Is there a perfect vagina? What’s normal and the facts on labiaplasty

No. There’s no perfect vagina, and no single normal one either. The NHS says it’s completely normal to have noticeable skin folds around the opening of your vagina. The British Association of Aesthetic Plastic Surgeons, whose members carry out this surgery, says female genitals come in a wide variety of shapes, sizes and appearances, all of which are within the limits of normal.

Vagina or vulva?

Most people who talk about a “perfect vagina” mean the vulva, the part on the outside. The NHS describes the vulva as the area around the opening of the vagina, including the inner and outer lips (the labia) and the clitoris. The vagina is the passage inside.

What varies from one woman to another?

A booklet for young people by the British Society for Paediatric and Adolescent Gynaecology and the sexual health charity Brook says everyone’s vulva is unique. It says:

• the inner lips can look straight or wavy
• the skin might be smooth or bumpy
• one lip may be a bit longer than the other
• the labia are often a different colour from the rest of your skin

Brook adds that the labia can hang down or be barely visible.

How the vulva changes through life

The same booklet says that before puberty the inner lips are smaller and can’t easily be seen, and that it’s really common for one side to develop before the other. The NHS says the labia continue to develop beyond puberty into early adulthood.

After the menopause, the Royal College of Obstetricians and Gynaecologists (RCOG) says falling oestrogen can make the skin of the vulva pale and cause itching or soreness.

The first version of this article said more than 2,200 women a year were having labiaplasty on the NHS, including 250 girls under 14, and that this was a 500% rise in ten years. We couldn’t trace those figures to a source, so we’ve taken them out. Here’s what we could confirm:

• A fivefold rise: in 2014, a report by MPs on the Home Affairs Committee said there had been a fivefold increase in labiaplasty procedures in 10 years, citing evidence from the charity FORWARD.
• Young girls: a 2012 paper in the journal BMJ Open said 343 labiaplasties had been performed in the NHS on girls aged 14 or under in the previous 6 years.
• Mostly private: the MPs’ report said this kind of surgery is mainly done in the private sector, where it isn’t monitored as closely as in the NHS.
• Today: we couldn’t find up-to-date NHS figures. The International Society of Aesthetic Plastic Surgery estimates that plastic surgeons did 184,764 labiaplasties worldwide in 2025, about 12% fewer than in 2024. Its UK estimate for 2024 was 2,916. These are projections from a survey of plastic surgeons, not counts.

Why do women ask for it?

The NHS says some women want a labiaplasty because they don’t like the look of their labia. The surgeons’ association says a significant proportion report physical symptoms, such as discomfort in tight clothing, during exercise, when sitting for long periods or during sex.

What part do images play?

• Edited pictures: Brook says that because we rarely see other people’s vulvas, it’s easy to worry about whether yours is normal. It says porn is often edited and features actors who’ve had surgery.
• A measured difference: a study in the journal Medical Humanities found that the labia in images from online pornography were about 7 mm less prominent than those in feminist publications.
• Clinic websites: the BMJ Open paper looked at 10 clinic websites, 5 in the UK and 5 in the US. It found scanty reference to how much appearance varies and only minimal information on outcomes or risks. None gave a lower age limit for surgery.
• Advertising: in 2016, the Advertising Standards Authority upheld complaints about an advert for labia reshaping that used the words “Achieve a more natural appearance”. It said it was irresponsible to imply that any part of a person’s body was not natural in appearance.

Labiaplasty is surgery to reduce the size of the labia minora, the inner lips either side of the vaginal opening. That’s how the NHS describes it. The NHS says:

• it’s done under a general anaesthetic, or a local anaesthetic with sedation, and takes about 1 to 2 hours
• the unwanted tissue is cut away with a scalpel or laser, and the edge may be closed with dissolvable stitches
• you may need up to 2 weeks off work, and it can take a couple of months for the skin to fully heal
• soreness, bruising and swelling for up to 2 weeks are normal
• its advice is to avoid sex for at least 4 weeks and physical activity for 4 to 6 weeks

Labiaplasty isn’t usually available on the NHS. The NHS says it may be offered in some circumstances, for example if the vaginal lips are abnormal, to repair tears after childbirth, or to remove cancerous tissue in vulval cancer.

The NHS suggests talking to a doctor before deciding, because a condition that can be treated may be causing the discomfort. It adds that a doctor may advise speaking to a counsellor or psychologist before committing to surgery.

The NHS lists bleeding, infection, scarring of tissue and reduced sensitivity of the genitals. Like any operation, it also carries a small risk of a blood clot in a vein or an allergic reaction to the anaesthetic.

The NHS adds that there’s no guarantee you’ll get the result you expected, and that surgery won’t necessarily make you feel better about your body.

How do women feel afterwards?

The evidence is thin. In one study, 49 women who had a labiaplasty were compared with 39 who didn’t:

• of the 25 women assessed after 3 months, 24 were more satisfied with how their genitals looked
• 19 of the 49 women were lost to follow-up
• 26% reported minor side effects

The authors said larger studies were needed to find out how common side effects are. In 2017, the Nuffield Council on Bioethics asked the RCOG to review its guidance and to stress the need for evidence of safety and effectiveness before procedures like this are offered outside research.

