Labia Majora · Patient guide

How Is Labia Majora Reduction Surgery Performed?

Labia majora reduction is performed by marking a crescent of excess skin on the inner side of each outer labium, numbing the area with sedation plus long-acting local anesthetic (or local alone), excising the marked skin, and closing with fine absorbable sutures so the scar sits in the natural crease. At Somssi Women's Clinic in Gangnam, Seoul, it takes about an hour and you go home the same day.

Medically reviewed by Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist, Somssi Women's Clinic · Last updated October 2026

At a glance

Key facts

The essentials, based on how Somssi Women's Clinic performs this procedure or answers this question. Your plan is confirmed at consultation.

• Steps: assessment and marking, anesthesia, excision, optional volume restoration, layered closure
• Incision placement: inner side of the outer labia, hidden in the crease
• Anesthesia: sedation plus long-acting local, or local only
• Procedure time: about 1 hour
• Sutures: absorbable; no removal visit
• Hospital stay: none; discharged the same day after urinating
• Performed by: Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist

Labia majora reduction is performed by removing a carefully measured crescent of loose skin from the inner side of each outer labium and closing the edges with fine absorbable sutures, so that the fold becomes smaller and smoother and the scar hides in the natural crease. The whole operation takes about an hour. Here is what happens at each stage at Somssi Women's Clinic, a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD.

Before surgery: assessment and design

The operation is planned at consultation, where Dr. Yoon examines the labia majora with you standing and lying down. Gravity changes how the folds hang, and a design that looks right only on the operating table can look wrong when you stand. He assesses how much skin is redundant on each side, how elastic it is, whether the fat pad beneath has shrunk, and whether the labia minora or perineum also need attention.

Photographs are taken, and the plan is confirmed: excision alone, excision with volume restoration, or a combination with labiaplasty. If sedation is planned you fast for two hours before the visit, wear loose clothing and remove nail polish. Surgery can follow consultation on the same day when appropriate.

Step 1: Marking

On the day, the skin to be removed is marked with a surgical pen. The excision is a crescent or ellipse on the inner aspect of each labium majus, next to the labia minora. This placement is chosen because the resulting scar lies in the crease between the outer and inner labia, where it is hidden, and because tightening from this side pulls the fold inward and upward rather than outward.

Both sides are measured against each other. For women whose main complaint is asymmetry, the markings are deliberately different on each side so that the result matches.

Step 2: Anesthesia

Most patients choose sedation ("sleep") anesthesia combined with a long-acting local anesthetic, so there is no memory of the procedure and the area stays numb into the evening. Local anesthesia alone is available if you prefer to be awake; the clinic's approach to anesthesia is explained on the labia majora reduction page. Either way, you walk out of the clinic the same day.

Step 3: Excision

Following the markings, the strip of redundant skin is removed. The excision is kept conservative: enough to smooth and lift the fold, not so much that the labia become flat or feel tight when the legs are spread. Bleeding is controlled carefully as the clinic goes, because a collection of blood under the skin is one of the main causes of problems with healing. The clinic uses excision for severe wrinkling and low elasticity; for folds that are loose mainly because they have lost volume, excision is reduced or replaced by volume restoration.

Step 4: Volume restoration, when planned

If the fat pad has shrunk, volume is restored in the same session. The clinic offers three options: grafting your own fat, harvested from the abdomen or thigh and injected in thin layers (fat transfer); a filler injected into the labia majora; or a plasma-based injection used to improve elasticity. Which is used depends on how much volume is missing and your preference, as discussed in Labia Majora Reduction vs Augmentation.

Step 5: Closure

The wound is closed in layers with fine absorbable sutures. The deeper layer takes the tension off the skin so that the surface edges meet without pulling, which gives the finest scar. The sutures dissolve on their own, so there is no removal visit, which matters for patients traveling from abroad. A non-narcotic anti-inflammatory is injected at the site at the end of surgery to limit early pain.

Step 6: Recovery room and discharge

You rest until you are fully awake, pass urine and feel steady, then go home the same day with ointment, medication and written aftercare instructions. You can shower that evening. An ice pack in short intervals for the first three days, ointment applied with a cotton swab about four times a day, and loose cotton underwear are the core of early care. Healing takes about three weeks and intercourse can usually resume after about four. The full timeline is in How Long Does Labia Majora Reduction Recovery Take?

