Labiaplasty at Gender Confirmation Center San Francisco

Medically reviewed by Jennifer Richman on July 8, 2025.

What Is Labiaplasty?

Labiaplasty is a surgical procedure that alters the size or shape of the labia (the folds of skin around the vaginal opening). The procedure is typically performed for either functional or aesthetic reasons, including addressing discomfort during physical activity or reshaping tissue to achieve a desired appearance.

The labia minora are the thinner inner folds that lie within the labia majora, which are the thicker outer folds. A labiaplasty may involve one or both types of tissue, depending on the patient’s goals and needs.

During labiaplasty, surgeons often work with existing labial tissue. For example, in cases where reconstruction is needed, tissue from the labia majora may be used to reconstruct the labia minora. In rare cases, skin grafts from areas such as the hips may be used.

Labiaplasty can be performed on both cisgender and transgender women. For transgender women, it may be part of gender-affirming bottom surgery, performed after or simultaneously with other surgeries like vaginoplasty or vulvaplasty. For cisgender women, labiaplasty is sometimes pursued to relieve irritation, improve comfort, or address changes due to aging, childbirth, or genetics.

At the Gender Confirmation Center (GCC), Dr. Zara Ley (she/her/they) only offers labiaplasty to transgender and non-binary patients that have already undergone a vaginoplasty or vulvaplasty.

Motives for Undergoing Labiaplasty

Patients seek labiaplasty for a variety of reasons, including refining the shape, size, or symmetry of the labia minora or majora, or addressing discomfort related to excess tissue. For transgender and transfeminine non-binary individuals, labiaplasty is often part of a staged surgical process to refine the appearance or function of the vulva after a patient has undergone a vaginoplasty or vulvaplasty.

At the GCC, labiaplasty is only offered to transgender and transfeminine non-binary patients who have already undergone a vaginoplasty or vulvaplasty. This approach ensures that the procedure is used as a secondary or refinement surgery that is personalized to each individual’s unique anatomy and goals.

Labiaplasty at the GCC is performed by Dr. Ley (she/her/they), a board-certified surgeon and a former patient herself. Her personal and professional experience allows her to approach care with empathy, specialized skill, and a patient-centered perspective

Labiaplasty after Vaginoplasty or Vulvaplasty

For many patients, labiaplasty is the second stage of a vaginoplasty or vulvaplasty, which is typically performed about five months after the initial bottom surgery. During this stage, the labia minora and clitoral hood are sculpted, mainly using skin grafts taken from the labia majora. This technique helps tighten any loose skin remaining from the initial surgery, improving the function and desired appearance of the vulva. Many patients decide on the two-stage process to minimize the risk of needing further revision surgeries in the future.

Functional Concerns

Both transgender and cisgender women may seek labiaplasty to address physical discomfort or improve hygiene. Common functional reasons include:

• Reconfigure the labia majora and minora: After a vulvaplasty or vaginoplasty, many patients are left only with labia majora. Other patients may have a labia minora and majora after surgery, but may have concerns about their configuration after healing.
• Reduce labia minora protrusion: When the labia minora extends longer than the labia majora, the excess tissue can twist, pinch, or tug, causing discomfort during activities such as cycling, jogging, or sex.
• Minimize irritation: Friction from tight clothing or repetitive movement can lead to chafing, soreness, or skin irritation.
• Improve hygiene: Excess tissue can make it more challenging to maintain hygiene in the area, potentially leading to issues like yeast infections, urinary tract infections (UTIs) or bacterial growth.

Aesthetic Concerns

Every vulva is unique, and not everyone has concerns about the appearance of their labia. However, for some individuals, personal concerns about how their vulva looks can affect their self-confidence, body image, or comfort during intimacy. Common aesthetic concerns include:

• One side of the labial area is larger or shaped differently than the other.
• Labia minora (inner lips) are larger than the labia majora (outer lips) or are visibly protruding.
• Uneven pigmentation or texture of labial tissue.

The Labiaplasty Procedure Explained

The First Step is scheduling a Surgical Consultation

Your journey begins with a surgical consultation with Dr. Ley (she/her/they), GCC’s board-certified surgeon, a trans woman of color, and a former patient herself. Dr. Ley brings both medical expertise and personal experience to every consultation, ensuring compassionate and affirming care. You can request an in-person or virtual consultation here. All consultations at the Gender Confirmation Center are completely free, even if you are seeking a revision after having surgery with another provider.

