As a Labiaplasty Surgeon, I Don’t Perform Labia Removals/Amputations – Here’s Why

By Dr. Courtenay Poucher, MD – Labiaplasty Center of Los Angeles

When women visit my Los Angeles practice for their initial consultation – often traveling from places like Las Vegas, San Francisco, Sacramento or even New York – they might arrive with some “baggage,” but not the luggage kind.

Image courtesy Shutterstock

Instead, some of my recent patients have shared anxiety about what labiaplasty really involves. One of the most common fears I hear during consultations sound like this:

“Are you going to remove my labia?”

“I don’t want my labia amputated. I just want to feel comfortable.”

Let me be very clear: At Labiaplasty Center of Los Angeles, we do not perform labial amputations. I do not remove labia. It’s my belief that no ethical, highly-trained labiaplasty surgeon should, unless under extreme conditions, like cancer.

Here’s why.

Preserving the Labia While Prioritizing Comfort & Confidence

Your labia minora are an important, functional part of your anatomy. They protect the vaginal opening, help maintain moisture and contribute to sensitivity and comfort during intimacy. Removing them entirely would compromise form, function and long-term wellbeing.

Unfortunately, I see the consequences of overly-aggressive surgeries far too often.

Many of my “revision labiaplasty” or “botched labiaplasty” patients come to me after a doctor, often a plastic surgeon, removed too much tissue. In many cases, these surgeons are not intimate-anatomy specialists. They may be excellent at breast augmentation or rhinoplasty but perform only a handful of vaginal surgeries a year.

Your vagina, vulva, perineum and labia require specialized knowledge.

I’m grateful to have the skills and education to perform corrective surgeries, helping women restore comfort, symmetry and confidence after a botched labiaplasty elsewhere… but I wish it wasn’t necessary.

What I Do Instead: Precision, Preservation & Proportion

At Labiaplasty Center of Los Angeles, the vast majority of my patients receive a modified wedge labiaplasty, not a trim “edge removal” approach and certainly not a labial amputation.

Here’s why:

1. The Modified Wedge Preserves your Natural Skin Edge
   Your natural edge is important! It contains soft, flexible tissue that looks natural and ages naturally. Removing the entire edge – especially in a “trim” style performed too aggressively – can increase the risk of retraction, discomfort and unnatural shaping. The wedge approach allows me to strategically remove excess tissue while maintaining the correct anatomical border.
2. It Provides Greater Reduction while Respecting Anatomy
   Many of my patients want a meaningful reduction that solves discomfort during exercise, intercourse or daily movement. The wedge technique allows for that reduction without compromising function.
3. It Supports Comfort
   Over 90 percent of our patients come to me not for cosmetic reasons, but because their labia pull, pinch, chafe or cause pain during intimacy. My goal is always to reduce discomfort without removing structures your body needs.

Why Women Think They Need “Removal”or a “Barbie Vagina”: A Quick Reality Check

Many women use words like “meaty,” “too long,” “bulky,” or “hanging” when describing their labia. These descriptors are completely normal – but they often reflect laxity, prolapse, thickening or volume loss elsewhere – not a need for complete removal. Many women have not been made aware of the important function of the labia minora – namely, keeping the vagina closed to maintain moisture and prevent infections. Once educated, my patients understand and agree that complete removal or amputation is not only unneeded but undesirable.

For example:

• Labia minora that tug during intercourse may need a conservative labia minoraplasty.
• Labia majora that look “loose” or “deflated” may require labia majoraplasty to maintain volume while reducing laxity.
• An overstretched vaginal opening may need perineoplasty to improve tightness and regain anatomical positioning.

None of these solutions require amputating or removing the entire labia.

My final thought to you: Your concerns are valid. Your body is normal. And you deserve to understand all your options.

Women come to us because they want to feel comfortable, confident and supported. My role is not to remove something that protects you; it’s to help you feel good in your body.