When contemplating having a labiaplasty or clitoral hood trimming procedures, patients ask whether they will lose sensation and not be able to reach orgasm.
Patients hear all types of horror stories online and a lot of what is said on social media does not match what actual published studies find.
What do the published studies show?
The conclusions are more unanimous than what is posted on social media or the internet.
When experienced surgeons perform the procedure and have a knowledge of the anatomy the results in studies show that labiaplasty surgery no matter which technique is used do not alter clitoral or labial sensation and do not alter sexual function. They show quite the opposite. About a third or women report improved organism and sexual function.
The clitoris is an inverted V shaped structure that sits under the pubic bone and the legs or crus run deep along the side of the vaginal opening. It is not located in the areas where the extra skin is trimmed. The vessels and nerves sit on top of the clitoris or on the dorsal surface. These nerves are usually not touched when the excess skin is removed in both the labia and the clitoral hood. The inner lips after labiaplasty surgery can be numb at first but the fine nerves grow back and some women are more sensitive than before.
Here are the studies that showed the above mentioned results.
Otto J. Placik and JP Arkins1 published a study in PRS in 2015. They used fine nylon hairs that neruologist use to test sensation of diabetic feet. The tested the hood and for spots on the labia minora. They tested before surgery, at 2 weeks, and 3, 6, and 12 months. On their 37 patients that were studied they found no significant changes in sensation with clitoral hood or labia reduction surgeries. Their sexual function survey found a third of their participants had an increase in sexual function with more frequent and stronger organisms.
The largest series on 1981 patients was published by Alter2 and Gress3. In the two studies they described eight different techniques reported in English and non-English literature.
Alter2 in his 407 patients studied, found a 22.9 % increase in sexual function with easier orgasm and increased sensation but did find a 5.4% negative change with difficulty reaching orgasm and decreased sensation. Gress3 found a 35% increase in ability to be stimulation in his 812 series of patients.
There is a about a 90% increase in patient satisfaction described with different techniques in the literature.4,5 The perceived improved aesthetic results seen, inevitably results in improved self-esteem . This is probably responsible for the improvement in sexual function in the majority of studies. Sexual function and desire can be greatly influenced by complex psychological factors. Unresolved trauma can also negatively influence sexual function, which could explain Alter’s2 change in sexual function.
In summary, patients can be reassured that there will not be loss of sensation and over 30% of patients will experience improved sexual function. There is a high satisfaction rate with the aesthetic appearance which leads to patients feeling better about themselves.
References
- Placik OJ, Arkins JP. A prospective evaluation of female external genitalia sensitivity to pressure following labia minora reduction and clitoral hood reduction. Plast Reconstr Surg. 2015;136:442e-452e.
- Alter GJ. Aesthetic labia minora and clitoral hood reduction using extended central wedge resection. Plast Reconstr Surg. 2008;122:1780-1789.
- Gress S. Composite reduction labiaplasty. Aesthetic Plast Surg. 2013;37:674-683.
- Oranges, CM, Sisti A, Sisti G. Labia minora reduction techniques. A comprehensive literature review. Aesthet Surg J. 2015;35:419-431.
- Motakef S, Rodriguez-Feliz J, Chung MT et al. Vaginal labiaplasty: Current practices and a simplified classification system for labia protrusion. Plast Reconstr Surg. 2015;135:774-788.