Aesthetic Clinique, Body, Skin & Wellness Centre
Specializing in Modern Cosmetic-Plastic Gynecology
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Female Anatomy & GlossaryProceduresVaginal Rejuvenation, Cosmetic-Plastic GYNLabiaplastyThermiVaG-Spot Enhancement

Labiaplasty ~ Cosmetic Gynecology

Dr. John Serrão is proud to be one of the first physicians to offer labiaplasty or labial reduction surgery (labioplasty or labiol reduction), to women in and around Orlando, Florida. Labiaplasty is a one to three hour surgical procedure designed to sculpt the external genitalia by reducing and/or reshaping long or uneven labia. This cosmetic gynecologic surgery may involve multiple procedures involving the labia minora (inner lips), labia majora (outer lips), perineum, clitoral hood, prepuce, and frenulum in order to provide for a pleasing aesthetic outcome. The details of these procedures will be discussed with you at your initial consultation.

Childbirth, the aging process, and the effects of gravity may all erode the beauty of the female genitalia including the labia minora, labia majora, and perineum. Long labia minora may interfere with exercise or intercourse, and may cause embarrassment for some when wearing certain clothes, such as bathing suits, leggings, or jeans; which may call attention to any bulge. Over time the labia majora may relax and sag, while the perineum may show signs of scarring from an episiotomy or laceration incurred during childbirth. Together, you and Dr. Serrão will create a surgical plan based our your needs and requests so you can restore the beauty of your genitalia and feel feminine again.

At the Serrão Rejuvenation Center, the five principles that Dr. Serrão considers in order to achieve aesthetically pleasing results for the external genitalia are as follows:

1. Contour – the shape of the labia minora needs to be smooth and pleasing with a natural appearance. Some women prefer rounded or curved labial shape while others want a straight or linear labial shape.

2. Color – the colors should be consistent and matching on both sides. Many women request to have darkened areas corrected and prefer pinker edges.

3. Symmetry – both sides should be even and look-alike.

4. Size – most women want their inner labia just below or even with the level of the labia majora. They want the labia minora (inner lips) smaller and the labia majora (outer lips) fuller – you choose how much.

5. Smooth edges – the “natural” look has smooth edges with hidden suture lines.
Although, each patient is unique and surgery is designed to your individual specifications, the most common procedures are as follows:

LABIA MINORA (Smaller Inner Lips)

Labia Minora Labiaplasty / Labia Minora Reduction
This is a surgical procedure to reduce labial hypertrophy (thickened or enlarged labia), create balance and smooth contours, and reduce the height and length of the labia minora. This is the most common cosmetic external genitalia problem that women are concerned with. There are many different surgical techniques that may be used or combined based on your labial characteristics and requests

Clitoral Hoodoplasty / Prepuce Reduction
This is a surgical procedure to transform the clitoral prepuce to a more pleasing appearance with preservation of function. The clitoral prepuce is the overlying skin fold over the clitoris, also known as clitoral hood or clitoral foreskin. Often patients complain of too much skin or skin folds lateral to or over the clitoris. Aesthetically it gives the clitoris a wide appearance. Patients sometimes describe less friction with stimulation in this area because there is too much skin over the clitoris. This is the second most common cosmetic external genitalia problem women are concerned with. Women tell us that they want the skin to drape neatly over the clitoris like a curtain; this can be achieved through clitoral hoodoplasty. There are two distinct types of clitoral hoodoplasty: restorative clitoral hoodoplasty and reductive clitoral hoodoplasty. Different surgical procedures will be used based on your clitoral characteristics and requests.

Clitoral Frenuloplasty
The clitoral frenulum is an anatomical structure that is created by the extension of the upper part of the thin labia (the labia minora). It attaches to the back of the clitoral glans (the visible part of the clitoris when the overlying skin is pushed-up away). A surgery for aesthetic motives is usually needed when the clitoral frenulum is enlarged, asymmetrical or over-pigmented or any combination thereof. Sometimes it also requires transposition of the frenulum to the posterior clitoral glans. This procedure is performed almost always in association with a clitoral hoodoplasty. Caution must be exercised during clitoral frenuloplasty, since between and posterior to both frenula just under the epithelium lays the bulboclitoral region that is a very neurosensitive area. The bulboclitoral region incorporates the clitoral root and the commissure of the vestibular bulbs known also as the “Pars Intermedia”. It is much safer to reduce the frenulum by excising the outside part of the clitoral frenulum. In many instances, the clitoral frenuloplasty is mandatory to perform in order to achieve aesthetically desirable results.

