Internationally renowned
Top Specialist
★★★★★
Prof. asoc. Dr. Stefan Gress
Plastic & Aesthetic Surgeon
Sculpting
of the Labia Majora
In childhood and adolescence, the labia majora are tight and of an almost firm consistency. However, as we age, the fatty tissue in the labia majora decreases, giving them less volume. The skin stretches and loses its elasticity, hanging down loosely. The aging process in the genital area is most clearly visible when it comes to the changes to the labia majora. The good news? This problem is easy to correct.
Everything important at a glance
Sculpting of the Labia Majora
Duration of surgery
1.5 – 2.5 hours
Combination dates possible
1st day consultation, 2nd day surgery, 3rd day aftercare
Anesthesia
Local anesthesia
Surgery
Outpatient in the practice’s operating room
Preparation before surgery
Complete intimate shaving, taking antibiotics and painkillers
Follow-up treatment
Local cooling, compresses insoles, wearing tight underpants for 14 days, own pressure treatment after 14 days for 4 weeks (not for autologous fat injections)
Convalescence period
Take it easy for approx. 1 week after the procedure, no sport (cycling, jogging, horse riding etc.) for 6 weeks, no sexual intercourse and no use of tampons
Costs
2,900 – 4,300 euros
Before/After Pictures
for Labia Reduction, Labia Correction and Labia Revision
Important information
Sculpting of the Labia Majora
Why?
In most cases, the decision to undergo labia majora sculpting can be attributed to a combination of physical and psychological issues:
Functional reasons
Loss of protective function, exposed vaginal opening with frequent inflammation
Aesthetic reasons
Hesitation to get naked, negative impact on sex life, etc.
Function and anatomy
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.
Result, shape and appearance
Firm and tight labia majora enclose the labia minora and resemble a closed shell.
The labia minora are completely covered by firm, well-shaped labia majora, similar to the shape of a closed shell.
Fat or hyaluronic acid?
Hyaluronic acid is a gel that is usually used to treat wrinkles. It is sometimes injected into the labia majora to give them more volume. From our perspective, this is prohibited.
Hyaluronic acid encapsulates itself, clumps together, and can leave permanent hard, scarred nodules. What’s more, only a little volume is necessary in most cases to get a visible result. This is comparatively more expensive.
Autologous fatty tissue is the only suitable filler that is available free of charge and does not cause any reactions to foreign bodies. Even though some of the transplanted fatty tissue will deplete again, around 40-50% of it does, however, heal permanently. When overcorrecting, the desired volume can be achieved then and there in the first procedure. Sometimes it can be necessary to repeat the procedure. On average, around 20 ml fatty tissue is required on each side to sculpt and boost volume.
Getting there
The ideal treatment for you will be determined following a physical examination as part of your consultation at our practice.
Before the 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.
The procedure is usually performed under local anesthesia, meaning no special preparation is required (if it is being performed under general anesthesia or twilight sedation, you should fast, i.e. refraining from eating, drinking, and smoking, for six hours prior to your surgery).
The result
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. 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 minora 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.
How it works
Je nachdem, ob die Haut der äußeren Schamlippen erschlafft ist und ein Hautüberschuss besteht oder ob das Volumen (Fett) der äußeren Schamlippen mit den Jahren abgenommen hat, bestehen 3 Möglichkeiten der Korrektur:
1. Tightening the labia majora by removing excess saggy skin
2. Filling the labia majora with autologous fatty tissue (lipostructure)
3. A combination of both approaches
1. Tightening/reduction
This involves the removal of excess skin by making a spindle-shaped incision along the line of reflection through to the labia minora. The labia majora are tightened/reduced by closing the wound edges. This procedure can easily be performed under local anesthesia.
2. Filling with autologous fat
Autologous fat gives the labia majora volume and consistency. The fat is usually removed from the outer thigh under local anesthesia, specially prepared, and then injected into the labia majora all in one procedure.
