Scroll Instagram or TikTok and you'll find countless people documenting their breast augmentations, facelifts, and nose jobs. They post before-and-after photos, their recovery journeys, and surgeon recommendations, and the comments are usually flooded with encouragement and hand-clapping emojis (as they should be).

Labiaplasty doesn't get the same treatment. Despite the growing number of patients who have the procedure each year, it’s still rarely discussed openly. Instead, it's often reduced to the phrase "designer vagina"—a catchy term that can make the procedure sound superficial, frivolous, and purely aesthetic. It’s not. I know because a few months ago, I had one.

What Is a “Designer Vagina,” AKA, Labiaplasty?

The term “designer vagina” was coined around the 2000s as a marketing phrase to categorize female genital cosmetic procedures. However, the zippy nickname is quite inaccurate: Labiaplasty doesn’t actually involve the vagina at all. In the simplest of terms, labiaplasty is a surgical procedure that alters the labia minora, the inner folds of skin surrounding the vaginal opening, typically by reducing their size or reshaping them to improve comfort or symmetry, says Dr. Courtenay Poucher, MD, a board-certified ob-gyn based in Santa Clarita, California and founder of the Labiaplasty Center of Los Angeles. Dr. Gary J. Alter, MD, a board-certified plastic surgeon in New York and Los Angeles who has specialized in labiaplasty for decades, says that while the term “designer vagina” can technically refer to procedures involving the labia majora (like a labia majoraplasty or a “labia puff”), it’s most commonly associated with labiaplasty.

While labiaplasty is often categorized as a cosmetic surgery, that classification doesn’t fully reflect why many women seek it out. “Over 90% of the patients in my practice who seek out labiaplasty are experiencing physical or significant emotional discomfort,” Dr. Poucher explains. The emotional discomfort is a result of feeling self-conscious about the appearance, and the physical is typically the result of excess tissue that's more susceptible to everyday irritation. While the outcome may also be a welcome aesthetic change, the motivation is often functional—relief from discomfort during movement, chafing during exercise, pinching in clothing, pain with intimacy, and recurrent infections.

What surprised me most during my research was how many people undergo this procedure. Labiaplasty hasn’t benefited from the growing transparency around plastic surgery, so it’s easy for a patient to feel like they’re alone in pursuing it. But according to the most recent available data from the American Society of Plastic Surgeons, more than 10,800 labiaplasties were performed in the United States in 2024. And while the surgery is still nowhere near as common as procedures like breast augmentation (over 306,000) or rhinoplasty (over 48,000), demand has been growing steadily. The ASPS only started including labiaplasty in its annual report in 2016. That year, the group noted that, in 2015, 9,138 labiaplasties had been performed in the U.S. by licensed surgeons. That comes out to about an 18% increase over the past decade.

There isn't one "typical" labiaplasty patient. A recent analysis of published scientific literature on labiaplasty found that the average age of patients in those studies was around 29, but ages ranged from as young as 10 and up to 72. The most commonly reported reasons for pursuing the procedure were dissatisfaction with appearance, discomfort in clothing, pain during sports and exercise, discomfort during intimacy, hygiene concerns, recurrent infections, and sexual dysfunction. For some patients, these are issues that arise for the first time after childbirth, weight loss, hormonal changes, or as natural changes that occur with aging. Others, like me, have experienced them for as long as they can remember.

In either scenario, many women assume this is something they just have to deal with. Dr. Poucher says that many patients don’t know the procedure is even an option, and often spend years living with symptoms before learning a treatment exists. (That was definitely true for me.)

Part of that delay comes down to the way we talk, or don't talk, about women's intimate health. "While procedures on breasts or noses are visible, widely discussed and normalized, the vulva remains a private and often stigmatized part of the body," says Dr. Poucher. That silence has real consequences for patients like me who don't realize their everyday pain could be treated.

Why I Got a Labiaplasty

I’ve played sports at a high level for most of my life. Track and soccer specifically, which meant a lot of running and daily movement. And for as long as I can remember, there was always something that didn’t feel right.