LABIA MAJORA (Larger Outer Lips)

Labia Majora Labiaplasty / Labia Majora Reduction
This is a surgical procedure to transform the redundant skin of the labia majora. The skin of the labia majora may lose volume and laxity thus creating a sagging and deflated appearance. The incisions will be hidden in the intralabial crease (crease between the labia minora and labia majora) or will be hidden in pubic hairline. Dr. Serrão can enhance the sagging labia majora by utilizing different techniques providing for a more youthful and aesthetically appealing vulva.

Augmentation Labiaplasty (Labioplasty)
This minor procedure can provide aesthetically enhanced and youthful labia majora by autologous fat transfer. Dr. Serrão will remove the patient’s fat via liposuction or cannula with syringe and transfer it by droplet fashion into the labia majora. This procedure may require a repeat/refill transfer to achieve the woman’s desire of plumpness or fullness in the labia majora.

Mons Pubis & Vulvar Liposuction
This procedure can remove unwanted fat of the mons pubis and upper parts of the labia majora. Liposculpting can alleviate the unsightly fatty bulges of this area and produce an aesthetically pleasing contour.


This procedure can reconstruct or can repair the hymen. The Women’s Center for Cosmetic Surgery and Wellness is sensitive to the needs of women from all cultures and we embrace these particular issues based on cultural, social, or religious reasons. Dr. Serrão and his entire surgical team will always maintain strict policies of patient confidentiality.

Combination Surgeries (Our Mommy Make-Overs)
Labial surgeries may be performed in conjunction with other cosmetic procedures including vaginal rejuvenation, clitoral hood reduction, breast augmentation, fat transfer and liposuction.

The Women’s Center for Cosmetic Surgery and Wellness, founded in 2008, offers highly specialized cosmetic labial surgery and is comprised of a caring team who is dedicated to the needs of today’s total woman.

E. John Serrão, M.D., a Board Certified Gynecologist and Fellow of the American Congress of Obstetricians and Gynecologists, is on the forefront of labial surgery. He has performed hundreds of cosmetic labial procedures, and works diligently to bring the latest technologies to women across the state of Florida and from around the world. He has trained with Professor Adam Ostrzenski, M.D., Ph.D., Dr. Hab., Dr. David Matlock, and Dr. Marco Pelosi, all of whom are recognized pioneers and experts in the field of cosmetic–plastic gynecology. His specialized training and comprehensive understanding of varied surgical techniques, enable him to utilize either laser or non- laser labiaplasty, depending on the specific nature of the case and needs of each patient. Dr. Serrão’s trained eye allows him to preserve the natural contour and pigmentation of the labia with minimal scarring, while maintaining sensation thus producing the most natural results.

Privacy and discretion are upheld at all times in our practice. You will speak with Dr. Serrão directly and he will gladly answer any questions you may have regarding the labiaplasty surgery, recovery time, medications, and what to expect before, during and after the procedure.

Remember, when choosing a cosmetic - plastic gynecologist, focus on their qualifications, experience, and functional results. At the Serrão Rejuvenation Center you will be given the opportunity to speak with other patients who have undergone the procedure, read testimonials, meet our healthcare team, tour our facility, and view our before and after photo gallery. Call to schedule your consultation at 407-896-3772 and begin your rejuvenation today.

More Information Just for You

If you wish to view Dr. Serrão’s labiaplasty before and after photos please click here. For labiaplasty costs and financing options please click here.
The labiaplasty procedure is not the same as vaginal rejuvenation or vaginal tightening - it only involves the external genitalia. For vaginal rejuvenation or vaginal tightening information please click here. To review medical journal articles concerning cosmetic - plastic gynecology click here.
Please call Dr. Serrão at 407-896-3772 or toll free at 1-866-834-3297 to schedule a consultation or if you have any questions regarding cosmetic – plastic gynecology.

