The motivation of women who have nymphoplasty is the hypertrophy, that is to say the increase in volume, of the labia minora, which seem too prominent to them. Thus, the operation of nymphoplasty, also called labiaplasty, is performed on women who are not satisfied with the appearance of their external genitalia. This operation, which therefore tends to surgically modify the morphology of the vulva, has mainly been carried out since the end of the XNUMXth century, and focuses on improving the appearance of the labia minora of the vulva. An author specializing in sexology, Gérard Zwang, nevertheless considers that “committed on a normal woman, these nymphoplasty operations are in no way founded in reason, and have no justification of a pathological or aesthetic nature”. This French urologist surgeon puts forward, as an explanation for this new standard injunction concerning the labia minora in women, the fact that the anatomy of the vulva has almost never been described in a truthful and realistic way.

The term nymphoplasty is etymologically derived from ancient Greek: nymph means “young girl”, and -plasty derives from the Greek plastos which means “molded” or “formed”. In anatomy, nymphs are another term for the labia minora of the vulva (labia minora). In surgery, plasty is a technique for reconstructing or modeling an organ, to restore its function or modify its anatomy, most often for aesthetic purposes.

The vaginal lips are folds of skin forming the outer part of the vulva, the labia minora being located inside the labia majora. At their upper end, the labia surround and protect the clitoris. Located inside the labia majora, the labia minora protect the vestibule, or entrance, of the vagina from external aggressions.

The labia minora are visible by spreading the labia majora: these two hairless skin folds are very sensitive. At the front, the labia minora therefore form the hood of the clitoris: it is the most sensitive of the female sexual organs, the equivalent of the glans in men and, like him, erectile and richly vascularized. The labia minora, also called nymphs, are more or less developed, of various shapes and colors. They are also rich in nerve endings and blood vessels, and change during sexual arousal.

Regularly denounced as too long, the nymphs can be partially amputated: this is called nymphoplasty, or even labiaplasty; that is to say the operation which consists in reducing the labia minora. However, Gérard Zwang, French surgeon-urologist and author of works devoted to sexology, writes: “These artificial modifications have long been part of the claims of only autodysmorphic people and a few“ worried ”. Here they are now, and quite the opposite, deliberately proposed, as a process of bodily embellishment. ” However, according to him, the operation of nymphoplasty carried out on a normal woman is not at all founded in reason: it has no justification of a pathological or aesthetic nature.

The book Gynecology by Felix Jayle, dated 1918, is in fact the first book to recognize that there is a wide variety of nymph development. This morphological diversity was also described, thirty years later, by Robert Latou Dickinson. In fact, in two out of three women, the clitoral hood and the nymphs have an emergent part which comes out of the vulvar slit. Finally, Gérard Zwand assures us that “with her nymphs, each woman has an individualized and original anatomical formation”.

Doctor Zwang estimates that in forty years of surgical practice and thirty years of sexological experience, he has known only one indication of instrumental intervention of labiaplasty: that of the asymmetry of the nymphs. 

Lymphoplasty is sometimes performed after a trauma, or a stretching that has occurred in this region, more particularly during childbirth.

In fact, Gérard Zwang observes that the surgical “rectification” of imaginary defects is becoming a clearly growing demand. Thus, in the most common cases, nymphoplasty is a surgical operation that is performed on women who are not satisfied with the appearance of their external genitalia. It is therefore very often carried out in people living with complexes in relation to this intimate part of their body.

On his website, Doctor Léonard Bergeron, plastic surgeon, assures him that “this intervention allows patients to reduce the physical discomfort that can cause too prominent labia minora and to reduce the pain felt during sexual relations”.

Doctor Romain Viard, a surgeon performing reduction nymphoplasty, also specifies on his website that it happens that women, on a daily basis, experience discomfort such as irritation, or discomfort in their sex life, in due to an enlarged labia minora. In her personal experience, patients wishing for labiaplasty usually have at least one of the following conditions: 

• daily discomfort in various activities by rubbing or “jamming” of the labia minora; 
• discomfort in dressing with pain in the labia minora with tight pants or thongs; 
• discomfort or pain during sports (especially horse riding or cycling);
• sexual discomfort with pain during penetration by blocking the labia minora;
• psychological discomfort such as shame at being naked in front of your partner;
• and finally an aesthetic discomfort.

