Dr. Medalie of Cleveland Plastic Surgery is an expert in labia minora reduction and vagina rejuvenation (labiaplasty and vaginoplasty) and has been peforming these procedures for more than 25 years. He also performs clitoral hood reduction and fat injection to the labia majora. He has presented his techniques and results at national meetings and in book chapters. His labiaplasty and vaginoplasty patients travel from all over Ohio, the midwest, east coast and west coast. Please visit his photo gallery to see examples of his work!
The term vaginal rejuvenation covers several different procedures. It is sometimes called female genital plastic surgery, female genital rejuvenation surgery, female genital cosmetic surgery, vulvovaginal plastic surgery and designer vagina surgery, among other terms. Among the procedures that comprise female genital plastic surgery are labiaplasty, clitoral hood reduction, labia majoraplasty (reduction or fat grafting), monsplasty, pubic lift and vaginoplasty.
External anatomy of the female genitalia
Before discussing the different types of vaginal rejuvenation surgery, it is important to look at the anatomy. The hairbearing area over the pubic bone at the upper portion of the female genitalia is called the mons. The hair-bearing outer lips are called the labia majora (singular is labium majus). The inner lips are called the labia minora (singular is labium minus). In the upper portion in the center is the clitoral hood, sometimes called the prepuce, which covers the clitoris in part or entirely. Below the clitoris is the urethral opening, and below that is the vaginal opening.
TV interview of Dr. Medalie about Labiaplasty
Labiaplasty and Vaginoplasty combination procedure
Labiaplasty procedure
Labiaplasty, Vaginoplasty, Hoodectomy What’s the difference?
Before you begin navigating through this site or surfing the web, its important to know what procedure you are looking for. Depending on your need, there are three common procedures performed to the vulva.
Vaginal Rejuvenation Comparison Chart: Labiaplasty vs. Vaginoplasty vs. Clitoral Hood Reduction
| Procedure | Main Purpose | Common Candidates | Surgical Technique | Recovery Time | Benefits | Considerations |
|---|---|---|---|---|---|---|
| Labiaplasty | Reduces or reshapes the labia minora or labia majora | Women experiencing discomfort, irritation, or cosmetic concerns with enlarged or uneven labia | Trimming or wedge excision of excess labial tissue | 1–2 weeks for daily activity, full healing in 6–8 weeks | Improved comfort in clothing and exercise, enhanced appearance, reduced self-consciousness | Swelling and temporary sensitivity; results are permanent but can change with childbirth or aging |
| Vaginoplasty | Tightens and reconstructs the vaginal canal | Women after childbirth, aging, or with concerns about vaginal laxity affecting sexual function | Removal of excess tissue and tightening of vaginal muscles | 2–3 weeks for light activity, 6–8 weeks for sexual activity | Increased vaginal tightness, improved sexual satisfaction, enhanced muscle tone | Longer recovery compared to labiaplasty, requires surgeon skilled in pelvic anatomy |
| Clitoral Hood Reduction (Clitoral Unhooding) | Reduces excess clitoral hood tissue for improved exposure and sensitivity | Women with redundant tissue covering the clitoris causing reduced stimulation or cosmetic concerns | Excision of excess skin while preserving clitoral nerves | 1–2 weeks for most activities, 4–6 weeks for full healing | Enhanced clitoral stimulation, improved aesthetics, can be combined with labiaplasty | Requires precision to avoid nerve damage; results vary depending on anatomy |
Labiaplasty
For women that experience discomfort when wearing tight pants or exercising or feel embarassement about the size of their labia, labiaplasty surgery (also known as labia minora reduction or labioplasty) is the right procedure.
No-Labiaplasty can be performed with mild oral sedation and local anesthesia.
Typical surgery time is around 1-1.5 hours.
I typically give my patients antibiotics for three days around the surgery. I have NEVER had a post-operative infection. Sometimes patients who take antibiotics get yeast infections and this has happened to several of my patients. The treatment consists of stopping the antibiotics and applying a topical anti-yeast agent. Please be aware that smoking is the number one reason for post-operative infections and healing problems. I thus require my patients to STOP SMOKING at least 6 weeks prior to any labiaplasty procedure.