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Q: What is labiaplasty?
A: Labiaplasty is an out-patient procedure performed to sculpt the skin surrounding the vaginal opening called the labia. When elongated, the labia minora (inner labia) may interfere with exercise or intercourse and limits clothing options due to the appearance of a bulge or discomfort. Most patients who undergo labiaplasty do not want the labia minora to protrude beyond the labia majora (outer labia).
Q: How long does labiaplasty take?
A: Individual procedures typically take between 1 and 3 hours. If cosmetic labial surgery is combined with other procedures the surgery could be longer.
Q: Where is the surgery performed?
A: Most surgeries are performed in our private in-office surgical suite. It is registered with the state of Florida and is fully accredited by the Accreditation Association of Ambulatory Health Care (AAAHC), the gold standard in patient safety. Our caring surgical staff specializes in modern cosmetic-plastic gynecology emphasizing patient safety and comfort. Most of our patients tell us this is preferable to a hospital setting or a large surgery center as patient privacy is more fully protected and a patient is never exposed to hospital based germ cross-contamination. The surgical suite is also superior to in-office procedures because we can use more appropriate anesthesia to achieve the best cosmetic results for our patients. Your surgery day will be scheduled for you and you alone, our surgical team and surgical suite will be completely committed to your needs and safety. Dr. Serrão and his surgical team have hundreds of hours of experience in this state-of-the-art facility.
Q: How much does labiaplasty cost?
A: Fees range from $5000 to $7000 including the surgeon’s fee, anesthesia fee, facility fee, all pre and post-operative appointments, post-care kit and blood work. A quote based on your specific medical history, physical exam, desired requests and goals will be provided upon the conclusion of your initial consultation.
Q: What about financing?
A: A: Women’s Center for Cosmetic Surgery and Wellness has made arrangements with several companies that offer financing plans to meet your individual needs. We also provide in-office financing plans as well. Our financial coordinator will be happy to assist you with any financial arrangements at your initial consultation.
Q: How long does labiaplasty take?
A: Individual procedures typically take between 1 and 3 hours. If cosmetic labial surgery is combined with other procedures the surgery could be longer.
Q: Is there a fee for the initial consultation with the surgeon?
A: Yes. The initial consultation lasts approximately 90 minutes to 2 hours and costs $200. This fee will be applied to your surgery when you decide to schedule your labiaplasty. The consultation will be with Dr. Serrão and will focus on an individualized plan of care to address each patient's personal desires. Surgical procedures are discussed in detail, before and after photos are reviewed, and all post-surgical protocols are explained. You will meet with our experienced surgical team and tour our facility. Photographs may be taken and utilized during your evaluation and surgical planning to help you understand your needs and expected outcome.
Q: Is labiaplasty covered by my insurance?
A: No, it is not covered by insurance. Cosmetic labial surgery is considered an elective cosmetic-plastic procedure done by patient request, such as breast augmentation, liposuction, face-lift, or abdominoplasty.
Q: Should I have my labiaplasty performed by a plastic surgeon or by an OB/GYN?
A: The answer is neither. Plastic surgeons generally have no training in residency with any cosmetic labial surgery. They tend to focus the majority of their practice and time on the most common elective procedures, including breast augmentation, face lifts, and rhinoplasties (nose jobs). Obstetricians and gynecologists are trained in residency to perform vaginal surgery. However, they have minimal, if any training or experience performing state-of-the-art vaginal rejuvenation or cosmetic labial surgery, a modern cosmetic-plastic gynecologic surgical procedure to achieve the desired results of the woman.

Cosmetic labial surgery is ideally performed by a gynecologist who specializes in the field of modern cosmetic-plastic gynecologic surgery. Ideally, patients should seek out a specialist who has performed hundreds of labial procedures and is intimately familiar with the varied anatomy, patient preferences and latest surgical management to provide optimal results both aesthetically and functionally.
To choose a qualified cosmetic-plastic gynecologic surgeon:
• Verify credentials and specialized training
• Review before and after photos
• Consider the number of vaginal rejuvenation procedures performed
• Request patient testimonials

Q: How many labiaplasties has Dr. Serrão performed?
A: Dr. Serrão has performed hundreds of cosmetic labial procedures since he became the first modern cosmetic-plastic gynecologic surgery specialist in Orlando in 2008.
Q: Why should I choose Dr. Serrão as my surgeon over other surgeons?
A: As a specialist in modern cosmetic-plastic gynecologic surgery, Dr. Serrão has years of experience performing cosmetic labial surgery. He has studied and trained with Professor Adam Ostrzenski, M.D., Ph.D., Dr. Hab., Dr. David Matlock, and Dr. Marco Pelosi, all of whom are recognized pioneers and experts in the field of cosmetic–plastic gynecologic surgery. Dr. Serrão considers Professor Ostrzenski to be his current mentor and is proud to be a member of his distinguished educational team. He has been honored with invitations to lecture to other surgeons from around the world on cosmetic-plastic gynecology.

