Elongated labia are outer folds of tissue on the vulva that are large enough to hang down and be readily visible, in contrast to the more closed appearance that many people expect of the vulva. There is considerable natural variation in the shape of structures found on the vulva, and elongated labia are not particularly unusual, nor are they dangerous or abnormal. Patients can elect to undergo a surgical procedure to shrink them if they become a problem. In the surgery, a plastics specialist will trim the tissue down and reshape it for a less protruding appearance.
The labia majora and minora are symmetrical structures on the outside of the vulva that provide some protection for delicate mucus membranes. They also have a number of sensitive nerve endings that can play a role in human arousal as well as cover the vaginal opening when it is not in use. Patients with elongated labia may have enlarged inner and outer labia, or just one set of tissue may be somewhat longer than expected.
There appears to be a genetic component in the size of the labia, as some ethnic groups are more likely to have protruding labia. Some cultures accentuate this with a practice called labia stretching, where the tissue is encouraged to grow larger and longer. The folds of skin are highly elastic and when stretched gently over time can grow quite large. Once stretched, they will not return to their original size.
For some patients, elongated labia can be a problem. If the tissue is large enough, it may be uncomfortable to wear underwear or pants, and engaging in some physical activities may put stress on the tissue. This could cause groin pain or irritation. The woman may have a higher risk of infection and inflammation in and around the vulva, which can be a cause for concern for sexually active patients. In other cases, patients may experience psychological distress.
In elongated labia surgery, a plastic surgeon will meet with the patient to discuss the goals of the procedure and decide how much tissue to take off. He will carefully trim tissue while leaving nerves intact. The patient may experience pain and inflammation immediately after surgery and may need to take pain management medications as well as anti-inflammatories to stay comfortable. Usually sexual activity immediately after surgery is not recommended, but once the wound heals fully, the patient can resume normal activities.