A 48-year-old avid athlete had a hood reduction, labiaplasty, and perineoplasty to address pinching and pulling that had been interfering with her athletic life. Her before-and-after shows a dramatic transformation, especially in the perineal area.
Today’s patient is 48 years old and has been an avid athlete her entire life. She has long been bothered by excess labial tissue, but what brought her in specifically was persistent pinching and pulling in the perineum — the skin at the vaginal opening — that had become particularly uncomfortable during intercourse and exercise. She had been considering a labiaplasty for a long time and was very ready to move forward.
She was awake during the procedure with oral sedation (Valium) to take the edge off. She tolerated the local anesthesia injections with only minor discomfort, and we had a great conversation throughout her surgery. As always, I performed the hood reduction first, then the labiaplasty, and finally addressed the excess perineal skin through a perineoplasty.
As you can see from her before and after photos, the change is dramatic — especially in the lower portion of the vulva where the perineal tissue was removed. She was able to see her results on the surgical table and was visibly thrilled. I am equally excited for her. This is a transformation that has truly been a long time coming.
In patients who experience pulling or pinching near the vaginal opening, a perineoplasty can make the most dramatic functional difference of all three components. Excess skin at the perineum can fold or catch during intercourse and exercise — removing it often eliminates a discomfort that patients have lived with for years without realizing it was surgically addressable.
For patients who are nervous but prefer not to have IV sedation, oral sedation with a benzodiazepine like Valium provides a meaningful level of relaxation without the need for an IV line or anesthesia team. It takes the edge off the experience, allowing the local anesthesia to do the rest. Most patients are comfortable and conversational throughout.
Women who are highly physically active often experience more pronounced discomfort from excess labial tissue — the repeated motion of running, cycling, and other sports amplifies pinching and chafing that might otherwise be tolerable. For athletes, labiaplasty is not cosmetic — it is about reclaiming the ability to train and compete without distraction or pain.
A perineoplasty removes excess skin from the perineum — the area between the vaginal opening and the anus. It is performed to address pulling, catching, or discomfort in this area during intercourse or physical activity.
For many patients, oral sedation (such as Valium) combined with local anesthesia provides a very comfortable procedure experience. IV sedation is available for patients who want a deeper level of sedation or have higher anxiety.
Excess labial tissue can catch, pinch, and chafe during running, cycling, horseback riding, and other activities. Reducing the labia minora and, when needed, the perineal tissue eliminates the source of this friction and restores comfortable physical activity.
Yes. Labiaplasty is performed safely across all adult age groups. Active patients typically recover very well, and return-to-exercise timelines are the same: about three weeks before resuming the gym or strenuous activity.
Dr. Oppenheimer typically begins with the hood reduction, then performs the labia minora reduction, and finishes with the perineoplasty. This order allows him to assess the overall result progressively and ensure balance across all three areas.
Schedule a free phone or in-person consultation with Dr. Oppenheimer. No pressure, no judgment — just clarity and care.