My Labiaplasty Was About More Than Just Getting a “Designer Vagina”

23.07.2026, 16:33 allure.com

Scroll Instagram or TikTok and you'll find countless people documenting their breast augmentations, facelifts, and nose jobs. They post before-and-after photos, their recovery journeys, and surgeon recommendations, and the comments are usually flooded with encouragement and hand-clapping emojis (as they should be).

Labiaplasty doesn't get the same treatment. Despite the growing number of patients who have the procedure each year, it’s still rarely discussed openly. Instead, it's often reduced to the phrase "designer vagina"—a catchy term that can make the procedure sound superficial, frivolous, and purely aesthetic. It’s not. I know because a few months ago, I had one.

The term “designer vagina” was coined around the 2000s as a marketing phrase to categorize female genital cosmetic procedures. However, the zippy nickname is quite inaccurate: Labiaplasty doesn’t actually involve the vagina at all. In the simplest of terms, labiaplasty is a surgical procedure that alters the labia minora, the inner folds of skin surrounding the vaginal opening, typically by reducing their size or reshaping them to improve comfort or symmetry, says Dr. Courtenay Poucher, MD, a board-certified ob-gyn based in Santa Clarita, California and founder of the Labiaplasty Center of Los Angeles. Dr. Gary J. Alter, MD, a board-certified plastic surgeon in New York and Los Angeles who has specialized in labiaplasty for decades, says that while the term “designer vagina” can technically refer to procedures involving the labia majora (like a labia majoraplasty or a “labia puff”), it’s most commonly associated with labiaplasty.

While labiaplasty is often categorized as a cosmetic surgery, that classification doesn’t fully reflect why many women seek it out. “Over 90% of the patients in my practice who seek out labiaplasty are experiencing physical or significant emotional discomfort,” Dr. Poucher explains. The emotional discomfort is a result of feeling self-conscious about the appearance, and the physical is typically the result of excess tissue that's more susceptible to everyday irritation. While the outcome may also be a welcome aesthetic change, the motivation is often functional—relief from discomfort during movement, chafing during exercise, pinching in clothing, pain with intimacy, and recurrent infections.

What surprised me most during my research was how many people undergo this procedure. Labiaplasty hasn’t benefited from the growing transparency around plastic surgery, so it’s easy for a patient to feel like they’re alone in pursuing it. But according to the most recent available data from the American Society of Plastic Surgeons, more than 10,800 labiaplasties were performed in the United States in 2024. And while the surgery is still nowhere near as common as procedures like breast augmentation (over 306,000) or rhinoplasty (over 48,000), demand has been growing steadily. The ASPS only started including labiaplasty in its annual report in 2016. That year, the group noted that, in 2015, 9,138 labiaplasties had been performed in the U.S. by licensed surgeons. That comes out to about an 18% increase over the past decade.

There isn't one "typical" labiaplasty patient. A recent analysis of published scientific literature on labiaplasty found that the average age of patients in those studies was around 29, but ages ranged from as young as 10 and up to 72. The most commonly reported reasons for pursuing the procedure were dissatisfaction with appearance, discomfort in clothing, pain during sports and exercise, discomfort during intimacy, hygiene concerns, recurrent infections, and sexual dysfunction. For some patients, these are issues that arise for the first time after childbirth, weight loss, hormonal changes, or as natural changes that occur with aging. Others, like me, have experienced them for as long as they can remember.

In either scenario, many women assume this is something they just have to deal with. Dr. Poucher says that many patients don’t know the procedure is even an option, and often spend years living with symptoms before learning a treatment exists. (That was definitely true for me.)

Part of that delay comes down to the way we talk, or don't talk, about women's intimate health. "While procedures on breasts or noses are visible, widely discussed and normalized, the vulva remains a private and often stigmatized part of the body," says Dr. Poucher. That silence has real consequences for patients like me who don't realize their everyday pain could be treated.

I’ve played sports at a high level for most of my life. Track and soccer specifically, which meant a lot of running and daily movement. And for as long as I can remember, there was always something that didn’t feel right.