Why these choices matter

• Marking in two positions prevents the common error of over-resecting on the table and finding the labia too flat when standing.
• Incision in the crease hides the scar and avoids a visible line on the outer surface of the labia.
• Conservative excision protects against the flattened, tight look that is hard to reverse.
• Layered absorbable closure gives the finest scar and removes the need for a return visit.
• Assessing volume before cutting avoids treating a deflated fold as if it were a loose one.

What the operation does not involve

Labia majora reduction does not touch the clitoris, the labia minora (unless labiaplasty is combined), the urethra or the vaginal canal. It is an external skin procedure, which is why sexual sensation is not expected to change and why recovery is straightforward. Concerns inside the vagina are addressed by separate procedures.

Next steps

If you would like to know how this applies to you, a consultation with Dr. Yoon will confirm the plan and provide a written estimate. International patients can read Labia Majora Reduction in Korea for Foreigners or go straight to the contact page.

Bottom line

The operation is simple in outline, mark, numb, excise, close, but the result depends on judgment: how much to remove, where to place the incision, whether to add volume and how to close. At Somssi those decisions are made by a gynecologic surgeon in practice since 2000, in about an hour, with same-day discharge.

Questions patients ask

Frequently asked questions

Short, honest answers. For anything personal, a consultation is the right place to ask.

See the full FAQ →

Is the skin cut with a scalpel or a laser?

For labia majora reduction the excision is a conventional surgical one, since the tissue is ordinary skin with a fat layer and the priority is precise removal and careful control of bleeding. The clinic uses laser cutting for labia minora edges, where a clean, fine edge matters most; the two techniques are chosen to suit the tissue.

Will I be asleep during the surgery?

If you choose sedation, you will be asleep and have no memory of the procedure, with a long-acting local anesthetic keeping the area numb afterwards. If you prefer local anesthesia alone, you will be awake and can speak with Dr. Yoon during the operation. Both options end with same-day discharge.

How much skin is removed?

Only the redundant portion, measured on each side with you standing and lying down. The aim is a smooth, naturally full fold, not a flat one. Over-resection is a known complication of this surgery and difficult to correct, so the clinic errs on the conservative side.

Do the stitches need to be removed?

No. The sutures are absorbable and dissolve on their own over the following weeks. This means there is no stitch-removal appointment, which is why overseas patients can fly home after a wound check and complete their follow-up by message and photo.

Can volume be added during the same operation?

Yes. When the fold has lost its fat cushion, Dr. Yoon can graft your own fat, inject a filler or use a plasma-based injection in the same session so the outer labia are smooth and full rather than merely smaller. Whether this is needed is decided at consultation.

How long does the operation take?

About one hour for labia majora reduction. Adding fat transfer or labia minora surgery extends it modestly. Including recovery time in the clinic before discharge, plan for a half day.

Keep reading

Related treatments and guides

• Labia Majora Reduction — the treatment overview
• How Long Does Labia Majora Reduction Recovery Take? — what happens after the operation
• Does Labia Majora Reduction Leave Scars? — where the incision sits and how it heals
• Is Labia Majora Reduction Safe? — risks and the safeguards built into the technique
• Labia Majora Reduction vs Augmentation: Which Do I Need? — when volume is added
• How Is Labia Minora Reduction Surgery Performed? — the equivalent guide for the inner labia

Sources and medical review

• Te Linde's Operative Gynecology (textbook), chapters on vulvar surgery.
• American College of Obstetricians and Gynecologists (ACOG), guidance on elective female genital cosmetic surgery.
• Yoon HJ. Perineal plastic surgery (colpoperineoplasty) and female sexual function. Korean Journal of Obstetrics and Gynecology. 2005;48(6).

Next step

A consultation first. A decision only when you are ready.

Tell us what you are experiencing and what you hope to change. Dr. Yoon examines, measures and explains the options, including when no surgery is the right answer. International patients can start with an online consultation before travelling to Seoul.