This procedure is perfect if you are looking to shape and fill the volume of the labia majora. We generally add more volume than is actually necessary as our experience has shown us that some of the transplanted fatty tissue will deplete again. However, the part of the autologous fat that is connected to the vascular and blood supply (approx. 50-60%) is permanently preserved.
FAQ / Questions and Answers
How many appointments do I need?
For outpatient operations, you will need a total of three appointments:
consultation/preliminary examination, surgery, and a follow-up examination the morning after the operation. The consultation and surgical procedure may not take place on the same day. There has to be an interval of at least 24 hours between the initial consultation and the surgery itself.
After the operation, you should spend the night in Munich. We will be glad to help you find a suitable hotel.
Personal advice and information
You can request further information or arrange an appointment here. This is non-binding and free of charge. Call +49 (0)89 24 22 39 22 for advice on your own surgical needs. This personal advice service is non-binding and free of charge.
Risks
Risks and potential complications
Volume replenishment with autologous fatty tissue is usually overcorrected as some of the transplanted fat will deplete again. To what extent, however, cannot be predicted. In some cases, some fat will need to be injected again after six months.
After the procedure, there will be some swelling which will generally start to subside gradually after the first or second day. Around 80% of the swelling will subside within the first six weeks after surgery; the remaining swelling takes comparatively longer to disappear, in some cases up to six months. You may experience minor bruising. You can help prevent this by wearing firm-fitting underwear immediately after the procedure to apply some pressure to the area.
Varying levels of pain can also be expected, especially during the first night after surgery. You should, however, be able to tolerate this quite well if you take the pain medication prescribed by us.
Wound healing may be disturbed, especially if the area is exposed to excessive forces too early. It is therefore crucial that you avoid any kind of strong friction (e.g. sexual intercourse) during the first six weeks after surgery. Likewise, you should not use tampons during this period.
Once the wound has healed, scars in the genital area are usually very inconspicuous and hardly noticeable, even on close inspection. Theoretically, scars can develop to become thick, reddened, or painful. However, this has so far not been observed in the genital area. Special ointments would help in this case. To promote good scar healing, you should squeeze the scars between your fingers two weeks after surgery. We will show you exactly how to do this at our practice.
Sensory disturbances are not to be expected. You may experience some numbness or sensitivity to touch in the beginning, but this will disappear once the wound has fully healed.
Postoperative bleeding, asymmetries, wound infections, etc. are very rare.
Laser or scalpel?
Laser or scalpel?
We perform the procedure using a radiofrequency surgical device. Similar to a laser, the tissue is cut using thermal energy; however, the tissue is separated through contact between the wire and the skin, instead of a light beam. The advantage is that any trembling of the hand is not transferred to the incision line, as is the case with a laser. It is virtually impossible to perform this procedure using a scalpel as a precise incision line cannot be achieved, given the looseness of the tissue.
Your contribution to the healing process
What can I do to promote healing?
Take the medications as prescribed by us. You will be given a painkiller that reduces swelling plus an antibiotic. Please avoid any kind of friction for at least six weeks after surgery! To aid the healing process, place a compress between the labia during the first two weeks after surgery so that they do not touch.
Working
When will I be able to return to work?
You can return to work after just two days. You should find a sitting position that is comfortable for you. Should your work involve a lot walking, allow at least three days for recovery.
Shaving
When can I start shaving again?
Please completely shave your genital area before the procedure. After surgery, you should not shave or wax, etc. the area for six weeks.
Periods
Can the procedure be performed during menstruation?
Having your period on the day of surgery does not constitute a problem.
Pain
We will issue you with a prescription for two effective painkillers to treat your pain. These should prove sufficient. Patients generally experience mild burning and varying levels of pain the first night after labia reduction/labiaplasty. This tends to be much better or has disappeared completely by the following day.
Sexual intercourse
When can I resume sex?
Sexual intercourse is to be strictly avoided during the first six weeks after surgery as the significant friction would open up the wound edges again. As long as the sutures do not get in the way, you can have oral sex again four weeks after surgery. If you are only undergoing volume replenishment of the labia majora with autologous fatty tissue, sexual intercourse is permitted after just two weeks.
