Critical Appraisal of “What is the anatomical basis of labiaplasty? A review of normative datasets for female genital anatomy”
Citation
Hayes JA, Temple-Smith MJ. What is the anatomical basis of labiaplasty? A review of normative datasets for female genital anatomy. Aust N Z J Obstet Gynaecol. 2021 Jun;61(3):331-338. doi: 10.1111/ajo.13298. Epub 2020 Dec 31. PMID: 33382090.
Understanding Labial Diversity and Labiaplasty: What You Need to Know
Overview
This review by Hayes and Temple-Smith explores the natural range of labia minora sizes and shapes in women. It highlights that medical education lacks clear guidelines on what is considered “normal,” which can impact decisions around female genital cosmetic surgery (FGCS). The study analyzed ten research papers and found that labial size varies widely, reinforcing that there is no universal standard for what is “normal.”
Take Home Messages
- Labiaplasty is often influenced by personal preferences rather than medical necessity.
- Labial size and shape vary widely—there is no single “normal” appearance.
- Surgery is a choice, not a requirement
- Educating yourself about natural genital diversity can help you make a confident and informed decision.
- If you’re considering labiaplasty, talking to a knowledgeable healthcare provider can provide clarity on your options.
- Understanding social and personal influences can help you decide if surgery is right for you.
Key Takeaways
1. Labiaplasty is Often About Perception, Not Medical Need
Many women seek labiaplasty because they believe their labia don’t look “normal.” This belief is often shaped by social influences, media, and cosmetic surgery marketing rather than medical necessity.
What this means for you:
- Your labia are likely completely normal.
- Surgery is a personal choice, but it is not usually needed for health reasons.
- Understanding natural variations can help you feel more confident in your body.
2. There is No Single “Normal” Labia Size or Shape
Studies show that labia minora can range from 5 to 100 mm in length and 1 to 60 mm in width—a huge variation! Many women have asymmetry (one side larger than the other), and in most cases, the labia minora naturally extend beyond the labia majora.
What this means for you:
- Visible labia minora are common and normal.
- Size differences between your left and right labia are also normal.
- The idea that labia should always be hidden within the labia majora is a social preference, not a medical fact.
3. Medical Education Often Overlooks Labial Diversity
Most anatomy textbooks don’t show the full range of what natural labia look like. This means that even some doctors might not be fully informed about normal variations, leading to unnecessary referrals for cosmetic surgery.
What this means for you:
- If a healthcare provider suggests surgery without medical reasons (such as discomfort or infection), consider getting a second opinion.
- More education is needed for both doctors and patients about genital diversity.
- Learning about different labial shapes and sizes can help reduce unnecessary concerns.
4. The Term “Hypertrophy” (Enlarged Labia) Can Be Misleading
Some surgeons define “labial hypertrophy” as labia minora longer than 2 cm, while others set the threshold at 5 cm—there is no medical consensus. The review found that most women who seek labiaplasty actually have labial measurements within the normal range.
What this means for you:
- If you have been told your labia are “too big,” know that there is no single definition of what is “too large.”
- Decisions about surgery should be based on comfort and function, not just appearance.
5. Psychological and Social Pressures Influence Labiaplasty Decisions
Some women feel reassured after learning that their labia are normal, but others (called “persistors” in the study) still desire surgery despite understanding the facts. This suggests that emotions, body image, and social expectations play a big role in FGCS decisions.
What this means for you:
- If you’re unhappy with your labia, take time to reflect on why you feel this way.
- Speaking with a healthcare provider or therapist might help you explore your feelings before deciding on surgery.
- Making informed decisions based on facts, not just emotions or social influences, is important for your well-being.
Final Thoughts
Labiaplasty is a personal decision, but it’s important to separate medical necessity from social pressures. Understanding the wide range of normal labial anatomy can help women make confident, informed choices about their bodies. If you are considering surgery, discussing your concerns with a trusted doctor or counselor can help you determine the best path forward.