The labia are very vascular and bleed easily. During the surgery, local anesthetic is injected into the tissue-this blocks the sensation and also constricts blood vessels. As a result, there is very little bleeding during the surgery. I have NEVER had a patient have a bleeding complication post-op.
While it may seem that this is a very bad area to have surgery on, in fact, the labia are very resilient and heal speedily. Pain that may require narcotic pain medicine typically lasts only a few days. After that, ibuprofen (Motrin and Advil) is sufficient. I recommend that patients take a week off from work, but if you have a desk job, you can go back sooner. The post-op care is fairly easy and involves cleansing several times per day and the application of antibiotic ointment for a week. Most of the swelling and all of the external stitches have disappeared by two weeks.
I recommend that patients refrain from intercourse for at least 4 weeks after surgery. This does not mean that other types of sexual activity cannot take place. Even after 4 weeks, the labia incisions may be sensitive and patients need to use caution and plenty of lubrication.
Some of the deep sutures under the skin can take up to three months to completely dissolve. For this reason, some patients may report sensitivity issues such as itching for up to three months post-op. After that, sensation issues are very uncommon. Damage to the clitoris with resulting changes in the ability to have orgasm has never happened in my patient population.
Yes – I frequently perform multiple procedures on labiaplasty patients. Sometimes, I perform clitoral unhooding. This procedure removes some of the skin overlying the clitoris to allow for greater stimulation during intercourse. The labia majora can also be reduced (this is more typically asked for by my older patients or patients who have lost significant amounts of weight). Vaginoplasty or vaginal rejuvenation is a procedure to tighten the vaginal introitus after child bearing. This is easily performed in conjunction with labiaplasty. Finally, all the other cosmetic procedures that I perform (e.g. breast augmentation, tummy tuck etc.) can be performed at the same time as labiaplasty. These would require a trip to the operating room and general anesthesia.
Simple labiaplasty under local anesthesia and mild sedation costs around $4300 at Dr. Medalie’s outpatient procedure clinic. Clitoral hood reduction can be added for $750. Labia majora reduction is an additional $2000 (or $3500 as a stand alone procedure). All procedures are less expensive when combined with other procedures such as vaginoplasty or breast augmentation.
I frequently perform labia reduction and vagina rejuvenation surgery on patients who live out of town and are unable to easily to see me in consultation prior to the procedure. I have several requirements for these patients: I must see pictures of them prior to scheduling surgery. They need to contact my office and have my patient care manager email them a medical history form to be filled out and sent back. Typically, the patient will come into town 1 day prior to the procedure, and I will see them the day of surgery. I will perform a phone consultation about 3 weeks prior to surgery. I will then perform the operation and patients can usually return home the day after surgery. Your post-op visit will be a virtual visit with my nurse, Michelle, about 10-14 days after surgery. I will then follow the progress of the patient via e-mailed pictures. My patient care manager has information about hotels in the area as well as financing. You may contact her at valerie@clevelandplasticsurgery.com.
Please visit Dr. Daniel Medalie’s photo gallery to see before and after labiaplasty and vaginoplasty pictures. You may also call him at 216-393-9924. You can also e-mail his patient care manager, Valerie, at valerie@clevelandplasticsurgery.com.
Vaginoplasty
After childbirth, or as women age, their vagina can become, in popular terms, “loose.” Vaginoplasty, also known as vaginaplasty or “vaginal rejuvination”, is popular for tightening the vagina or improving sexual experience.
