Labial reduction is a form of labiaplasty and refers to a surgical procedure to reduce the inner labia (labia minora) if they are perceived to be too long or too thick. The inner labia may be reduced in size or made more symmetrical for predominantly aesthetic reasons, which can enhance the wellbeing of women tremendously. Causes and symptoms Age is the main cause of anatomic changes to the labia. The older the patient, the larger the inner labia and smaller and more atrophic the outer labia. This is part of the natural aging process. Pregnancies, hormonal treatments and weight gain can also affect the anatomy and volume distribution, however. If weight gain is significant, it can lead to considerable unwanted enlargement of the mons pubis. There are also genetic and cultural differences in the pigmentation, size and length of the labia. Physical symptoms can arise if the inner labia are no longer covered by the outer labia, allowing them to dry out and leaving them insufficiently protected from pressure and chafing. This situation can be perceived as aesthetically disturbing and may cause women affected to avoid tight clothing or even certain sports. It can also lead to pain and discomfort, recurrent infections and a shameful feeling that something isn’t right «down there». Women affected also describe feeling «exposed» or «as if your bladder or uterus might fall out». Sexual intercourse may also be experienced as unpleasant due to lack of muscle contraction. The operation The surgical technique that is most frequently used and is associated with the fewest complications is longitudinal resection (lazy-S resection). Depending on the medical history taken before the procedure, part of the tissue of the inner labia is removed and the outer labia are also enlarged, using fat grafting or augmentation with hyaluronic acid, usually as an outpatient procedure. Longer or combined operations may need to be carried out on an inpatient basis. Possible side effects and complications for this relatively small procedure are manageable, but in rare cases weeping wounds, soft tissue damage, discomfort or numbness may occur.