What started as friction and pulling during practices became something I experienced across many parts of my life. Running was the most obvious trigger, but long walks, certain pilates classes, tight workout clothes, bathing suits, anything that involved movement or compression made the discomfort worse. The discomfort was consistent, and it didn’t go away once I stopped playing sports competitively. It followed me into adulthood and showed up throughout my daily routine. At a certain point, I also started noticing a pattern of frequent UTIs, something I didn’t initially connect to my longtime discomfort, but now understand can be related.

According to Dr. Poucher, these symptoms are more common than most people realize—and are often under-discussed. “Common complaints include chafing or even bleeding during physical activity like jogging, pinching in clothing, and frequent adjusting,” she says. Dr. Poucher also explains that recurring irritation can sometimes contribute to frequent infections, including UTIs, because extra labial tissue naturally creates more surface area where bacteria can collect near the urethra.

In her experience, nearly all patients seeking labiaplasty are dealing with some form of physical discomfort tied to their anatomy. According to Dr. Poucher, this happens when excess labial tissue extends beyond the natural protective barrier of the outer labia, leaving it more exposed to friction and physical pain. For me, for a long time, it wasn’t something I questioned, or ever considered talking to a doctor about; it was just something I dealt with.

We’ve made important progress in normalizing that labia come in an enormous range of shapes and sizes—and they do (hello, labia library). If your labia minora isn’t neatly tucked away inside your labia majora, that does not automatically mean you need a labiaplasty. But it’s also okay to acknowledge when a completely anatomically normal part of your body is causing you real physical discomfort. There was nothing “wrong” with my anatomy, but it caused me years of pain.

When I did finally become aware of labiaplasty, it wasn’t through medical sources but, of all places, reality TV. When Jessi Draper of The Secret Lives of Mormon Wives and Molly O’Connell from Southern Charm both spoke about having the procedure, it caught my attention: they were among the first people I heard talk openly about the issues I’d been dealing with for years.

I was inspired to start doing my own research and was disappointed with what I initially discovered. On one end, there were highly technical medical explanations that didn’t reflect what the discomfort that warrants the procedure feels like in real life. On the other hand, there were conversations about how porn and social media were making young women feel bad about their labia, and therefore being “influenced” into getting the procedure, even if their anatomy wasn’t causing discomfort.

What I didn’t find was a judgement-free, straightforward explanation of what the procedure actually involves—how it’s performed, what it changes anatomically, and why someone would choose to do it in the first place. That led me to online forums, Reddit specifically, where I read firsthand accounts from women describing the exact same discomfort I had been dealing with. At one point, my browser history was almost exclusively labiaplasty forums. If anyone had looked over my shoulder during that time, there would have been a lot of questions. C’est la vie, or yolo, or whatever the kids say now. For the first time ever, the pain I’d been dealing with felt less like a me problem and more like something that was actually quite common, just rarely talked about, especially when it came to solutions.

The Potential Risks

Labiaplasty remains an ever-evolving area of medicine. There isn't universal agreement within the medical community about the safety of the procedure, or how patients should be counseled on it. Despite the growing popularity of the surgery, there remains a limited amount of high-quality published research on its long-term safety, effectiveness, and marked benefits.

The American College of Obstetricians and Gynecologists’ (ACOG) most recent guidance on Elective Female Genital Cosmetic Surgery, first published in 2020, reflects that uncertainty. “ Lack of published studies and standardized nomenclature related to female genital cosmetic surgical procedures and their outcomes translates to a lack of clear information on incidence and prevalence and limited data on risks and benefits," the statement reads. The organization goes on to recommend that physicians carefully counsel patients on the risks and limitations of the available evidence, noting that many claims surrounding cosmetic improvement, sexual function, and overall well-being have not been supported by rigorous scientific evidence. There is also a recommendation that ob-gyns “have sufficient training to recognize women with sexual function disorders as well as those with depression, anxiety, and other psychiatric conditions," including body dysmorphic disorder. A spokesperson from the ACOG told me that this guideline was reaffirmed in 2026, as there has been no new evidence that warrants an update to their position.

Like any surgery, labiaplasty can have risks. For this particular procedure, that includes bleeding, infection, scarring, wound separation, changes in sensation, persistent pain, painful intercourse, dissatisfaction with cosmetic results, and the possibility of needing revision surgery.

