Labiaplasty vs Vaginoplasty: What's the Difference?

Labiaplasty and vaginoplasty are often mentioned together, but they are different operations. Labiaplasty works on the outside, reducing the inner lips (labia minora). Vaginoplasty works on the inside, repairing the vaginal wall and the muscles around the vaginal opening.

This guide compares them side by side so you can work out which one, if either, matches what you are experiencing. Labia vary widely and almost all are normal, results vary, and both operations carry risks.

The short answer

If the concern is something you can see or feel on the outside, such as long inner lips that rub, pinch or twist, that is labiaplasty. If the concern is inside, such as a feeling of looseness after childbirth or a widened vaginal opening, that is vaginoplasty.

Some women have concerns in both areas. Dr Reema Hadi, a specialist plastic surgeon, examines both before suggesting anything, and sometimes the right answer is a pelvic floor physiotherapist rather than surgery.

What labiaplasty involves

Labiaplasty reduces the length or size of the labia minora. Dr Hadi most often uses the wedge (butterfly) technique, which keeps the natural edge and places the scar away from the edge. It can be combined with reducing the sides of the clitoral hood.

It does not change the vagina itself, its width or how it feels inside. Read the full labiaplasty guide and labiaplasty techniques.

What vaginoplasty involves

At The Swan Clinic, vaginoplasty means vaginal wall repair and perineal body repair. It repairs the back wall of the vagina and the muscles and tissue between the vaginal opening and the anus (the perineum), which can be stretched or torn by childbirth.

The surgeon removes some of the stretched vaginal lining and repairs the muscles and soft tissue underneath. When the main concern is the skin of the perineum, a smaller perineal repair (perineoplasty) may be enough.

Vaginaplasty or posterior compartment repair is performed in conjunction with a gynaecologist.

Labiaplasty at a glance

• Area treated: the outside. The inner lips (labia minora), sometimes with the clitoral hood or outer lips.
• Common reasons: long labia that rub in clothing, pinch during exercise or cycling, make hygiene harder, or cause concern about appearance.
• Anaesthetic: general or local, depending on your preference and the procedure. Day surgery, usually about 2 hours [CHECK 8], home the same day.
• Recovery: about 1 week off physical work, light exercise from about 2 weeks, heavier exercise from about 4 weeks [CHECK 9], and sex, tampons and menstrual cups from 6 weeks. Swelling can last several weeks.
• Medicare position: not covered for appearance alone. Item 35534 may apply if you are 18 or older, your labia extend more than 8 cm below the vaginal opening when standing, and they cause significant functional problems
• Who it suits: women 18 or older who are bothered by the length or shape of their inner lips, have realistic expectations, and are making the choice for themselves.

Vaginoplasty at a glance

• Area treated: the inside. The back wall of the vagina, the muscles around the vaginal opening and the perineum.
• Common reasons: a feeling of vaginal looseness or a widened opening after childbirth, or discomfort from tissue that stretched or tore during birth.
• Anaesthetic: usually general anaesthetic. The operation usually takes 1 to 2 hours.
• Recovery: no strenuous exercise or heavy lifting for at least 4 to 6 weeks, and no sex for at least 6 to 8 weeks. Swelling can last several weeks and sitting may be uncomfortable at first.
• Medicare position: surgery to tighten the vagina for appearance or sensation is not covered. If an examination finds a problem such as the back wall of the vagina bulging (prolapse), Medicare items for vaginal repair may apply, for example item 35571
• Who it suits: women whose symptoms come from stretched vaginal or perineal tissue, usually after vaginal birth, and whose symptoms have not settled with pelvic floor exercises.

Why they get confused

Advertising often groups labiaplasty, vaginoplasty and other genital procedures under one umbrella term, which makes them sound like a single package. They are not. Each treats a different part of the body, has a different recovery and carries its own risks.

Childbirth can affect both areas, which adds to the confusion. A birth can make the labia more noticeable and can also stretch the vaginal wall and perineum.

Which symptoms point to which?