Under 18s

The NHS says labiaplasty shouldn’t be done on girls younger than 18, because the labia continue to develop beyond puberty into early adulthood. An RCOG guideline says UK guidance includes the recommendation that female genital cosmetic surgery should not normally be carried out on those under 18.

UK advertising rules say adverts for cosmetic interventions must not be directed at under 18s.

The law

In England, Wales and Northern Ireland, the Female Genital Mutilation Act 2003 makes it an offence to cut away or otherwise mutilate any part of a girl’s or woman’s labia or clitoris. There’s an exception for an operation by a registered doctor that is necessary for her physical or mental health.

How that applies to cosmetic surgery isn’t settled:

• the Home Office’s guidance says the Act contains no specific exemption for cosmetic surgery, and that it would ultimately be for a criminal court to decide whether surgery without a medical reason counts as mutilation
• the Crown Prosecution Service says cosmetic labiaplasty is likely to be caught by the Act’s definition, but that the exception may apply if there’s evidence of a medical reason
• the Nuffield Council on Bioethics described the position in 2017 as one of legal uncertainty

This is a summary, not legal advice.

Doctors’ rules

The General Medical Council says doctors who offer cosmetic procedures must give patients the time and information they need to reach a voluntary and informed decision. They must not use promotional tactics that could encourage an ill-considered decision, or offer their services as a prize.

Checks the NHS suggests

• only registered doctors can perform cosmetic surgery in England, and you can check the General Medical Council’s online register
• independent hospitals and clinics that provide cosmetic surgery in England must be registered with the Care Quality Commission
• you should be given a cooling-off period after your consultation, and shouldn’t feel pressured or rushed

A shape you’ve always had isn’t a symptom. A change can be. These are some of the changes the NHS describes, and what it says they can be.

The NHS says vulval cancer is rare and mostly affects women over 65. Its symptoms include:

• a lump, or a sore, growth or ulcer
• itching that doesn’t get better
• red, white or dark patches of skin, or an area of thickened or raised skin
• a mole that changes shape or colour
• bleeding from your vulva that isn’t related to your periods

The NHS says these symptoms are very common and can be caused by many different conditions, but that it’s important to get them checked by a doctor.

The RCOG’s advice is to check your vulva regularly, and the gynaecological cancer charity The Eve Appeal says it’s crucial to know what’s normal for you.

If a change could be an infection, a test will tell you. Better2Know offers:

• Comfort Screen: a urine test for anyone with discomfort or unusual discharge. It tests for 8 infections, including Chlamydia, Gonorrhoea, Trichomonas and Herpes, from 14 days after sex, with results in 2 days at a clinic, or order a Comfort Screen home test.
• Blemish Screen: for a sore, blister, lump or wart. It tests swabs from the affected area for Herpes 1, Herpes 2, HPV and Syphilis, with results in 5 days. You can also order a home test kit.
• Doctor Consultation (Image review): if you’d like a doctor to look first, you can email a photograph for one of our doctors to review. The doctor then talks to you about it and about treatment.

The Comfort Screen and Blemish Screen don’t check for thrush or for skin conditions such as lichen sclerosus. Not sure which test you need? Our Patient Care Team is available 24/7 on 020 7099 0955.

Is it normal for one side to be longer than the other?

Yes. The booklet by the British Society for Paediatric and Adolescent Gynaecology and Brook says one lip may be a bit longer than the other, and that it’s really common for one side to develop before the other.

Is labiaplasty available on the NHS?

Not usually. The NHS says it may be offered in some circumstances, for example if the vaginal lips are abnormal, to repair tears after childbirth, or to remove cancerous tissue.

Will labiaplasty make me feel better about my body?

There’s no guarantee. The NHS says surgery won’t necessarily make you feel better about your body, and it suggests talking to a doctor first, who may advise speaking to a counsellor or psychologist before you decide.

Can an STI change how the vulva looks?

It can. Genital warts cause small, rough lumps, genital Herpes causes blisters and sores, and Syphilis can cause a painless sore. Read more in “What can be mistaken for Herpes?”

There’s no perfect vagina, and the range of what’s normal is much wider than edited images suggest. Labiaplasty is a real operation with real risks, it isn’t recommended for under 18s, and the NHS says it won’t necessarily change how you feel about your body. Whether to have it is your decision, and good information makes that decision easier.

What does deserve attention is a change: a new itch, sore, lump or discharge. For an itch or a change in discharge, book a Comfort Screen at a clinic near you or order a home test kit from 14 days after sex. For a sore or lump, the Blemish Screen tests a swab from the affected area. Our Patient Care Team is available 24/7 on 020 7099 0955.

Not in the UK? Choose your country from the selector at the top of the page for local tests and prices.

This article originally appeared on 9 December 2013 and was last updated on 5 October 2026.

This article is general information and not a substitute for personal medical advice.

