Perceptions of Female Genitalia Following Labiaplasty

Simultaneous Surgery of the Clitoral Hood-Labia Minora Complex with the Central Neurovascular Pedicle Retained

BACKGROUND

Hypertrophy of the labia minora with clitoral hood redundancy always occurs simultaneously and should be considered in its entirety. This study investigated a new simultaneous procedure for the clitoral hood-labia minora complex (CLC) that retains the central neurovascular pedicle.

METHODS

This retrospective observational study, conducted between January 2021 and August 2022, included 29 patients with labia minora hypertrophy and clitoral hood redundancy who underwent a surgery wherein procedures on the CLC were performed simultaneously. A divisional design to separate the medial and lateral labia minora and to remove the skin and subcutaneous tissue asymmetrically, while retaining the central neurovascular pedicle and the natural margin of labia minora, was employed. Postoperatively, all patients were followed up via the Internet or at the outpatient clinic. The follow-up included observing postoperative outcomes and any complications and completing the satisfaction questionnaires.

RESULTS

All the patients who underwent surgery showed good wound healing without discomfort of thread friction. Postoperatively, the labia minora had a natural appearance and retained sexual sensitivity. The scarring on the surgical incision was not evident. Hematoma and evident bilateral asymmetry occurred in one patient each. The satisfaction rate within 14 days and after 3 months of surgery was 96.6% and 92.6%, respectively.

CONCLUSIONS

This method uses a hidden incision, to remove the hypertrophic tissue and retain the natural edge and shape of the labia minora. Qualitatively, the patients were highly satisfied. This method was safe, effective, and easy to implement.

LEVEL OF EVIDENCE IV

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Quantitative analysis of the labia minora morphology in 400 Chinese women: A new method for assessing the shape of the labia minora

Purpose

To investigate the shape of labia minora in Chinese adult women.

Methods

Women who visited the Genital Plastic Surgery Center from January 2021 to February 2022 were included and the vulvar regions were photographed. The shape of the labia minora was converted into quantifiable values [left side line segment 1-9 (L1-L9 values) and right side line segment 1-9 (R1-R9 values)]. The 400 enrolled patients were grouped by age, parity, and the types of vulvar surgeries they planned to undergo.

Results

After a graphic-to-digital and digital-to-graphic conversion, the simulated average image of the labia minora in Chinese adult women was constructed based on the mean values of L1-L9 and R1-R9. Comparing the values of Ln and Rn in the four age groups revealed that the mean values of Ln and Rn gradually decreased with age, but only two subgroups showed statistically significant differences (P-value <0.05). When the patients were stratified according to the number of births and whether labiaplasty was planned to perform, there were no significant differences among all groups (P-value >0.05).

Conclusion

To measure and evaluate the labia minora, a new assessing method was used. It is an innovative attempt to transform the simple rough description of the shape of the labia minora into more precise data reflecting the shape features. It allows the comparison of labia minora shape between individuals by comparing quantifiable values. Besides, the average shape of labia minora in Chinese adult women was provided visually. Factors including age, parity, and whether the patient planned to undergo labiaplasty were not significantly associated with the shape of the labia minora.

Evaluations of Black and White Female Genitalia by Labiaplasty Status: A Pre-Registered Contextualization, Replication, and Extension of Findings on Labial Perceptions

Labiaplasty is an increasingly common form of cosmetic surgery involving the removal of portions of the labia minora to achieve a smaller, more symmetrical labial appearance. Labiaplasty is inextricably linked to the colonial medicalization of Black women's labia, necessitating examination of labiaplasty and race in concert. Participants (N = 4351, M_age = 26.58; SD_age = 8.89) were shown 12 randomized images of White and Black female genitalia - unaware that they were "before and after" images of labiaplasty procedures - and evaluated them on their alignment with societal ideals, personal ideals, perceived normalcy, and disgustingness. As hypothesized, postoperative labia were rated as more normal, more societally ideal, and more personally ideal than their preoperative counterparts; preoperative labia were rated as more disgusting than postoperative labia. Preoperative Black labia were perceived as more normal, more societally ideal, and more personally ideal, as well as less disgusting, than preoperative White labia. Postoperative White labia were perceived as more normal, more societally and personally ideal, and less disgusting than postoperative Black labia. Gender trends were inconclusive. Our findings point to the need for greater examination of how White bodily ideals shape evaluations of bodies, and for greater historical contextualization in research on labiaplasty.

Gayzing Women's Bodies: Criticisms of Labia Depend on the Gender and Sexual Orientation of Perceivers

The heterosexual male gaze is often credited with producing bodily anxieties among women, yet empirical and popular cultural evidence suggest gay men have especially negative views toward women's bodies, particularly women's genitalia. Across two studies (N = 6,129; M_age = 27.58; 2,047 women, 4,082 men) we conducted secondary analyses of existing datasets to test the hypotheses that gay men would evaluate labia more negatively than heterosexual men, and that lesbian women would evaluate labia more positively than heterosexual women. We conducted fixed-effects mini meta-analyses to estimate summary effect sizes for perceptions of normalcy and fit with societal ideals; we additionally assessed an outcome of disgust in Study 2. We found support for our hypotheses: For normalcy and societal ideal, we found small summary effects such that gay men evaluated labia more negatively than heterosexual men, and medium summary effects such that lesbian women evaluated labia more positively than heterosexual women. Gay men also rated labia as more disgusting than any other demographic group, and lesbian women rated the stimuli as less disgusting than heterosexual women, supporting our hypotheses. The current findings suggest a pressing need to acknowledge and incorporate gay men's perceptions of women's bodies into literatures on misogyny, objectification, and body image more generally.