Traveling from afar
We offer to accommodate consultation and surgery in one stay for patients who have a long journey to get to Munich. This would involve arriving the day before surgery for a consultation and physical examination with Prof. Gress. The procedure is performed the next day and the follow-up examination is carried out the day after. You would therefore need to spend two nights in Munich.
Sport
When can I resume sporting activities?
It is extremely important that you avoid any strong friction in the genital area for at least six weeks to support the healing process. Sexual intercourse, horse riding, jogging, cycling, etc. are prohibited during this time! We recommend that you use a cross trainer or stepper if you would like to exercise during this period, as the leg position is somewhat wider, meaning there is no friction.
Showering, water, soap
What intimate hygiene is best for me after surgery?
You can take a shower after two days, but may only use clear water for one week. Please only use pH-neutral products. Do not take a bath as this would soften the wound edges! We only use absorbable sutures. Unpleasant itching may be experienced along with suture absorption. We recommend that you use Bepanthen ointment or pure Aloe Vera gel to alleviate this symptom.
Swimming
When can I resume swimming?
You should avoid chlorine-treated water in public swimming pools for six weeks. You are allowed to swim again in lakes or the sea after four weeks.
Scar creams
Are scar creams recommended?
Since scars in the genital area generally tend to heal very well, these are usually not necessary.
Sauna, sun bed
When can I be in the sun or use a sun bed again?
Sun and UV rays have a negative impact on scar healing. Please ensure that the area is protected from them for a period of six months.
Childbirth
Does labia reduction have an impact on giving birth?
No. If you become pregnant after the procedure, you can give birth naturally. The surgery does not affect the process of giving birth, and conversely, giving birth has no negative impact of the result achieved with the procedure.
Clothing
What kind of clothing is advisable?
On the day of surgery, please bring along firm-fitting underwear to wear after the procedure to apply some pressure to 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.
Final result
When will I be able to see the final result of the labiaplasty?
Around 80% of the swelling will have subsided within six weeks or so. The rest of the swelling is barely visible but will disappear relatively slowly and it may be up to six months before it has subsided completely. After this, there will be no further changes and the end result will be achieved.
Sutures, stitches
The stitches are made of absorbable sutures and do not need to be removed. They can, however, start to itch after a few days. If this happens, you can apply a sterile ointment (e.g. Bepanthen) to the wound to relieve the itching or have the sutures removed from 12 days after the labiaplasty (by us or by your gynecologist or family doctor).
Simultaneous correction of labia minora and majora
It is not possible to perform a reduction of both the labia minora and majora in one single surgery. The healing process is extremely complicated which would have a negative impact on the result. There should be an interval of around six months between each procedure.
A reduction of the labia minora can, however, be combined with a procedure to fill the labia majora with autologous fatty tissue (lipostructure).
Costs for sculpting of labia majora
The costs for labia surgery depend on the type and duration of the procedure and range between EUR 2,900 and EUR 6,200 Euro; fees for complex reconstructions are somewhat higher.
If the procedure is being performed under twilight sedation or general anesthesia, the anesthetist fees are charged in addition to the usual cost of the surgery.
- Reduction/tightening of the labia majora, approx. 2.0 hours operating time EUR 4,300
- Filling (Lipostructure) of the labia majora, approx. 1.5 hours operating time EUR 2,900
- Reduction/tightening/filling of the labia majora, approx. 2.5 hours operating time EUR 6,200
If the procedure is being performed for cosmetic reasons alone, VAT of 19% is applied to the costs, in accordance with German law. If the main reason for the operation is due to medical impairments, e.g. pain during sexual intercourse or playing sport, a deflected urinary stream, skin irritation, or frequent bladder or fungal infections, VAT is not applicable. Before the day of the surgery, you need to provide confirmation from your gynecologist that there is a medical indication for surgery. A brief written confirmation that the reduction of the labia minora is being performed for medical reasons is sufficient.