Before the nymphoplasty, the surgeon sees the patient in consultation. The goal is to answer all her questions, and also remind her of the biological function of the vaginal lips. Then, the surgeon will determine with the patient the size of her labia minora.

The nymphoplasty operation lasts about an hour. It can be performed as an outpatient surgery. It can be carried out either under local anesthesia with sedation, or under short general anesthesia. The surgeon, following this anesthesia, will then remove the excess tissue. Thus, he removes the excess before performing the suture by means of an absorbable thread: there is, therefore, no thread to remove, and this technique ensures the formation of a flexible scar.

If the surgical intervention therefore consists in removing the portion deemed excess of the labia minora, in fact, various technical procedures are possible. On the one hand, the nymphoplasty can be carried out in a triangular fashion, in order to hide the scar as much as possible. This also prevents friction, irritation or scar retraction. In addition, the second technique of nymphoplasty consists in removing the excess lip lengthwise, that is to say all along the lip. The advantage over the triangular technique is that it allows more of the excess lip to be removed. And invisible suturing techniques make it possible to obtain an undetectable scar. The surgeon also performs hemostasis, in order to avoid excessive bleeding.

After this operation to reduce the labia minora of the vulva, it is possible to return home the same day. During the days following the operation, it is recommended to wear a panty liner, to take a shower once or twice a day, but also to clean the vagina after each bowel movement. Generally the postoperative effects are simple, and often not very painful. It is best to wear light clothing and cotton underwear. The first days, the wearing of the skirt is preferable to the pants.

The postoperative effects are often not very heavy, and the pain is light, when the operation is going correctly. It therefore results in the reduction of the size of the labia minora. Walking can sometimes be awkward for a few days. As for sexual intercourse, it is not recommended during the first four weeks of convalescence following labiaplasty.  

But in the end, don’t most patients who ask for such a “rectification” of their vulva give in to perfectionist propaganda? They are thus concerned, even worried, about their appearance, including in their most intimate places. And so, as Gérard Zwang points out, the operator, in fact, brings back “a stereotype”, a conforming model which will make all the vulvas passed to the “rectification” look alike. One of the origins of this quest which may seem almost insane would also come from the systematic censorship, in the West, “of the truthful representation of the external female genitalia, in the figurative arts and in the teaching”.

Ultimately, Dr. Zwang questions the results as well as the reasons pushing women, as well as the doctors who operate them, to carry out such rectification of the vulva: “Is it justifiable, in terms of medical ethics, to decide in organs – the nymphs, the clitoral hood – strictly normal, or to reduce the volume of a perfectly normal mount of venus, on the pretext that they do not please their carrier? ” One of the explanations put forward is in particular the ignorance, in general, in women, of the direct visual appearance of the vulva of their adult counterparts. In fact, Gérard Zwang criticizes the stereotypical artificial model of the vulva that the West seems imperative to standardize, and which ultimately leads to the increasingly frequent recourse, especially among young women, to this type of surgical operation. for aesthetic purposes.

The “vulva re-tailors”, as Gérard Zwang calls them, are obviously not immune to the setbacks inherent in any act affecting bodily integrity. Admittedly, in many cases, the postoperative consequences will be of no consequence. But the genitals being very vascularized, any negligent haemostasis exposes to the risks of haemorrhage and hematoma. In addition, there are also infectious risks. Another possible complication: when the nymphs have been sectioned flush with their insertion, the retractile scars can disfigure the vestibule, which is stunted and painful. Some women may also suffer from spontaneous pain. A failed vaginal nymphoplasty can, moreover, be devastating for the sex life. Indeed, a loss of sensitivity is possible, fortunately in rare cases, but the risk then is to take away all pleasure from the woman. 

Doctor Zwang points out that “the greatest silence still reigns over possible legal consequences, these disappointed women not daring to spread their scabrous grievances too much in front of a court”. For Dr. Zwang, this phenomenon of rectification of the labia minora of the vulva has become “a socio-cultural problem affecting sexual behavior, sexual mores in all countries of Western civilization”. He wonders: “Will adults be able to resist the sirens of“ trendy ”hair removal, interested promoters advocating the“ perfectionism ”of their rectification of nymphs – among others?”

Finally, Gérard Zwang believes that anatomists and their treatises should play an important role, notably having to teach “the morphological varieties of nymphs and of the clitoral hood”. He insists on the need to be able to also represent the labia minora emerging, more or less, beyond the border of the inner edge of the labia majora.