The physicians I spoke with also flagged the lack of training opportunities for aspiring labiaplasty specialists. Dr. Alter told me that labiaplasty is generally not taught extensively during plastic surgery or gynecology residency, unless a physician trains directly under someone who specializes in the procedure, which he says is uncommon. “Detailed instruction on female anatomy and vulvar procedures has also not traditionally been part of formal medical education,” Dr. Poucher adds. Instead, many surgeons develop labiaplasty expertise through additional education, research, publications, conferences, and performing a high volume of cases. (I reached out to the American Society of Plastic Surgeons to ask how many surgeons currently specialize in labiaplasty, but did not receive a response.)

Dr. Umbareen Mahmood, a board-certified plastic and reconstructive surgeon in New York, shared something similar, explaining that while some residency programs now include labiaplasty training, many surgeons—particularly those who completed training years ago—developed their expertise through specialized education after residency.

But that lack of education doesn’t just apply to surgeons—it affects patients, like myself, too. Social media has become a massive resource of information about plastic surgery options…though the quality of that information can vary. "There's only so much educating you can do in a 30-second social media post," Dr. Poucher says. She told me that educational content about female anatomy is often flagged or restricted on social media, making it harder for physicians to share factual information. "Even when the goal is purely educational, you often have to tailor the content to avoid sensitive violations," she says. "That creates another barrier to getting accurate information into patients' hands."

This combination explained why researching labiaplasty felt so difficult. Without long-term research, standardized training, and accessible patient education, it’s incredibly difficult to understand not only what labiaplasty is, but ultimately decide if the procedure could be the right choice for you.

Choosing a Labiaplasty Surgeon

Emboldened by months of research, Reddit rabbit holes, and conversations with women who had undergone the procedure, I decided to seriously consider labiaplasty. I scheduled consultations with about six board-certified ob-gyns and plastic surgeons across a few major cities. (I arguably overdid it a bit here, but I would recommend speaking to as many providers as possible before making your final choice.)

Both board-certified ob-gyns and plastic surgeons perform labiaplasty, but because formal training in the procedure isn't standardized, every doctor I interviewed emphasized that a surgeon's experience and track record with labiaplasty mattered far more than their specialty alone.

I live in a major city where many reputable doctors list labiaplasty as a procedure they offer, but when I looked more closely at before-and-after photos, patient reviews, and actual experience, I felt like I found very few that are true experts at performing it. “You want someone who specializes in labiaplasty, not someone who ‘can do’ labiaplasty,” says Dr. Poucher. “I also recommend that you choose a board-certified doctor who is performing labiaplasty at least a few times a week—not a few times a month or year.”

“This is not simply removing tissue,” Dr. Amir Marashi, MD, a board-certified gynecologist based in New York says. “This is functional anatomy. The goal is preserving sensation, minimizing scarring, maintaining natural contours, and respecting how the tissue functions.”

As someone who’s gotten other cosmetic procedures in the past, the consultation process for my labiaplasty was also more involved than I expected. Four of the doctors I met with were men, which isn’t inherently a problem, but it did make me realize how important comfort would be when discussing something so personal. This wasn’t a formal “diagnosis” as much as an evaluation of my anatomy, symptoms, and goals. Some doctors asked for photos before the consultation so they could assess whether I was a candidate from an anatomical standpoint; others evaluated me in person. Across those conversations, I was asked about what I was experiencing day to day, where I felt discomfort, how long it had been going on for, and what I was hoping to change.

Those consultations also answered a lot of the practical questions I had about the procedure. I learned that labiaplasty typically costs anywhere from $5,000 to $50,000 or more, depending on your location and provider, the complexity of the procedure, and whether it's done in a private practice, surgical center, or hospital setting. Insurance rarely covers labiaplasty, even when the primary concern is prolonged physical discomfort. Dr. Poucher thinks this disconnect contributes to why so many women continue to suffer in silence. “The cultural conversation, in my opinion, should revolve around why we are so collectively comfortable with women's discomfort,” she says. That’s a much bigger conversation… for another day.