On another important note, patients are typically thrilled with their aesthetic and functional results, and all patient survey results are available for review during the initial consultation. Our results will attest to Dr. Serrão’s vast knowledge of female anatomy and his extensive surgical skill. Moreover, as an experienced gynecologist, Dr. Serrão, fully comprehends the sensitive nature of the subject and is able to communicate with empathy and understanding. Many patients say they feel more comfortable, respected, and protected being surrounded by a health care team who truly cares for them before, during, and after your cosmetic labial surgery. Finally, the on-site AAAHC accredited surgical suite available to Dr. Serrão’s patients is the perfect setting to undergo surgery of the labia. The suite is reserved for modern cosmetic-plastic gynecologic procedures ONLY providing an exclusive, comfortable, patient-focused experience throughout your stay with us. Dr. Serrão and his surgical team will take very good care of you.

Q: What symptoms are typical among women who elect to have labiaplasty?
A: Common complaints include labial pain and irritation from rubbing against clothing (especially jeans and workout clothes), as well as interference with activities including intercourse, tampon placement, urination, cycling or horseback riding and the appearance of a bulge when wearing certain clothes. For some women elongated or asymmetrical labia may cause embarrassment or interfere with a sexual relationship. A significant percentage of our patients simply do not like the appearance of their labia and request subtle sculpting.
Q: What are the surgical risks of labiaplasty?
A: Risks of surgery are extremely rare and seen in less than 1% of cases. Complications may include infection, bleeding, scarring or nerve injury. To put this into perspective, the risks involved with pregnancy and delivery far exceed any risks of labiaplasty when performed by a surgeon with expertise in the field of cosmetic labial surgery. Dr. Serrão will discuss all of the risks of labiaplasty with you during your consultation and again at your pre-operative visit.
Q: What types of anesthesia are available?
A: Cosmetic surgery of the labia minora and labia majora is performed using local anesthesia alone or with IV sedation that is provided by our highly experienced CRNA (licensed certified registered nurse anesthetist). This type of anesthesia allows you to sleep gently while remaining conscious and able to breathe on your own, thus reducing the risk associated with general anesthesia. You will be safely monitored throughout the entire procedure and will feel no discomfort during your labiaplasty. You will remain in our recovery room until you meet our discharge criteria and will then be able to go home with your family member or to our over-night facility with our private duty nurse. Our patients do very well with this type of anesthesia.
Q: What is recovery like after labiaplasty?

A: Most patients are up and about the afternoon of their surgery day. During the first 48 hours after surgery, patients should place ice packs or frozen peas on their incisions to minimize swelling and bruising. Routine tasks are allowed as long as there is no irritation or pressure at the incision sites. Loose clothing and cotton underwear “granny panties” are mandatory during the 6-week recovery period.

By 72 hours you may resume regular activities, making sure there is minimal friction to the labia, however, we encourage minimal activities the first week after surgery whenever possible. Patients may drive at any time as long as they are not taking narcotics. Patients may return to work within 3 to 5 days as long as rigorous physical activity is avoided. The stitches will usually dissolve by the 6-week follow-up appointment. During the 6 week recovery, patients are on pelvic rest meaning no tampons, douching or sexual relations of any kind. Please be aware that bath tubs, hot tubs, swimming (pools, lakes, or ocean), exercise, cycling, dancing, skiing, horseback riding, jet skis, motorcycles, etc. should be avoided during the recovery period. You will be allowed to do walking exercise after your 2-week follow-up visit.

A complete list of post-operative instructions will be given to you in your surgery packet at your pre-operative appointment.