• Labia that rub, catch, twist or show in swimwear: usually a labiaplasty question. See am I a candidate?
• A feeling of looseness, air escaping, or tampons slipping: usually vaginal wall or pelvic floor. A pelvic floor physiotherapist is a good first step.
• A bulge or dragging feeling inside the vagina: this can be prolapse. See your GP, who may refer you to a gynaecologist or pelvic floor physiotherapist.
• Leaking urine when you cough, laugh or exercise: neither operation is designed to treat this. See your GP.
• Pain with sex: there are many possible causes. Your GP is the right first stop, and surgery is not always the answer.

Try pelvic floor exercises first

For a feeling of looseness after birth, pelvic floor exercises are usually the first step. healthdirect notes that they help with bladder control, sexual function and recovery after birth. A women's health physiotherapist can check you are doing them correctly.

Labiaplasty, by contrast, cannot be replaced by exercise, because the labia minora are skin and soft tissue, not muscle.

Can you have both?

Some women have concerns in both areas and ask about combining them. Whether that is sensible depends on your examination, your health and your recovery plans, and Dr Hadi will talk this through with you. Combining operations means a longer anaesthetic and a recovery that follows the slower of the two.

If you plan more vaginal births, ask about timing, because a later birth can stretch the tissue again. See labiaplasty and childbirth.

The risks are different too

Both operations share general surgical risks: infection, bleeding or haematoma, scarring, changes in sensation and anaesthetic risks. Labiaplasty adds risks such as wound separation, asymmetry and over-reduction. Vaginal wall and perineal repair adds risks such as pain that lasts beyond recovery, difficulty passing urine early on, and changes in sexual sensation or function. Vaginaplasty is performed in conjunction with a gynaecologist.

Read our labiaplasty risks guide and the risks listed on the vaginal wall repair page.

Questions to ask at your consultation

• Which area is causing my symptoms: the labia, the vaginal wall, the perineum or my pelvic floor?
• Would pelvic floor physiotherapy help before, or instead of, surgery?
• Which technique would you use for me, and why?
• What would my recovery look like, and how much time off work should I plan?
• Does a Medicare item apply to my situation, and what will I pay out of pocket?
• What happens if I have another baby afterwards?

Bring a list of your symptoms and when they started. It helps Dr Hadi work out which area is involved. See your labiaplasty consultation.

The steps are the same for both

• A referral from your GP or another specialist before your first appointment [CHECK 5].
• Two consultations with Dr Hadi, at least one in person [CHECK 6].
• At least 7 days to think it over after giving consent, before surgery is booked.
• A written, itemised quote after your first consultation [CHECK 10]. See labiaplasty cost.

Surgery is a personal choice and deciding not to have it is always an option. To talk through which procedure, if any, fits your concerns, contact us on 02 9526 6885.

Frequently asked questions

What is the difference between labiaplasty and vaginoplasty?

Labiaplasty reduces the inner lips (labia minora) on the outside. Vaginoplasty repairs the vaginal wall and the muscles around the vaginal opening on the inside, usually after childbirth.

Does labiaplasty tighten the vagina?

No. Labiaplasty only changes the labia. It does not change the width of the vagina or how it feels inside.

Which has the longer recovery, labiaplasty or vaginoplasty?

Vaginoplasty. After labiaplasty, sex can usually resume at 6 weeks. After vaginal wall repair, it is at least 6 to 8 weeks, and heavier activity is avoided for at least 4 to 6 weeks.

Can I have labiaplasty and vaginoplasty at the same time?

Yes. However, It depends on your examination, health and plans for future births. Dr Hadi will talk through whether combining makes sense for you.

Is vaginoplasty covered by Medicare?

Not for appearance or sensation. If an examination finds a problem such as prolapse of the back vaginal wall, a Medicare item for vaginal repair may apply (posterior compartment repair).

Should I try pelvic floor exercises before vaginoplasty?

Usually, yes. Pelvic floor exercises, ideally guided by a women's health physiotherapist, are the usual first step for a feeling of looseness after birth.