As a woman’s body ages, it goes through a number of changes. Wrinkles develop and skin sags. Fat deposits increase and muscle mass may decrease. The vagina is no stranger to change either. While most young women have taut and stretchy vaginas, a number of women find that they lose vaginal tone and strength as they age. Some of this simply comes as a woman ages, and some of it comes from childbirth or simply because of the natural vaginal state. The severe strain put on the pelvis and the vagina in particular can cause the vaginal opening to be stretched, and it can cause a loss of tone in the muscles which surround the vagina. Vaginal rejuvenation is a technique which is used to help increase the tone and tightness of the vagina. During vaginal rejuvenation, the vaginal opening and walls will typically be tightened, and the surgeon will also help to rebuild and reinforce some of the surrounding supportive tissue. All of this helps to return the vagina to a younger, tighter state. Vaginal rejuvenation is not only a surgery designed to correct or perfect a physical condition, but it is also meant to boost the patient’s confidence and help them achieve a better quality of life. After vaginal rejuvenation, a patient should return soon to their normal activities. Vaginal rejuvenation is a surgery that with the proper care will not interfere with the patient’s quality of life and should show results in a very short time.
Reduced vaginal tone can be a contributing factor in a loss of sexual sensation and satisfaction. During sexual intercourse, a certain amount of friction is needed to ensure the ideal amount of pleasure for both partners. Oftentimes, a loose and weak vagina is unable to provide enough friction to give the woman or the man optimal pleasure. This can leave both partners with a feeling that sex isn’t as good as it once was, and this, in turn, can result in a lowered interest in sex and a lowered level of intimacy. Restoring tightness to the vagina can increase sexual satisfaction for both partners.
Vaginal rejuvenation can solve problems with sexual sensitivity that are directly related to a lack of vaginal tone or stretching of the vaginal mucosa from childbirth or episiotomy. If the vaginal walls or opening have been stretched too much during childbirth, vaginal rejuvenation can decrease their size. If a man feels like his wife’s vagina is just too loose and the wife feels that his penis isn’t thick enough to fill her up, vaginal rejuvenation may be able to help. Vaginal rejuvenation can also address issues where a lack of vaginal tone is caused by weak vaginal and perineal muscles.
Vaginal rejuvenation cannot solve every problem relating to female sexual function and pleasure. It cannot solve sexual problems that stem from emotional or relationship issues. It is not a solution for sexual dysfunction or anorgasmia. It cannot solve a low interest in sex, unless that low interest is an outgrowth of low sexual satisfaction due to vaginal relaxation. Vaginal rejuvenation only affects the vaginal introitus or opening. It does not typically address issues relating to the labia or the clitoris (for more information on how to address these issues, please see the labiaplasty page). Similarly, vaginal rejuvenation can’t solve incontinence issues that are caused by weak pelvic muscles. It cannot solve urge incontinence, which is caused by overactive bladder muscles. It also cannot cure overflow incontinence, which occurs when the bladder doesn’t fully empty.
Vaginoplasty (vaginal rejuvenation) is designed to remove extra mucosa, plicate (tighten) the underlying muscle and close the defect in a way that tightens the vaginal vault. A diamond shaped piece of perineum and internal vaginal mucosa is removed to allow tightening of the underlying muscle and closure of the vaginal introitus (external opening). Typical tightness is to allow only two and one half finger breadths of space in the vaginal introitus (opening). The operation is outpatient and takes around 1-2 hours. It is typically well tolerated, and healing is similar in time and length to a standard episiotomy performed at childbirth. This must be performed in a surgery center under general anesthesia. The average cost, including anesthesia and facility fees, is around $7000. It is less expensive if performed in combination with other procedures such as labiaplasty and clitoral unhooding.
Yes – I frequently perform multiple procedures on vaginoplasty patients. Sometimes, I perform clitoral unhooding. This procedure removes some of the skin overlying the clitoris to allow for greater stimulation during intercourse. The labia majora can also be reduced to decrease the extra skin or augmented with fat to puff up the loose skin (this is more typically asked for by my older patients or patients who have lost significant amounts of weight). Labiaplasty is commonly performed at the same time as vaginoplasty. Finally, all the other cosmetic procedures that I perform (e.g. breast augmentation, tummy tuck etc.) can be performed at the same time as vaginoplasty. These would require a trip to the operating room and general anesthesia.
Vaginoplasty needs to be performed in the OR with the patient asleep and typically costs around $7000. It is less expensive when combined with other procedures such as labiaplasty or breast augmentation.