Q: How soon after surgery can I return to work?
A: Most patients return to work within 3 to 5 days. The amount of time off that will be needed is dependent on the extent of your surgery as well. Dr. Serrão will discuss this with you at your initial consultation.
Q: What kind of pain can I expect after labiaplasty?
A: Pain overall is minimal due to nerve blocks and local anesthetic injected at the conclusion of the case. You should expect limited pain for the first 18-24 hours. After this, most patients report mild to moderate discomfort and swelling for a few days, which can be easily controlled by analgesics and ice packs. You are likely to have some continued soreness for a few weeks after surgery which may be relieved by anti-inflammatories such as ibuprofen (Motrin or Advil).
Q: How soon may I have sex after surgery?
A: We ask that you abstain from sexual relations of any kind for 6 weeks to ensure the best aesthetic results and adequate healing.
Q: Will I have a scar after labiaplasty?
A: Any incision on the body will leave some form of scar. Labial scarring, however, tends to be minimal as the incisions are small, the tissue is thin with a good blood supply and labia naturally have a slightly "wrinkled" appearance prior to surgery already. The goal of surgery is to have such a natural appearance that your OB/GYN doesn't even realize you had surgery.
Q: Will labiaplasty affect my sexual satisfaction?
A: For some women, enhanced self-confidence and reduced labial tissue can actually improve sexual experience and sensation. A patient’s ability to achieve stimulation and clitoral orgasms should not be diminished as Dr. Serrão takes extreme care to spare the clitoris any injury during surgery protecting this very sensitive organ at all times.
Q: How long will it take for me to see my final results?
A: Final optimal results are typically appreciated 4 to 6 months after surgery. By the 6 week post-operative visit the sutures should have dissolved and most of the bruising and swelling will have resolved.
Q: Does Dr. Serrão perform laser labiaplasty?
A: Dr. Serrão is proficient with many surgical instruments including the laser, cautery device, radiofrequency, CO2 ablative laser, electric knife, iris scissors and the scalpel. The instrument best suited for your particular surgery will be discussed during your initial consultation and the advantages and disadvantages of each instrument may be reviewed in detail.
Q: What do "normal" labia look like?
A: There is no such thing as “normal” labia, just as “normal” breast size is impossible to define. Every woman displays her own individualized anatomy – labia are thick or thin, dark or pink, and labia come in every variable size and shape. A woman’s labia are never considered abnormal. When women request labiaplasty of the labia minora (inner lips) they usually request that the labia not protrude beyond the labia majora (outer lips). The bottom line is if they bother you it’s time to explore your options.
Q: Is it possible to lighten the dark skin on my labia and in the vaginal area?
A: Darker skin, attributed to hormonal changes or genetic factors, can usually be addressed surgically or with prescription medication. During your consultation Dr. Serrão will discuss your individual options.
Q: Can labiaplasty be combined with other cosmetic surgical procedures?
A: Yes. Many times patients choose to combine labiaplasty with vaginal rejuvenation for a full feminine make over. In addition, Dr. Serrão specializes in cosmetic surgery of the female patient, combining elective procedures such as breast augmentation, liposuction, or tummy tucks. With this option your surgery may be performed in a single surgical session or as two surgical sessions depending on the extent of the procedures to be performed. This will be discussed with you at your initial consultation and will be scheduled accordingly.
Q: I am from out of town. How long before I can travel back home after my surgery?
A: Many of our patients travel nationally and internationally to experience vaginal rejuvenation with Dr. Serrão and to enjoy all that Orlando has to offer. Most prefer a long distance initial consultation, which may be scheduled by calling our office or using the contact page on this website. If a patient wishes to pursue surgery, she arrives the day before surgery and must remain in the Orlando area for 3 to 5 days after surgery.

All patients have a follow-up visit 24 hours after surgery and again before their departure. Remaining follow-up visits can be done through scheduled telephone calls and photographs to our confidential photo e-mail site. Our concierge service is accustomed to facilitating hotel reservations, transportation, private in-room nursing care, and fine dining restaurant delivery services. We are fortunate to have accommodations through Comfort Suites and Florida Hospital for over-night stays that are located one block from our in-office surgical center. Our private duty nurse, Kathy Onofre, LPN, will pick you up from our surgical suite, care for and pamper you overnight, and bring you back to the office in the morning for your post-operative visit. Kathy has worked with Dr. Serrão for more than 5 years and is very knowledgeable in the post-operative care of cosmetic-plastic gynecologic surgery patients. We will be glad to assist you with the arrangements for private-duty nursing at your request.

Q: May I personally speak with other patients who have had labiaplasty surgery performed by Dr. Serrão?
A: Yes. Many of our previous patients have offered to speak with other women who are considering labiaplasty. Just ask, we will make the arrangements.
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E. John Serrão, MD, FACOG, FAACS, FAAAAM | Larissa R. Serrão, RN, ACE
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