During your consultation, you and Dr. Ley will review your medical history, discuss informed consent, and develop a personalized surgical plan. It’s important to go into your consultation with realistic expectations for your desired surgical outcome.

This initial consultation is a crucial opportunity to ask questions, learn about the procedure, and explore how labiaplasty can help you feel more at home in your body.

The Day of Surgery

The day of your labiaplasty, you’ll check in at the surgical center or hospital for your scheduled procedure with Dr. Ley. You can expect:

• Undergoing Anesthesia: The surgery is performed under general anesthesia, meaning you’ll be completely asleep and won’t feel any pain during the procedure.
• Duration of Surgery: The length of the surgery can range from a couple of hours to several hours, depending on the type of labiaplasty and if any additional procedures are being performed simultaneously.
• Duration of Hospital Visit: Labiaplasty, when not combined with other longer procedures, is performed outpatient, meaning you will be discharged from the hospital or surgery center the same-day.

Surgical techniques:

In most cases, Dr. Ley uses skin grafts from the labia majora to construct or refine the labia minora. If further reconstruction is needed, additional grafts may be taken from the hip area.
The tissue can also be tightened, reduced, or reshaped to meet the desired goals. Additionally, a revision labiaplasty may involve both augmenting existing tissue and reshaping or reducing labial skin.

As previously mentioned, some patients choose to have labiaplasty performed alongside other procedures, such as adjustments to the clitoral hood, urethra, or clitoris, depending on their specific needs.

A labiaplasty is a same-day outpatient procedure, meaning you can go home after surgery. You must have a trusted loved one available to pick you up and stay with you during the initial recovery period.

Dr. Ley and her skilled team will strive to keep you informed and supported during the entire process, from the very first consultation through recovery.

Frequently Asked Questions about Labiaplasty

Does labiaplasty affect pleasure?

No. Undergoing a labiaplasty does not affect sexual sensation/pleasure. The procedure is focused on the labial tissue and does not involve the nerves that are critical to arousal or orgasm, such as those connected to the clitoris.

Will labiaplasty surgery leave scars?

Incisions made on the labia typically heal well, leaving little to no visible scarring over time. In the rare cases where skin grafts are taken from the hips, those donor sites may result in small, visible scars. For guidance on minimizing scarring and promoting proper healing, refer to our scar care instructions.

Why do patients undergo labiaplasty after vaginoplasty?

Patients often choose labiaplasty after vaginoplasty or vulvaplasty to:

• Refine the appearance of the labia minora or majora
• Improve symmetry or adjust asymmetries in the vulva.
• Address changes due to healing, scarring, or graft contraction.
• Enhance comfort or confidence with the appearance and feel of the vulva.

How long do I have to wait to get a labiaplasty after vaginoplasty or vulvaplasty?

Once the initial healing process is done, most patients are eligible for labiaplasty around 5 months after vulva construction. This timeline may vary depending on a patient’s individual healing process and surgical results, which will be determined during your consultation with Dr. Ley.

Costs of Labiaplasty

For cash-pay patients, labiaplasty costs between $8,500 and $10,000 USD. This estimate covers the surgeon’s fees but does not include anesthesia or facility fees, which may vary depending on the surgical setting.

If you have insurance, your out-of-pocket costs may be lower, depending on your insurance coverage and benefits.

At the GCC, all patients are required to pay their full financial contribution at least 6 weeks before their scheduled surgery date. We have a dedicated advocacy team (with a 90% success rate!) that assists patients in securing coverage from their insurance provider. You can learn more about that process here. We’re here to help you understand your options and get the care you need. Please don’t hesitate to contact our office for personalized support.

Insurance Coverage for Bottom Surgery

Many insurance providers will cover bottom surgery for transgender and non-binary patients when medically necessary or part of gender-affirming care.

To qualify for coverage, you may need to provide:

• A support letter from a licensed mental health professional with a diagnosis of gender dysphoria.
• Proof of at least 12 months of continuous hormone replacement therapy (HRT).

