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Prof. asoc. Dr. Stefan Gress

Labiaplasty / Labia Reduction

Professor Gress is one of the
top specialists in female intimate surgery internationally


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Being unsure about the procedure

How is the procedure performed?

After the surgery

My success

Risks and complications

All important information

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.)

For many women, the anatomic variations of their genitals can be a source of significant suffering. Hormonal influences, weak tissue, genetic factors, or age-related changes may cause these deviations in shape. Large labia minora and sagging labia majora are found to be particularly distressing.

Functional problems, such as pain when wearing tight-fitting clothing, playing sports (horse riding, jogging, cycling), invagination of the labia minora during sexual intercourse, and hygiene issues, can motivate women to opt for surgical correction. Another reason to undergo a genital correction procedure is psychological distress, which can be significant in some patients, caused by restrictions on the patient’s sex life.

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 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.

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.

Beautiful labia minora that are not too long and are completely covered by firm,
well-shaped labia majora, resembling the shape of a closed shell.
The “ideal look” of the labia minora.

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 procedure is typically performed under local anesthesia; however, analgosedation (twilight sedation) or general anesthesia are also available on request. Prior to surgery, we will sit down with you to decide on every detail of the changes you desire. This involves us taking exact measurements to determine how much skin and tissue needs to be removed to achieve a perfect result that is as symmetrical as possible.

To make the necessary incisions, we use a radiofrequency surgical device (similar to a laser scalpel) to enable very precise and tissue-conserving surgery with minimal bleeding. This results in a markedly improved and significantly accelerated healing process. The edges of the incision wound are closed carefully with fine, absorbable sutures.

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.
There 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.

We differentiate between four techniques used for the reduction of the labia minora, depending on the examination findings and the starting situation:

  • Reduction of the labia minora in all three sections
  • Correction of the clitoral position in case of a bulging clitoris (clitoral protrusion)
  • Additional upward tightening of the clitoral hood

The excess tissue in the areas highlighted in orange is removed. Clitoral protrusion is corrected by lowering the protruding clitoral glans. To tighten the clitoral hood, both skin flaps are tightened downwards and the clitoral hood is tightened upwards.

  • Reduction of the labia minora in all three sections
  • Correction of the clitoral position in case of a bulging clitoris (clitoral protrusion)

This technique is almost identical to the variant described above. In this case, however, no skin area is removed above the clitoris

  • Reduction of the labia minora in all three sections

Removal of the excess tissue (highlighted in orange). Unlike the procedures described above, only a downward tightening of the clitoral hood is performed; there is no correction of the clitoral position and no additional upward tightening of the clitoral hood. Two triangles of skin are removed from the sides to prevent engorgement of the tissue that would otherwise develop as the flaps are pulled downwards.

This procedure should only be considered in cases involving isolated enlargement of the labia minora limited to the part below the clitoris. However, these cases are rare.

Excess tissue highlighted in red is removed.

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:

(click for further information)

Frequently asked questions about labia reduction

 How many appointments do I need?

 Traveling from afar



 Sexual intercourse

 Showering, water, soap


 Scar creams

 Sauna, sun bed







 Your contribution to the healing process

  Laser or scalpel?

 Final result

 Sutures, stitches

 Simultaneous correction of labia minora and majora


 Costs and operating time



 Individual information

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

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

The Aston Baker
Cutting Edge
Aesthetic Surgery

2018, New York

Faculty Member
The greatest honor for
a Plastic Surgeon

The international 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.