Labia minora reduction, also known as labiaplasty, is a surgical procedure aimed at reshaping or reducing the size of the inner vaginal lips (labia minora).This procedure is requested for medical, functional, or psychological reasons.

At MACS Clinic, we endeavour in thorough counselling before any procedure. During consultations for labia minora reduction, there are few factors patients should discuss in detail with the consultant in detail –

1. Recurrent Urinary Tract Infections (UTIs)

Women with enlarged or elongated labia minora may experience repeated urinary tract infections due to the trapping of moisture, urine, or bacteria in the vaginal area. This condition can create an environment conducive to bacterial growth. The urinary tract infection could be related to other causes .

Why this matters in counselling:

• It’s important to establish if the anatomy is contributing to recurrent infections.
• Other causes of UTIs need to be ruled out with urological evaluation.
• Surgery may provide relief in select cases, but is not always a definitive solution.
• The acute or recurrent infection should be treated before the surgery to minimise the perioperative exacerbation of urinary tract infection .
• It is advisable for the patient to seek further advice on urinary tract infection with her regular family physician ( GP)

2. Recurrent Vaginal Fungal Infections (e.g., Vaginal Thrush)

Similar to UTIs, the folds of enlarged labia minora can retain moisture and heat, increasing the risk of fungal infections such as Candida albicans (vaginal thrush). Women may experience itching, irritation, or discharge.

Considerations in counselling:

• Understanding hygiene practices, undergarment materials, and overall health.
• Recurrent fungal infections must be properly diagnosed and treated before the date to the Labiaplasty minora reduction to avoid postoperative exacerbation of the vaginal thrush .
• A labiaplasty may help in cases where labial enlargement is a mechanical factor causing recurrent fungal infection.

3. Pelvic Floor Weakness, Uterine Prolapse, and Post-Childbirth Changes

In some women, especially after childbirth, issues such as pelvic floor muscle weakness and vaginal wall prolapse ( bladder , cervix, rectum) may be present. These are gynaecological conditions that can cause discomfort or pressure in the vaginal region. This can cause incontinence of urine or bowel.

Counselling considerations:

• The patient should notify such symptoms to her GP with a view to get a gynaecologist involved before proceeding with labiaplasty.
• Pelvic floor physiotherapy or surgical options may be more appropriate.
• Patients must understand that labiaplasty won’t address internal pelvic support issues.

4. Current Psychological Fragility

If patient suffered any psychological illness requiring counselling or medications, it is prudent for her to disclose all the information to the consultant and bring all the relevant medical records from her GP or the mental health institution.

5. Important Note on Antibiotic Prophylaxis and Vaginal Health

During or after surgery, broad-spectrum antibiotics may be given to prevent infection. However, these can sometimes disturb the natural vaginal flora, leading to fungal overgrowth and vaginal thrush. It is advisable to treat any existing vaginal thrush – fungal infection before the date of surgery .

Patient should seek such treatment from her family physician.

Conclusion: A Tailored, Ethical Approach

At MACS Clinic, labia minora reduction is offered only after thorough assessment and appropriate medical counselling. We prioritise the patient’s functional, emotional, and psychological wellbeing.

Our multidisciplinary approach may involve:

• Gynaecological evaluation if required
• Urological investigations if necessary
• Psychological screening if required
• Individualised surgical planning