If the labiaplasty is part of a revision procedure(s) following an earlier bottom surgery, the documentation requirements may be different. In these cases, our advocacy team will aid you in the process.

Benefits and Risks of Labiaplasty

Risks and Complications

Surgical complications after labiaplasty are rare, especially when performed by an experienced, board-certified surgeon. Some side effects include: temporary bleeding, bruising, or swelling. These are a regular part of the healing process and typically resolve with time.

Choosing a skilled and experienced provider, such as Dr. Ley, can significantly reduce your risk of complications and help ensure a smooth recovery.

Possible risks and complications may include:

• Bleeding
• Bruising
• Infection
• Scarring
• Swelling
• Discomfort during sex

Our team will provide you with detailed aftercare instructions and remain available throughout your healing process to help you manage symptoms and identify any issues early.

Benefits of Labiaplasty

Labiaplasty can offer both physical and emotional benefits, especially for transgender and non-binary patients seeking revisions after bottom surgery. Benefits include:

• Improved body image and self-esteem
• Improved mental health
• Greater confidence during sex and intimacy
• Reduced gender dysphoria
• Decreased discomfort related to chafing, tight clothing, or physical activity

Benefits are most often seen in realistic expectations about what surgery can achieve. Here at the GCC, Dr. Ley will work with you to create a personalized plan that aligns with your goals and helps you feel more at home in your body.

What Recovery Looks Like

After your labiaplasty, Dr. Ley will provide you with detailed recovery instructions. Here’s what to expect during the healing process:

• Pain management: You may be prescribed pain medication or advised to use over-the-counter medicine. Do not drive or operate heavy machinery while taking prescription pain meds.
• Bleeding: Light bleeding or spotting is normal for the first week after surgery.
• Swelling and discomfort: These are expected and typically improve over the recovery period.
• Final results: Due to swelling and healing of incisions, the final results of your surgery may take 4 to 6 months to become visible.

If you have any concerns during recovery, please do not hesitate to contact your surgeon.

Signs to Watch During Recovery

Urgent Medical Concerns

Contact your care team immediately if you experience any of the following symptoms:

• Surgical dressings soaked with large amounts of blood (which may indicate excessive bleeding).
• Pain that does not improve with prescribed or over-the-counter medications.
• Inability to keep fluids down or persistent vomiting.
• Unusual swelling or pain in your groin or lower leg or new onset shortness of breath (this could be a sign of blood clots).

If, at any point during your recovery, you experience sudden shortness of breath, chest pain, lightheadedness, dizziness, or tender, swollen legs, call 911 immediately. These could be signs of a rare but serious medical emergency requiring urgent care.

Postoperative Depression

After a labiaplasty or other bottom surgeries, patients may experience temporary postoperative depression. Factors like having to take time away from work, exercise, and intimacy in addition to anticipating what your final results will look like once swelling and healing are complete, can lead to feelings of anxiety and/or low moods. These feelings are usually temporary and part of the body and mind adjusting to surgery. You can read more about the emotional recovery from surgery here.

Additional Procedures

Patients undergoing labiaplasty may choose to combine it with other bottom surgery revision procedures to refine their results further. Some common revision options include:

• Vaginal Widening/Deepening: Some patients may experience reduced depth or width of the vaginal canal after vaginoplasty. During a vaginal widening/deepening procedure, the surgeon may use skin grafts that can help improve width and depth.
• Labiaplasty Revision: The labia minora may lose definition during the healing process. The revision labiaplasty surgery often involves using additional skin grafts to augment the existing labia minora.
• Clitoral/Clitoral Hood revision: Refining the size, shape, or positioning of the clitoris and/or clitoral hood.
• Scar Revision: Some patients may be unsatisfied with the look of their surgery scars. The surgeon can create new scars, giving patients the opportunity to carry out proper scar care or try new treatment options to reduce their size, texture and discoloration.
• Release of the Posterior Vaginal Web: A revision surgery that removes skin that builds up and covers the vaginal entrance.
• Urethral revision: Correcting issues related to urethral positioning or function that can arise after initial surgery.

Ask your surgeon during your consultation if you would like to include any of these as a part of your individualized surgical plan.