Labiaplasty & Hoodplasty

Why “hoodoplasty” may be necessary at the time of labial reduction

Women who seek labial reduction (Labiaplasty / reduction of the inner lips) often do have labia minora that are somewhat more prominent than those of their counterparts. The prominent labia minora are more often than not accompanied by a prominent clitoral hood – it is unusual to have prominent labia minora but perfectly normal size clitoral hood. Most of the women seeking labial reduction make no distinction between the labia minora and the clitoral hood, and they imagine that following trimming of the labia minora everything will look “just perfect”. They often seek quite significant trimming, with an endpoint whereby the labia minora become flush with the labia majora (out lips) or end up beneath the edges of the labia majora, rendering the labia minora largely invisible.

Now, the trimming of the labia minora, without addressing the issue of the prominent clitoral hood, will mean that the clitoral hood becomes the dominant feature of the vulva. The patient then begins to be aware of the dominance of the clitoral hood, which she previously would not have been aware of because of the dominance of the labia minora. While she is happy that the labia minora have been trimmed, more often than not she remains unhappy with the overall appearance of the vulva.

Hoodoplasty seeks to trim away the excess para-clitoral tissue that renders the clitoral hood prominent, thereby creating smooth contours from the clitoral hood to the labia minora, and avoiding the prominence of the clitoral hood. The process involves the trimming away of excess para-clitoral tissue, and meticulous care is taken to avoid involving the clitoris itself. This is very important, since the clitoris is the most sensitive part of the vulva, and most women achieve orgasm via clitoral stimulation. Hoodoplasty is therefore NOT in any way related to female genital mutilation (FGM).

During the consultation leading up to labial reduction surgery, issues of the potential dominance of the clitoral hood following labiaplasty are explained, and the vast majority of the women immediately understand the concept and accept the need for hoodoplasty. They are reassured that everything possible is done to avoid touching the clitoris during hoodoplasty. The potential risks and complications are explained as per labiaplasty, and documented. These include swelling, bruising, pain, haematoma, delayed healing, scarring, changed sensation, asymmetry, infection and subjectivity.

The vast majority of women are very happy with the outcomes of their surgery – labiaplasty and hoodoplasty. Not all women need a hoodoplasty, but for those who do, they are consented for “labiaplasty and hoodoplasty”. For those women who are advised hoodoplasty but decline (usually due to added cost) the discussion is nevertheless documented in the notes, as some women will present at a later stage unhappy about the prominence of the clitoral hood.

Professor Isaac Manyonda

Professor Isaac Manyonda
c/o Parkside Hospital, 53 Parkside, Wimbledon, London, SW19 5NX

Secretary / PA  -
020 8054 3893

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