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Feeling confident and comfortable in your body is essential—but when enlarged or asymmetrical labia minora cause discomfort, irritation, or self-consciousness, it can affect everything from physical activity to intimacy. If you’ve been quietly researching labiaplasty or wondering whether relief is possible, you’re not alone—and you deserve to explore your options in a safe, supportive environment.
Dr. Karen Horton is a Board-Certified Plastic Surgeon in the San Francisco Bay Area who brings both extensive surgical expertise and a deeply personal understanding of women’s health and wellness to every consultation. As an active woman and a mother herself, Dr. Horton is committed to empowering women through procedures that improve function, enhance aesthetics, and restore confidence. Whether your goals are cosmetic, functional, or both, she approaches labiaplasty with respect, compassion, and a focus on individualized care.
Board Certified San Francisco Plastic and Aesthetic Surgeon Dr. Karen Horton understands how important it is for a woman to feel comfortable and confident in her body, as another physically active woman who happens to be a surgeon would intimately know. In some cases, women have insecurities about the appearance of their vagina, the size of the labia minora and/or labia majora, or the shape of their external genitalia may cause discomfort when walking, working out, or engaging in other daily activities. Enlarged labia may also make a woman more likely to get yeast infections or urinary tract infections, or it can create friction or soft tissue tears.
A labiaplasty is an aesthetic genital surgical procedure where long, enlarged or redundant labia minora or labia majora tissue is removed, and may be performed for cosmetic or functional reasons, or a combination of the two.1 A reduction of the clitoral hood skin is usually included in a labiaplasty to create the most aesthetically pleasing results.
Benefits of labiaplasty include:
For many women, this procedure offers both cosmetic and functional enhancement that leads to long-lasting confidence.
Dr. Horton and the Dream Team - A long overdue THANK YOU for your care and love this fall. Thank you for making my labiaplasty surgery amazing, simple - dare I say FUN!? (at times) and as painless and stress free as possible! Thank you for warmly welcoming all my kiddos as well (they keep asking to come back to see the nice beautiful Doctors with the great snacks!). I couldn't have dreamed up a better experience! ... and just like you said - the gift of "NOT THINKING/WORRYING ABOUT IT" anymore was the greatest! Lots of love, A
„There are a number of cosmetic procedures that are considered labiaplasty:
The most common type of labiaplasty is a labia minora reduction, which involves trimming the inner labia using the “trim technique”.
During this Plastic Surgery procedure, the labia majora (outer lips of the vulva) are reduced. This is a less common labiaplasty procedure, and may result in scarring and additional post-surgical swelling.3
Many women who are candidates for a labiaplasty also have redundant clitoral hood tissue. In these cases, the excess tissue is carefully trimmed away and overlying skin is rearranged. This procedure is done with extreme care, so as not to risk nerve injury to the clitoris or affect sexual stimulation or sensation.4 The best analogy to a clitoral hood reduction is transforming pleated-front pants to flat-front pants.
Some women have a variety of issues that dictate a combination of labia minora trim, clitoral hood reduction and labia majora reduction. The most common combination is labia minora and clitoral hood reduction. Every woman’s body is different, and each labiaplasty procedure is tailored to her unique anatomy and aesthetic goals.
Vaginal Rejuvenation Overview
Karen Horton MD
All About Labiaplasty Surgery
Karen Horton MD
If you are unhappy with the appearance of your labia, or if excess labial tissue causes you discomfort, you may be a good candidate for labiaplasty plastic surgery. Women of all ages, backgrounds, shapes, and sizes seek a labiaplasty, and we believe that women should feel no embarrassment in seeking this procedure.
Common concerns include enlarged labia, rubbing in tight clothing, or the visibility of the vaginal lips that can slip out of swimsuits, panties or activewear.
The first step in preparing for labiaplasty is a private consultation with Dr. Karen Horton. During this 45 minute long meeting, Dr. Horton will help you feel at ease so that you can candidly discuss your cosmetic concerns and goals. Together, you will review labiaplasty surgical technique options and decide whether this is the right procedure for you.
A full history and getting to know you as a patient, physical examination (no photos will be taken at the consultation) and evaluation of your anatomy will take place in a warm and friendly, professional setting. Labiaplasty is a very common procedure in our practice, having helped hundreds of women seeking improvement of their labia region.
Patients who are on GLP-1 medications such as Ozempic, Wegovy, Mounjaro, Gardiance and others for weight loss or diabetes should have completed their weight loss journey before having labiaplasty surgery and should plan to be off these medications prior to planning surgery. GLP-1 medications must be stopped a full month before any surgery under general anesthesia to avoid complications. Learn more about how to stay safe when taking diabetic or weight loss medications including semaglutides in this blog post.
Typical location of a labiaplasty scar, hidden in a natural fold.
Labiaplasty is an outpatient procedure, and is usually performed with the aid of inhaled laughing gas, an oral anti-anxiety medication and local anesthesia. General anesthesia can be used for patients who request it, but this is rarely needed.
The most common labiaplasty procedure is the “trim technique”, during which Dr. Horton removes excess tissue from along the edge of the labia, from back to front, including excess clitoral skin, taking a small “pinch” of tissue from each side of the clitoral hood region.
This procedure removes the darkly pigmented and cobblestone-like textured labia minora tissue that is unwanted by most women seeking a labiaplasty. The more smooth, shiny and pink tissue that is up higher on the labia minora is preserved to maintain a normal and natural appearance and normal labia function – lubrication and prevention of friction.
Following a labiaplasty, it is normal to experience some soreness and swelling. Dr. Horton’s office will make sure you are prepared with prescribed pain medication, and will provide you with detailed written post-surgical instructions and monitor your healing during follow-up appointments. It is best for patients to avoid strenuous physical activity for the first two to three weeks following labiaplasty surgery. You should also refrain from using tampons and engaging in sexual intercourse for four weeks after labiaplasty. Limiting sexual activity during recovery helps reduce the risk of reopening incisions or disrupting healing sutures.
