Nymphoplasty: surgery on the inner labia
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Nymphoplasty is the medical term for an operation which involves reducing the inner labia. Frequent in Asia, this procedure remains a thorny issue in France.
Half-hearted requests
Hypertrophy of the inner labia can be congenital (from birth) but more often, this over-development in the body occurs during puberty and is made worse by giving birth. On the other hand, after menopause, inner labia tend to become atrophied and are obscured by the outer labia.
Note on Anatomy
The vulva displays parts which are visible like the mons veneris and the outer labia but also has hidden parts like the inner labia (or nymphae), the vulval vestibule where the urethral opening is situated, the vagina and the clitoris. In contrast with the outer labia, the inner labia are not covered with hair but they do contain many sebaceous follicles and very sensitive nerve endings. They connect together at the top and in front to form the clitoral hood and frenulum clitoridis, but do not necessarily join at the base. Varying in size, they measure at least 3cm long. Their external edges surface and protrude beyond the vulvar slit.
But the requests for the procedure often come from young girls, who have not had children and who are “affected not only aesthetically but physically, through difficulties involving pain during sex, when practicing certain sports (cycling, horse-riding) or because of wearing too tight clothes”, explains Dr. Laurent Benabida, a plastic surgeon.1
In fact, exchanges in online forums show that certain changes in clothing (trend for tight jeans, thongs...) and the influence of porn films in which stars display juvenile pubic areas have caused a rise in requests for nymphoplasty.
V-shaped nymphae
The goal here is to reduce the inner labia by taking away the excess submucous tissue. Lasting at least 45 minutes, this operation can be carried out under local anaesthesia, but this is a very sensitive area of the body and the woman is therefore obliged to stay in the gynaecological position. This is the widely preferred option in the United States, but in France, patients opt for general anaesthetic. The procedure is completed in the day and does not require a night in hospital.2.
The initial technique involved removing a crescent shape from the surface of the skin. In this case, total amputation of the inner labia (nymphectomy) is possible. But the large resulting scar comes into direct contact with underwear (and there is therefore a higher risk of infection, hematoma and painful post-operative complications...) so a different technique is general preferred instead; central or upper resection in a “V”3 or even two resections in a “V” of the external parts (a VV technique). This means the scar is in the lesser exposed areas and therefore allows sexual relations to begin again sooner.
The post-operative effects generally require straightforward painkillers (paracetemol based) to sooth the stinging sensations, daily localised treatments to apply until the resorbable stitches fall out, and also means sex must take a back seat for four to six weeks. During this period, tampon use is forbidden.
Be careful, however, as the post-operative complications are not insignificant, even if they are very rare.2 These include: stitches coming undone due to injury, slow healing, localised infection, hematoma and even pain during penetrative sex or changes in sensitivity in the intimate area. The two latter are thankfully mostly transitory. When confronted with these risks, it is preferable to talk to a doctor who is familiar with this kind of operation.
A controversial surgical procedure
Certain doctors and sex therapists are worried about the increasing demand for these operations. According to the experts, the dictated aesthetic norms (mainly pedalled by porn films) lead to complexes which shouldn’t be there. Some sex therapists think that the reduction of these regions of the body where many sensory nerves are located is risky in terms of feeling, and they recommend that the technique should only be used for women for whom the size of their inner labia causes physical problems, affecting walking and therefore having an impact on everyday life.
1 - Gyn Obs.n°505-506- August-September 2006
2 - Am J Obstet Gynecol.2000 Jan ;182(1 Pt1) :35-40
3 - Plast Reconstr Surg. 2000 Jan;105(1):419-22; discussion 423-4
4 - Plast Reconstr Surg. 2006 Oct;118(5):1237-47; discussion 1248-50.
David Bême
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Cosmetic surgery: don't ignore the risks
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