Revision surgery was another topic that came up repeatedly during my consultations. Multiple doctors I spoke with said that a meaningful portion of their labiaplasty practices involve correcting procedures performed elsewhere. “Over half of the labiaplasties I perform are done on women with previous botched labiaplasties,” says Dr. Alter. Dr. Marashi notes that many revision patients present with scarring, asymmetry, over-resection (where too much tissue was removed), or outcomes they never anticipated, like chronic pain, discomfort, or changes in sensation. Hearing that made me take the consultation process even more seriously. It also made me really feel for the patients who don’t live near a major city or have the resources to travel for multiple consultations.

Some doctors I consulted with described the procedure as relatively straightforward. Others flagged my case as more complex, which made me pause. When I later asked Dr. Poucher about that, she told me she didn’t find my case one that posed unique challenges, but added that perspective often comes down to experience. “If a surgeon stated the case was difficult, it may have been due to having less experience,” she says.

At my final consultation with Dr. Poucher, I came in with a long list of questions: what technique she uses, what recovery actually looks like, how my specific anatomy factored into the approach, and when I’d realistically be able to get back to things like working out, or having sex. We also talked through smaller, but very real considerations like flying after surgery, whether I could continue laser hair removal, and if treatments like red light therapy would help with healing.

One thing I appreciated was that the conversation wasn't just about whether I was technically a candidate for this procedure. Dr. Poucher and I spent time discussing my symptoms, lifestyle, what was bothering me day to day, and what I hoped would be different afterward. It felt super personalized.

Just as facelifts come in deep plane and SMAS, surgeons can use different techniques when performing a labiaplasty. Two of the most common are trim and wedge labiaplasty. In a trim labiaplasty, the outer edge of the labia minora is removed; in a wedge, a V-shaped section of tissue is removed and the labia minora is sewn back together. Dr. Alter, who developed the central wedge labiaplasty technique, told me that the wedge approach can provide more natural-looking results because it preserves the natural labial edge and avoids creating a scar along the entire rim of the labia. There isn’t a one-size-fits-all technique for every patient, and the approach should be based on anatomy, goals, tissue quality, and safety considerations.

For my case, Dr. Poucher recommended her proprietary technique, which she says is similar to a modified wedge and was chosen based on my anatomy, aesthetic preferences, labial shape, and hood skin insertion (where the clitoral hood naturally attaches to the labia minora). “This technique removes tension and provides natural results while maintaining the natural labial edge and avoiding nerve-dense areas,” she says. She also recommended a clitoral hood reduction, which removes excess tissue surrounding the clitoris and, in some patients, can improve comfort, sensation, and function, along with a small adjustment to the perineal skin to improve overall comfort and balance. By the end of that appointment, I felt more confident than I expected. The way she spoke about the procedure, something she performs multiple times a week and has for more than a decade, made it feel far less intimidating. I gave myself about a week to sit with it all, then called to book my procedure with Dr. Poucher for the following month.

My Labiaplasty Procedure

Going into the procedure, I was definitely nervous, but not panicked. It was more just the reality of what was about to happen setting in. A few rounds of meditation and Wim Hof breathing on the way to my appointment helped calm my nerves a bit.

When I arrived, everything moved pretty quickly. I changed into a gown, numbing cream was applied, and I was given a Valium (which was optional, but I didn’t even think twice, just took it down the hatch) to help take the edge off. That helped a lot. It didn’t make me feel out of it, just calmer and more relaxed. I had also taken a dose of antibiotics before leaving my house that morning, which Dr. Poucher prescribed for the day of surgery to help minimize the already low (under 1%) risk of infection.

The procedure is done under local anesthesia, so I was awake the entire time. Once the lidocaine injections were administered, I didn’t feel any pain, just some pressure and general awareness of what was happening. There was a TV mounted on the ceiling above me, so I watched Love Story while Dr. Poucher worked. The procedure took about three hours, and I kind of lost track of time (thank you, Paul Anthony Kelly as JFK Jr.). It was honestly over before I knew it. For something I had spent so much time researching and thinking about, the actual procedure was pretty uneventful—just a few hours of lying there, watching TV, and then it was done.