I had the best experience having my surgery with Dr. Horton; I felt very listened to and very secure in her hands. She was extremely personable and understood me and what I wanted. She put me in touch with women who had had similar operations and made herself available to answer any questions or concerns I had. Moreover, I am extremely happy with all the results of my surgery, it is exactly what I have dreamed of and am so grateful she has given me this huge gift. Dr. Horton is skilled, personable, and accommodating, and is definitely someone I would recommend to any of my closest relatives. She has my 100% recommendation and if I need any surgery in the future, I would make the trip back to see her.
„Is liposuction done with labiaplasty?
In some cases, liposuction is performed with labiaplasty to improve contours of the pubic region, inner thighs, and/or buttocks. Liposuction can also be done on other areas of the body, like the abdomen, at the same time as labiaplasty for a more complete body contouring transformation.
What are the risks of labiaplasty?
Labiaplasty is considered to be a safe procedure, but any surgical procedure does carry some risk of complications. Working with an experienced aesthetic Plastic Surgeon like Dr. Horton is the best way to feel confident in the outcome of your labiaplasty. Risks of labiaplasty may include:
Can I have labiaplasty before pregnancy?
Labiaplasty has no effect on childbirth, and surgical results will not be affected by pregnancy, so it is reasonable to have this procedure before having children. Even after multiple vaginal deliveries, the labia will not stretch out again. Labiaplasty is a “one-time procedure” with lasting results, and is a “quality of life surgery” that can improve the ability to be physically active without discomfort in women as young as older teens to women in their 60’s and 70’s.Most women notice their labia minora grow darker and longer starting at puberty. With age and time, women lose supportive collagen and stretchy elastin in all areas of our body, including the labia minora and majora - thus, many women notice more redundancy and hanging of their external genitalia as they get older. The best time to plan a labiaplasty is personal, and should take into consideration lifestyle issues, ability to take time off work and physical activities for recovery, and level of readiness for surgery, both mental and emotional.
Is labiaplasty part of a Mommy Makeover?
Absolutely. In many instances, Moms choose to have a labiaplasty to address changes to their external genitalia that may have become accentuated by pregnancy and childbirth. It is not uncommon for women to combine this with other surgical procedures or treatments in their personalized Mommy Makeover.
Will I have scars after labiaplasty?
The labia minora is composed of mucosa, similar to the inner lining of your mouth and gums. Consequently, there is very little scarring after a labiaplasty - the tissue heals similar to when you bite the inside of your cheek accidentally. For labia majora reduction, we plan the procedure to carefully hide any scars in the natural folds of the labia where the labia minora and majora meet. In many cases, labiaplasty scars often heal so well that even a gynecologist can’t see them.6
Where can I see actual before and after images of labiaplasty?
Visit our labiaplasty website gallery here!
How much does labiaplasty cost near me?
Labiaplasty cost in San Francisco can vary depending on factors such as the complexity of your procedure, whether it is combined with other treatments, and the experience of your surgeon. At our San Francisco Bay Area practice, Dr. Horton provides highly individualized care, and your customized quote will reflect your unique surgical plan. During your consultation, we’ll review all costs in detail and discuss financing options to help make your procedure as accessible and stress-free as possible.
Dr. Karen Horton and her team understand that the decision to undergo cosmetic surgery of the labia – and other regions of the body – is deeply personal, and we make sure that each of our patients feels comfortable and confident during their experiences with us. To learn more about labiaplasty and vaginal rejuvenation, please Contact us to schedule a private and confidential consultation with Dr. Horton in San Francisco.
1 American Society of Plastic Surgeons. What is labiaplasty? Available: https://www.plasticsurgery.org/cosmetic-procedures/aesthetic-genital-plastic-surgery/labiaplasty. Accessed April 6, 2022.
2 Veale, D., Naismith, I., Eshkevari, E. et al. Psychosexual outcome after labiaplasty: a prospective case-comparison study. Int Urogynecol J 25, 831–839 (2014). Available: https://doi.org/10.1007/s00192-013-2297-2. Accessed April 6, 2022.
3 American Society of Plastic Surgeons. What is a labia majoraplasty? Available: https://www.plasticsurgery.org/cosmetic-procedures/aesthetic-genital-plastic-surgery/labia-majoraplasty. Accessed April 6, 2022.
4 American Society of Plastic Surgeons. What is a clitoral hood reduction? Available: https://www.plasticsurgery.org/cosmetic-procedures/aesthetic-genital-plastic-surgery/clitoral-hood-reduction. Accessed April 6, 2022.
5 American Society of Plastic Surgeons. What is labiaplasty? Available: https://www.plasticsurgery.org/cosmetic-procedures/aesthetic-genital-plastic-surgery/labiaplasty. Accessed April 6, 2022.
6 American Society of Plastic Surgeons. Four common questions women have about recovery after labiaplasty. Available: https://www.plasticsurgery.org/news/blog/four-common-questions-women-have-about-recovery-after-labiaplasty. Accessed April 6, 2022.
Dr. Karen Horton has either authored or reviewed and approved this content.
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Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the Pacific Heights District in the Pacific Professional Building.
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Saturday-Sunday: Closed
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9 AM to 5 PM
Tuesday:
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Wednesday:
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Thursday:
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Friday:
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Saturday:
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Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the
Pacific Heights District
in the Pacific Professional Building.
SHOP SKIN CARE*Please note: Our office is no longer a Participating Provider for insurance. We can provide a financial quote for what anticipated surgical fees will be after your consultation.