Sources

1. NHS, Labiaplasty (vulval surgery), reviewed 27 September 2023. https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/labiaplasty/
2. British Association of Aesthetic Plastic Surgeons, Aesthetic genital surgery. https://baaps.org.uk/patients/procedures/18/aesthetic_genital_surgery
3. NHS, What is vulval cancer?, reviewed 28 April 2025. https://www.nhs.uk/conditions/vulval-cancer/what-is-vulval-cancer/
4. British Society for Paediatric and Adolescent Gynaecology and Brook, So what is a vulva anyway? https://britspag.org/wp-content/uploads/2024/01/So_what_is_a_vulva_anyway_final_booklet.pdf
5. Brook, Love your vulva, updated 9 September 2020. https://www.brook.org.uk/your-life/love-your-vulva/
6. Royal College of Obstetricians and Gynaecologists, Skin conditions of the vulva, December 2013. https://www.rcog.org.uk/for-the-public/browse-our-patient-information/skin-conditions-of-the-vulva/
7. House of Commons Home Affairs Committee, Female genital mutilation: the case for a national action plan, 25 June 2014. https://publications.parliament.uk/pa/cm201415/cmselect/cmhaff/201/20107.htm
8. Liao L-M, Taghinejadi N, Creighton SM, An analysis of the content and clinical implications of online advertisements for female genital cosmetic surgery, BMJ Open, 2012. https://bmjopen.bmj.com/content/2/6/e001908
9. International Society of Aesthetic Plastic Surgery, International survey on aesthetic/cosmetic procedures performed in 2025, 29 September 2026. https://www.isaps.org/media/ua4leneo/isaps-global-survey_2025.pdf
10. International Society of Aesthetic Plastic Surgery, International survey on aesthetic/cosmetic procedures performed in 2024, 19 June 2025. https://www.isaps.org/media/30xldsyf/isaps-global-survey-2024.pdf
11. Howarth H, Sommer V, Jordan FM, Visual depictions of female genitalia differ depending on source, Medical Humanities, 2010. https://mh.bmj.com/content/36/2/75
12. Advertising Standards Authority, Ruling on London Bridge Plastic Surgery Ltd, 11 May 2016. https://www.asa.org.uk/rulings/london-bridge-plastic-surgery-ltd-a16-335126.html
13. Veale D and others, Psychosexual outcome after labiaplasty: a prospective case-comparison study, International Urogynecology Journal, 2014. https://link.springer.com/article/10.1007/s00192-013-2297-2
14. Nuffield Council on Bioethics, Cosmetic procedures: ethical issues, 22 June 2017. https://cdn.nuffieldbioethics.org/wp-content/uploads/Cosmetic-procedures-full-report.pdf
15. Royal College of Obstetricians and Gynaecologists, Female genital mutilation and its management (Green-top Guideline No. 53), July 2015. https://www.rcog.org.uk/media/au0jn5of/gtg-53-fgm.pdf
16. Committee of Advertising Practice, CAP Code, section 12: medicines, medical devices, health-related products and beauty products. https://www.asa.org.uk/type/non_broadcast/code_section/12.html
17. Female Genital Mutilation Act 2003, section 1. https://www.legislation.gov.uk/ukpga/2003/31/section/1
18. Home Office, Department for Education and Department of Health and Social Care, Multi-agency statutory guidance on female genital mutilation, updated 30 July 2020. https://www.gov.uk/government/publications/multi-agency-statutory-guidance-on-female-genital-mutilation/multi-agency-statutory-guidance-on-female-genital-mutilation-accessible-version
19. Crown Prosecution Service, Female genital mutilation: prosecution guidance, updated 30 July 2024. https://www.cps.gov.uk/prosecution-guidance/female-genital-mutilation
20. General Medical Council, Guidance for doctors who offer cosmetic interventions, updated 13 December 2024. https://www.gmc-uk.org/professional-standards/the-professional-standards/cosmetic-interventions
21. NHS, Choosing who will do your cosmetic procedure, reviewed 23 June 2023. https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/choosing-who-will-do-your-procedure/
22. NHS, Is a cosmetic procedure right for me?, reviewed 9 May 2023. https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-procedure-right-for-me/
23. NHS, Vaginitis, reviewed 27 February 2023. https://www.nhs.uk/conditions/vaginitis/
24. NHS, Thrush in men and women, reviewed 28 July 2023. https://www.nhs.uk/conditions/thrush-in-men-and-women/
25. NHS, Genital warts, reviewed 10 July 2023. https://www.nhs.uk/conditions/genital-warts/
26. NHS, Genital herpes, reviewed 27 June 2023. https://www.nhs.uk/conditions/genital-herpes/
27. NHS, Syphilis, reviewed 17 March 2026. https://www.nhs.uk/conditions/syphilis/
28. NHS, Lichen sclerosus, reviewed 9 December 2024. https://www.nhs.uk/conditions/lichen-sclerosus/
29. NHS, Symptoms of vulval cancer, reviewed 28 April 2025. https://www.nhs.uk/conditions/vulval-cancer/symptoms/
30. The Eve Appeal, Tips for checking your vulva, updated 11 August 2025. https://eveappeal.org.uk/tips-for-checking-your-vulva/