I frequently perform vagina rejuvenation surgery on patients who live out of town and are unable to easily to see me in consultation prior to the procedure. I have several requirements for these patients: I must see pictures of them prior to scheduling surgery. They need to contact my office and have my patient care manager e-mail them a medical history form to be filled out and sent back. Typically, the patient will come into town 1 day prior to the procedure, and I will see them the day of surgery. I will perform a phone consultation about 3 weeks prior to surgery. I will then perform the operation and patients can usually return home the day after surgery. Your post-op visit will be a virtual visit with my nurse, Michelle, about 10-14 days after surgery. I will then follow the progress of the patient via e-mailed pictures. My patient care manager has information about hotels in the area as well as financing. You may contact her at valerie@clevelandplasticsurgery.com.
Hoodectomy
Hoodectomy also known as “clitoral unhooding” is the right procedure for women that have decreased sexual sensitivity due to extra skin surrounding their clitoris. It can also reduce extra tissue that gives the labia an asymmetric or “top heavy” appearance after primary labiaplasty.
Labiaplasty Surgery: Cost, Recovery, and What to Expect
Labiaplasty surgery is a cosmetic and functional procedure designed to reshape or reduce the size of the labia minora (inner vaginal lips). Many women consider labiaplasty to relieve physical discomfort, improve confidence, or enhance the appearance of the vaginal area. Enlarged labia may also be noticeable in tight fitting pants, and can cause discomfort during intercourse, with clothes, or with exercise. Enlarged labia are usually congenital but may be increased from hormonal changes or childbirth. Whether for medical reasons or personal preference, labiaplasty has become one of the most sought-after vaginal rejuvenation procedures worldwide.
What Is Labiaplasty?
Labiaplasty is a minor outpatient surgery that reshapes the inner vaginal lips. Enlarged or uneven labia can cause:
- Irritation during exercise, cycling, or horseback riding
- Discomfort in tight clothing such as swimsuits or leggings
- Pain or pulling during sexual intercourse
- Self-consciousness about appearance
By removing excess tissue and sculpting a more symmetrical look, labiaplasty creates natural, lasting results that improve both function and aesthetics.
Benefits of Labiaplasty Surgery
Women choose labiaplasty for many reasons. Some of the most common benefits include:
- Reduced discomfort from rubbing or pinching during daily activities
- Improved confidence in intimate settings and body image
- Enhanced sexual comfort with less pulling or irritation
- Better fit in clothing such as swimsuits, leggings, or yoga pants
- Balanced appearance of the vaginal area
Labiaplasty Procedure: How It’s Done
A labiaplasty can be performed using one of two main techniques:
- Trim Method: Excess tissue is removed along the edge of the labia for a smooth, natural contour.
- Wedge Method: A small wedge of tissue is removed from the center, maintaining the natural edge of the labia. I utilize almost exclusively the wedge technique of labia minora reduction (labiaplasty) which preserves the contour, color, and anatomy of the labia minora edge. The excess labium is excised in a “V” manner and the upper and lower edges are sutured together. Therefore, the only suture line visible on the edge is a small transverse line instead of a long longitudinal vertical suture line. This significantly decreases the discomfort and visibility of the procedure.
The surgery typically takes 1–2 hours under local anesthesia with sedation or general anesthesia. Patients go home the same day. Most of my patients have chosen to have the surgery with local anesthesia only and mild oral sedation (which is very well tolerated
Labiaplasty Recovery
Recovery after labiaplasty is generally quick and manageable. Most women return to desk jobs or light activities within a few days. Swelling and minor discomfort usually resolve within 1–2 weeks.
- Back to work: 3–5 days (depending on activity level)
- Exercise: Light activity after 2 weeks
- Sexual activity: Usually safe after 4–6 weeks
- Final results: Visible once swelling subsides, usually after 8–12 weeks
Following your surgeon’s instructions closely ensures the best outcome and smooth healing.