I was then put in period-style underwear, got dressed, and left with the full care kit that I would use for cleaning and swelling management, and instructions to ice multiple times a day for the first two weeks. Recovery would take about six weeks, with strict instructions to avoid sex, tampons, workouts involving leg separation, and soaking in baths, pools, oceans, or hot tubs. There was no hospital stay or extended monitoring required, just a fairly straightforward transition home to start the recovery process.

Dr. Poucher also sent me off with a sheet of paper with cartoon cats riding on a roller coaster, meant to show how up-and-down the recovery process can be—and it turned out to be pretty accurate. The first week was the hardest, mostly because of the swelling. It wasn’t necessarily painful, but it was uncomfortable, tight, sensitive, and swollen enough that I was aware of it.

I spent most of that time lying down, icing consistently, and trying to keep myself occupied without moving around too much. Most surgeons recommend taking about two to four days off work, but I took a full week. I probably could have gone back sooner, but I wanted to give my body the time and space to heal without feeling rushed. Dr. Poucher encouraged short, necessary walks around the house but recommended avoiding longer walks or unnecessary activity during that first week.

Recovery coincided with me conducting what can only be described as a comprehensive review of the full Erewhon smoothie menu, including the limited-edition flavors. I spent more money on blended organic fruit and artisanal nut milk that week than one ever should. But hey, it helped pass some time.

Mentally, this was also when I found myself overanalyzing everything. I was constantly checking my progress, questioning what I was seeing, and sending photos to Dr. Poucher through the secure portal with a steady stream of questions. Each time, she responded calmly, reassured me that everything looked normal, and told me to try not to check so often, especially in the two or three weeks when things are still settling. One thing Dr. Poucher also recommended was doing a few sessions in a hyperbaric oxygen chamber as soon as possible after the procedure. The idea is that increased oxygen delivery may help support the body's healing process. I ended up doing a few sessions in those early weeks, and while it's impossible to know exactly how much of my healing was attributable to that versus time, I personally felt like it helped with both swelling and overall discomfort.

By week two, things started to feel more manageable. I was still taking it easy, but I could leave the house for short walks around my neighborhood, run errands, even have a quick dinner with friends. I hadn’t told anyone in my life I was having the procedure done, and I didn’t feel the need to. Part of that was personal preference, but part of it was also a reflection of the stigma I'd spent months researching.

Around that time, I had my virtual follow-up with Dr. Poucher. I uploaded photos through the patient portal, she confirmed everything was healing normally, gave me the green light to start gently cleaning the area with a Q-tip (instead of just letting a foaming wash rinse over it), and told me I could ease up on the icing.

By week three, I felt mostly back to my normal routine, aside from the few restrictions I was still following. I wasn’t thinking about it constantly anymore, which was a big shift. Some days felt completely fine, and other days I’d notice more sensitivity or second-guess if everything was healing the way it should be. What kept me going through those early weeks was that even through the swelling, I could already tell certain things felt different. The constant pulling and awareness I had previously lived with wasn't showing up in the same way, which reassured me that I was moving in the right direction.

Most patients are cleared for full activity around six weeks, but healing continues well beyond that. According to Dr. Poucher, the body can continue settling for up to six months as residual swelling resolves, scar tissue softens and matures, and the final result becomes more fine-tuned. I was cleared to resume normal activity at my six-week in-person follow-up and, thankfully, had a very uncomplicated healing process overall.

How My Labiaplasty Results Feel Now

I’m now about four months post-op, and the biggest difference is how little I think about something that used to be a daily, even hourly, distraction in my life.

I’m not adjusting throughout the day. I’m not thinking about what I’m wearing or how something might feel once I start moving. I can go for a run, take a workout class, wear whatever I want, and move through my day without anticipating discomfort. The constant awareness that I had lived with for years is gone. Honestly, most days I don’t even remember that I ever had surgery.

This has been genuinely life-changing. I feel more comfortable in my body, more confident, and more at ease than I ever have. The physical discomfort that I spent years working around is gone, and so is the mental energy drain that came with it. I no longer plan around it, think about it, or worry about it.

For a long time, I assumed this was simply something I had to live with. Looking back, I wish I had known sooner that I didn't.

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