that gaps may appear.

6. Pronounced asymmetry
As a general rule, the two labia should be the same length after the procedure. It is always very difficult to achieve exact geometrical symmetry as the labia may heal differently, even when precise measurements were made prior to the procedure. The results should, however, appear symmetrical in all cases.

7. Contour defects
If the excess tissue is not removed along a previously drawn line, but freehand without measurement or marking, the wound edges may turn out wavy, leading to a defect in the contours. Correction is not usually difficult.

8. Mixed picture
It is, of course, possible for the issues and findings mentioned above to occur in combination to varying degrees.

You can find images of these errors on our pictures page (after registering/requesting the password).

There should be two aims in this regard:

  • To resolve the issues
  • To achieve the original desired result

Generally speaking, frayed wound edges can be smoothed out, contour defects and gaps can be closed, and undercorrection can be revised. However, it is more difficult to replace tissue when too much has been removed.
Reconstruction is more complicated in the case of overcorrection or a microphallic deformity and a complete repair may not always be possible.

There are essentially two possibilities for restoring the labia minora:

  • Reconstruction using excess tissue above the clitoris
  • Reconstruction using vaginal skin
  1. This technique consists of freeing two longitudinal flaps lateral to the shaft of the clitoris and rotating them downwards to be inserted and fixed into the remaining labia minora tissue.
  2. If the previous approach is not possible, especially when there is no available excess tissue above the clitoris, the labia minora have to be reconstructed using vaginal skin.
    Skin grafts are not considered for reconstruction purposes as they are not sensitive and the appearance is less aesthetically pleasing.

Video surgical technique 1

Video surgical technique 2

As with any surgical procedure, a difficult healing process may have a negative effect on the expected result. It is important not to put the area under stress too soon after labia reduction as the wound may not heal properly and may cause visible changes. You should therefore follow your doctor’s instructions without fail and avoid any kind of friction, in particular sexual intercourse, for at least six weeks after the operation. The most important thing you can do is research and choose your surgeon with the greatest care as the majority of problems and the most severe complications arise as the result of a botched operation.

Unfortunately, it is much more difficult to achieve an optimal result if damage has been caused in a previous surgery.
However, the aim is to achieve your desired result and resolve any issues (pain etc.).

For more information on the ideal shape and the different techniques, please see the following:

Labia reduction

Here is some important medical information about the function and structure of the labia:

The small (inner) vaginal lips seal the vaginal opening and prevent infections from developing inside the vagina, and other conditions.

The large (outer) vaginal lips enclose the small vaginal lips and offer mechanical protection.

The clitoris is the only organ that purely serves the purpose of sexual stimulation

The labia cover and seal the vaginal opening, protecting the vagina from drying out and stopping foreign bodies and pathogens from making their way in. Additional mechanical protection is offered by the fat pads of the labia majora.

The labia minora extend from the mons pubis towards the anus, encompassing the clitoris and the vaginal opening. The part of the labia adjacent to the clitoris is also referred to as the “clitoral hood”. In terms of morphology, the labia minora are equivalent to the foreskin of the penis. They are of secondary importance for sexual stimulation.

The term clitoris is commonly used to refer to a small, pea-shaped anatomical structure located a little above the urethral opening. However, the clitoris is not spherical but rather band-like in shape, similar to a small penis, with only the tip (glans clitoris) protruding and being visible. Its shaft (corpus clitoris) extends in a deeper layer across the pubis and is thus not visible. The clitoris is responsible for sexual stimulation.

Labia reconstruction is performed under local anesthesia. It is important that you do not take any blood-thinning medications (e.g. aspirin, etc.) 14 days prior to the surgery. Please bring all relevant documents with you to the preliminary consultation, if possible including the surgical report from the initial operation, so that we can get a good idea of what exactly happened during the previous 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. Reconstructive surgery usually involves mobilizing and displacing tissue. That is why circulation is a primary concern. Please do not smoke! Cooling and compression as well as follow-up treatment are determined on an individual basis depending on your procedure and healing process.
Avoid mechanical friction as much as possible for eight 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 eight weeks following the procedure: no sexual intercourse, jogging, cycling, horse riding, etc.! Likewise, tampons may only be used again after this period of time.
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.
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:

(click for further information)

All important questions

 Costs for labia reconstruction


 Personal advice and information



 Laser or scalpel?

 Your contribution to the healing process





 Sexual intercourse

 How many appointments do I need?

 Traveling from afar


 Showering, water, soap


 Scar creams

 Sauna, sun bed



 Final result

 Sutures, stitches

 Simultaneous correction of labia minora and majora


Experience makes the difference

  • More than 6700 procedures in the female genital area
  • Over 20 years of experience
  • Inventor and developer of the “Composite Reduction Labiaplasty”
  • Internationally recognized top specialist
  • Author of the international textbook “Aesthetic and Functional Labiaplasty” (Springer Publishers)
  • Professor and Lecturer in Plastic Surgery

„Pioneer of female genital surgery“

„The Vagina Picasso“

„The labia pope of Germany“

In the most important national and international specialist societies

American Society of Plastic Surgeons

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen

International Confederation for Plastic, Reconstructive and Aesthetic Surgery

International Society of Aesthetic Plastic Surgery

Best Results

by specially developed, internationally leading surgical technique “Composite Reduction Labiaplasty”

Greatest Experience

With the most operations in
the female genital
area worldwide

Media Partner

First point of contact for international media for all questions relating to intimate surgery

The Aston Baker
Cutting Edge
Aesthetic Surgery

2018, New York

Faculty Member
The greatest honor for
a Plastic Surgeon

The internatioanl Textbook
written by Prof. Gress

Published in January 2018 by Springer Verlag, it has developed into an international bestseller and standard work in plastic surgery.