What started as friction and pulling during practices became something I experienced across many parts of my life. Running was the most obvious trigger, but long walks, certain pilates classes, tight workout clothes, bathing suits, anything that involved movement or compression made the discomfort worse. The discomfort was consistent, and it didn’t go away once I stopped playing sports competitively. It followed me into adulthood and showed up throughout my daily routine. At a certain point, I also started noticing a pattern of frequent UTIs, something I didn’t initially connect to my longtime discomfort, but now understand can be related.

According to Dr. Poucher, these symptoms are more common than most people realize—and are often under-discussed. “Common complaints include chafing or even bleeding during physical activity like jogging, pinching in clothing, and frequent adjusting,” she says. Dr. Poucher also explains that recurring irritation can sometimes contribute to frequent infections, including UTIs, because extra labial tissue naturally creates more surface area where bacteria can collect near the urethra.

In her experience, nearly all patients seeking labiaplasty are dealing with some form of physical discomfort tied to their anatomy. According to Dr. Poucher, this happens when excess labial tissue extends beyond the natural protective barrier of the outer labia, leaving it more exposed to friction and physical pain. For me, for a long time, it wasn’t something I questioned, or ever considered talking to a doctor about; it was just something I dealt with.

We’ve made important progress in normalizing that labia come in an enormous range of shapes and sizes—and they do (hello, labia library). If your labia minora isn’t neatly tucked away inside your labia majora, that does not automatically mean you need a labiaplasty. But it’s also okay to acknowledge when a completely anatomically normal part of your body is causing you real physical discomfort. There was nothing “wrong” with my anatomy, but it caused me years of pain.

When I did finally become aware of labiaplasty, it wasn’t through medical sources but, of all places, reality TV. When Jessi Draper of The Secret Lives of Mormon Wives and Molly O’Connell from Southern Charm both spoke about having the procedure, it caught my attention: they were among the first people I heard talk openly about the issues I’d been dealing with for years.

I was inspired to start doing my own research and was disappointed with what I initially discovered. On one end, there were highly technical medical explanations that didn’t reflect what the discomfort that warrants the procedure feels like in real life. On the other hand, there were conversations about how porn and social media were making young women feel bad about their labia, and therefore being “influenced” into getting the procedure, even if their anatomy wasn’t causing discomfort.

What I didn’t find was a judgement-free, straightforward explanation of what the procedure actually involves—how it’s performed, what it changes anatomically, and why someone would choose to do it in the first place. That led me to online forums, Reddit specifically, where I read firsthand accounts from women describing the exact same discomfort I had been dealing with. At one point, my browser history was almost exclusively labiaplasty forums. If anyone had looked over my shoulder during that time, there would have been a lot of questions. C’est la vie, or yolo, or whatever the kids say now. For the first time ever, the pain I’d been dealing with felt less like a me problem and more like something that was actually quite common, just rarely talked about, especially when it came to solutions.

Labiaplasty remains an ever-evolving area of medicine. There isn't universal agreement within the medical community about the safety of the procedure, or how patients should be counseled on it. Despite the growing popularity of the surgery, there remains a limited amount of high-quality published research on its long-term safety, effectiveness, and marked benefits.

The American College of Obstetricians and Gynecologists’ (ACOG) most recent guidance on Elective Female Genital Cosmetic Surgery, first published in 2020, reflects that uncertainty. “ Lack of published studies and standardized nomenclature related to female genital cosmetic surgical procedures and their outcomes translates to a lack of clear information on incidence and prevalence and limited data on risks and benefits," the statement reads. The organization goes on to recommend that physicians carefully counsel patients on the risks and limitations of the available evidence, noting that many claims surrounding cosmetic improvement, sexual function, and overall well-being have not been supported by rigorous scientific evidence. There is also a recommendation that ob-gyns “have sufficient training to recognize women with sexual function disorders as well as those with depression, anxiety, and other psychiatric conditions," including body dysmorphic disorder. A spokesperson from the ACOG told me that this guideline was reaffirmed in 2026, as there has been no new evidence that warrants an update to their position.

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