The fee for the operation must be settled before the day of the surgery. A deposit of EUR 500 is required to secure an appointment for surgery Operating time and costs.
Insurance
Absorption of costs by health insurance companies
Statutory health insurance providers shall only bear the costs, if at all, in accordance with their rates and after examination by the medical service. We do not work in partnership with any of the statutory insurance companies.
Private insurance companies, on the other hand, are less restrictive and cover part or all of the costs if there is a medical indication. A medical indication exists if the patient is experiencing functional impairments, such as pain during sexual intercourse, playing sports, wearing tight clothing, hygiene problems with skin irritations, etc. Physical impairments can also represent an indication for surgery.
It is advisable to inquire in advance with your insurance company whether or to what extent the procedure is covered.
Financing
Please understand that we are unable to provide any financing ourselves. However, MEDIPAY has been our reliable partner on this matter for many years now. You can find all the relevant information on our information page or by visiting www.medipay.de.
„Pioneer of female genital surgery“
„The labia pope of Germany“
„The Vagina Picasso
Google Rating
★★★★★
From a technical point of view, I have to admit that Doctor Gress works wonders. I had little hope, but he manages to reconstruct everything and I can now feel safe and pain-free.
Google Rating
★★★★★
…I had a vaginal tightening and I must say this man has solved all the problems I had. I no longer have urinary incontinence and everything is perfect! I also had a labia reduction and I can only say: PERFECT! This man really is an artist! …More
Jameda Review
★★★★★
I know that Dr. Gress is a luminary in his field and my very high expectations were met one hundred percent. I can recommend him and his incredibly friendly team without reservation!
Jameda Review
★★★★★
I would like to thank Prof. Gress for his great work. He did such a great job that you can’t believe it. One wonders the whole time how he did it? …More
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Over 12,500 operations in total
★★★★★
Over 7,500 operations in the female genital area
★★★★★
Over 30 years of experience
★★★★★
Scientific Frontrunner
Inventor of the
Composite Reduction Labiaplasty
This publication by Prof. Gress in the Journal of Aesthetic Plastic Surgery describes the world’s most renowned technique for labiaplasty. It not only reduces the labia minora below the clitoris, but also in the area of the clitoris and above. It also corrects a protruding clitoris (clitoral protrusion). This is the perfect technique if the outer labia are to completely enclose or cover the inner labia.
While the reduction of the labia minora was still considered rather unusual a few years ago, it is now part of the on the homepages of most plastic surgeons and an increasing number of gynecologists. gynecologists…
★★★★★
Textbook author and teacher
of female genital surgery and intimate surgery
Standard
International
Bestseller
★★★★★
International textbook by Prof. Gress Intimate genital surgery, especially for techniques to reduce the labia minora, to reconstruct the labia minora and for labia revision and to reduce the labia majora and for shaping the mons veneris.
★★★★★
Specialist for
Labia Reconstruction and Revision, Labia Reduction, Labia Correction, Vaginal Tightening
This publication by Prof. Gress entitled “Labia Minora Repair” in the Journal of Aesthetic Plastic Surgery, describes the possibilities of reconstructing the labia minora after botched previous operations. The correction is described in particular detail when the labia minora below the clitoris have been excessively shortend and the clitoris protrudes too far (small penis deformity).
The demand for surgical procedures to treat the external female genital area, in particular labia reduction and labiaplasty has increased significantly in recent years…
Well known
from the media
Professor
of Plastic Surgery
Prof. Gress is a member of numerous professional societies.
It goes without saying that Prof. Gress actively participates in the most renowned specialist congresses worldwide and organizes and conducts his own teaching events and lectures, in particular to ensure the highest international standards for surgical and treatment techniques, the »State of the art«.
Memberships
Professor Gress is a member in the most important national and international specialist societies.
ASPS
American Society of Plastic Surgeons
DGPRÄC
Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen
ISAPS
International Society of Aesthetic Plastic Surgery
IPRAS
International Confederation for Plastic, Reconstructive and Aesthetic Surgery