Labia Majoraplasty is the reduction of the outer larger “lips” of the vulva. This broader outer lips of the vulva can be enlarged with excess skin and fat to give a bulky look but can also be deflated with no fat and just sagging like a deflated tire. This can cause an embarrassing bulge in tight outfits, bikinis, Lululemons. The slang is “Camel Toes” when the problem is a big bulge clearly outlined in clothes. Worse in a wet bikini. This is mostly genetic and not related to diet or exercise. You are just born with it. So it is either Deflation or a Camel Toe. Excess skin with little fat or bulkiness due to too much fat. Other common complaints include a feeling of fullness and heaviness and excess sweating. Reasons for the loose look are the stretching and aging of skin. You cannot defeat gravity. Major weight loss, stomach stapling, are other causes of fat loss in the labia majora.
The old technique of labia majoraplasty created railroad track scars on the surface. I modified this in 2005 and hid the scars by removing a crescent shaped portion of the inner labia majora and putting the suture line in the crease between the labia minora and labia majora. I learned this surgery when I was at MD Anderson Cancer and Tumor Institute doing vulvectomies for vulvar cancers in 1998. We did them pretty ugly then as our goal was to save lives. I modified the surgery to make it a cosmetic and functional. I just moved the suture lines to natural folds. It was a no brainer. I do these in my office and it takes me 1-2 hours. This surgery is simpler to do than labia minoraplasty.