Labiaplasty Cost
The cost of labiaplasty varies depending on the surgeon’s experience, location, and surgical technique. On average, labiaplasty costs range from $4000-5000 with Dr. Medalie. This fee may includes anesthesia, facility charges, and follow-up appointments. Many patients view the investment as worthwhile for the long-lasting improvement in comfort and confidence.
Labiaplasty Before and After
When researching labiaplasty before and after photos, keep in mind that results are highly individualized. Dr. Medalie can provide examples that showcase natural, balanced outcomes tailored to your anatomy and goals. Click HERE to see more before and after labiaplasty photos.
Is Labiaplasty Right for You?
You may be a good candidate for labiaplasty if you experience:
- Discomfort from enlarged or uneven labia
- Frustration with clothing fit
- Pain or irritation during intimacy
- Self-consciousness about appearance
A consultation with Dr. Medalie is the best way to determine if this procedure can help you achieve your goals.
Choosing a Labiaplasty Surgeon
When searching for labiaplasty near me, look for a surgeon who is:
- Board-certified in plastic surgery
- Why not Ob/Gyn? Dr. Medalie has had a great deal of experience revising trim labiaplasty poorly performed by Ob/Gyns. While he recognizes that every practitioner is unique in their skill set, in general he feels that plastic surgeons are more precise and meticulous in their attention to detail.
- Experienced in vaginal rejuvenation procedures
- Able to provide personalized recommendations and before/after results
- Dr. Medalie meets all of these criteria and has been performing labiaplasty for 26 years.
- Why Choose Dr. Medalie?
- Dr. Daniel Medalie has built a reputation as one of the most skilled plastic surgeons in the country. With over twenty six years of experience in Cleveland and numerous accolades, including being named one of America’s Best Doctors by Best Doctors, Inc. for 15 consecutive years, Dr. Medalie combines technical expertise with an artistic eye. He has been consistently recognized by his peers and patients, earning awards like the People’s Choice Award for over a decade and being named a Top Doctor by US News and Cleveland Magazine.In addition to his impressive credentials, Dr. Medalie’s approach is rooted in compassion and precision. As a Harvard graduate with extensive training in both medicine and art, he brings a unique perspective to every procedure. Whether guiding patients through reconstructive or aesthetic surgery, Dr. Medalie is an excellent choice for individuals seeking labaiplasty in Cleveland, Ohio.
Final Thoughts
Bottom line: Labiaplasty surgery is a safe, effective way to improve comfort, confidence, and vaginal aesthetics. From reducing irritation to enhancing appearance, the procedure offers both functional and cosmetic benefits with long-lasting results. If you are considering labiaplasty, schedule a consultation with Dr. Medalie to discuss your options.
Dr. Medalie also performs other female genital surgery including labia majora remodeling, vaginal rejuvenation or vaginoplasty, pubic liposuction and pubic lift.
*Plastic surgery results can vary from patient to patient and are not guaranteed.
Vaginoplasty Surgery: Cost, Recovery, and What to Expect
Vaginaplasty surgery (vaginal rejuvenation) is designed to remove extra mucosa, plicate (tighten) the underlying muscle and close the defect in a way that tightens the vaginal vault. Typical tightness is to allow only two and one half finger breadths of space in the vaginal introitus (opening). Most candidates for the surgery are women who have had several children and notice that their vaginal tightness is not the same as it was prior to child bearing. Frequently they have had episiotomies or tears in the posterior vagina during child birth and now have a rounded base of the vagina that looks and feels loose.
What Is Vaginoplasty?
Vaginoplasty is a surgical procedure that repairs and tightens the vaginal canal and surrounding muscles. Over time, the vaginal muscles may stretch due to childbirth, trauma, or natural aging, leading to looseness, reduced sensitivity, or a decrease in sexual satisfaction.
By surgically tightening these muscles and tissues, vaginoplasty restores strength, tone, and function while also improving confidence and intimate well-being.
