[CG] Labiaplasty in NHSGGC

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Requests for labial revision are only likely to be met in exceptional circumstances. As a general rule Greater Glasgow and Clyde Health Board is unable to offer cosmetic genital procedures. However, where there is significant variation from average female genitalia, this request will be considered. All surgeons who undertake Female Genital Cosmetic Surgery must comply with the Female Genital Mutilation Acts (RCOG Greentop Guideline 53)

Women who seek referral for labial revision should be advised by their primary care practitioner that these requests are only granted in a small number of cases. No referrals will be accepted in women under 18 years of age.

The average labia minora are between 1 and 4 cm but it is normal for the inner labia to be stretchy so may extend longer when pulled. About half of all women have labia minora that are longer than the labia majora. This appearance is exaggerated due to the increase in pubic hair removal and is not an indication for labioplasty. Most women do not have naturally symmetrical labia.

Referrals should initially be made to general gynaecology. The patient may then be seen by any gynaecologist. If that gynaecologist is of the opinion that the external genitalia are normal, then the patient should be reassured and discharged.

If the genitalia are considered to be outwith the “normal” range then referral should be made to the panel. This panel consists of a gynaecologist from each unit. The expectation is that the number of women who meet the criteria will be small. It is important that the panel members and patients remain anonymised to each other, and for this reason panel member names should not be included in any correspondence shared with patients.

Referral should be made by the originating gynaecologist to Kay McAllister at Sandyford for medical photography to be arranged. The images will be uploaded securely so that the panel can view the images and reach a decision. If the panel deems that the woman meets the criteria the woman will be offered an assessment with the Clinical Psychology team within the Plastic Surgery Service. If no psychological concerns are identified they will be offered an appointment with a clinician with appropriate skills who will perform the operation. It is anticipated that this will be one of a small group of named surgeons, but in some cases the opinion and/or input from the Plastic Surgery Service will be required. This will be the case in revisions of previous labioplasty cases.

Last reviewed: 28 February 2018

Next review: 31 December 2022

Author(s): C Bain

Approved By: Dr R Jamieson, Clinical Director