Benefits of Vaginoplasty Surgery
Women choose vaginoplasty for a variety of reasons. The most common benefits include:
- Increased vaginal tightness and muscle tone
- Enhanced sexual satisfaction for both partners
- Restoration of vaginal structure after childbirth or aging
- Improved confidence and body image
- Long-lasting results compared to nonsurgical treatments
Vaginoplasty Procedure: How It’s Done
Vaginoplasty is performed as an outpatient surgery, usually under general anesthesia or local anesthesia with sedation. During the procedure:
- Excess vaginal lining is removed.
- Vaginal muscles are tightened with sutures.
- The opening of the vaginal canal is narrowed for improved tone.
The surgery typically takes 1–2.5 hours depending whether the vaginaplasty is combined with labiaplasty, and all patients return home the same day.
Vaginoplasty Recovery
Recovery after vaginoplasty requires rest and careful aftercare, but most women find it manageable. It is typically well tolerated and healing is similar in time and length to a standard episiotomy performed at childbirth.Common recovery guidelines include:
- Back to work: 1–2 weeks, depending on activity level
- Exercise: Light walking after a few days; more strenuous activity after 4 weeks
- Sexual activity: Typically resumed after 6–8 weeks
- Final results: Fully noticeable within 3–6 months
Swelling and minor discomfort are normal during the early healing phase. Following your surgeon’s instructions is key for optimal results.
Vaginoplasty Cost
The cost of vaginoplasty varies depending on whether it is combined with other procedures (such as labiaplasty). On average, vaginoplasty alone costs around $6000-7000 with Dr. Medalie. Fees typically cover anesthesia, facility costs, and follow-up appointments. It is less expensive if performed in combination with other procedures such as labiaplasty and clitoral unhooding.
Vaginoplasty Before and After
When researching vaginoplasty before and after results, it’s important to remember that outcomes vary by individual. Dr. Medalie can provide examples of natural, functional improvements that highlight both aesthetic and restorative benefits.
Is Vaginoplasty Right for You?
You may be a good candidate for vaginoplasty if you experience:
- Vaginal looseness after childbirth or aging
- Reduced sensation during intimacy
- Desire for stronger muscle tone and structure
- Concerns with self-confidence or comfort
A consultation with Dr. Medalie can help determine if vaginoplasty is the right choice for your goals.
Choosing a Vaginoplasty Surgeon
When searching for vaginoplasty near me, consider these key factors:
- Board certification in plastic surgery or gynecology
- Extensive experience in vaginal rejuvenation procedures
- Ability to provide personalized treatment and before/after examples
- Dr. Medalie meets all of these criteria and has been performing vaginoplasty for 26 years.
Final Thoughts
Bottom line: Vaginoplasty surgery is a proven way to restore vaginal tightness, enhance intimacy, and improve overall confidence. With long-lasting results and significant functional benefits, vaginoplasty is one of the most effective vaginal rejuvenation options available. If you’re considering this procedure, consult with Dr. Medalie to learn more about your options.
The Consultation at Cleveland Plastic Surgery
- When you schedule a labiaplasty or vaginal rejuvenation consultation with Dr. Medalie, he will go over the procedure in depth, show you numerous patient pictures and let you examine photos of your own labia (if you wish) in order to get an accurate idea of what surgery can and can not do for you.
- This will gives you an opportunity to see if you can communicate well with Dr. Medalie.
- Dr. Medalie can assess you for any issues that may complicate or prevent your vaginal rejuvenation
- You can learn how different choices may impact your result.
- You can learn about different types of surgery (such as trim vs. wedge labiaplasty)
- Together, you and Dr. Medalie will come up with a plan for surgery that achieves your goals for a more refined and pleasing vaginal area.
- You can ask what to expect during your recovery from your vaginal rejuvenation.
Dr. Medalie also performs other female genital surgery in Cleveland, Ohio including labia majora remodeling (surgical reduction and fat augmentation), clitoral unhooding, pubic liposuction and pubic lift. Labiaplasty and vaginoplasty can be performed as a combined procedure and the average cost is around $10,000 (this includes anesthesia and facility fee).
For more of Dr. Medalie’s labiaplasty and vaginoplasty patient photos, please visit his photo gallery.
