Clitoroplasty - сlitoral hood reduction
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Clitoral hood reduction is a surgical procedure aimed at the controlled reduction of excess skin folds of the clitoral prepuce that partially cover the clitoral glans. The procedure is considered a form of clitoroplasty and may be performed for functional and/or aesthetic indications, with mandatory preservation of anatomical integrity and maximal respect for highly sensitive structures.
Types of Procedures
- Aesthetic procedures – aimed at correcting visual characteristics of tissues within the range of individual anatomical variation.
- Functional procedures – performed in the presence of symptoms and may include reduction of excess preputial tissue, release of the glans in cases of pronounced folding or scar changes, and correction of local adhesions (based on indications and after diagnostic evaluation).
Objectives
- Functional objective: reduction of mechanical discomfort (tension, friction, irritation) and/or facilitation of glans exposure in symptomatic cases.
- Aesthetic objective: correction of the visual appearance of the clitoral hood.
Indications
- symptomatic excess of clitoral hood tissue (discomfort, irritation, limited glans exposure);
- scar changes or adhesions in the hood area (when indicated);
- combination with other vulvar procedures (e.g., labia minora reduction), when anatomically and clinically justified.
In cases of suspected clitoromegaly or hypertrophy, initial evaluation of potential endocrine causes and correction of hormonal imbalance is recommended before considering surgical intervention.
Contraindications
Absolute or temporary (until stabilization):
- pregnancy, breastfeeding;
- acute illness, fever or active genital infections;
- inflammatory diseases of the external genitalia / vulvovaginitis;
- decompensated chronic diseases, severe systemic pathology;
- oncological diseases (decision made individually in consultation with relevant specialists).
Age considerations:
Elective surgery on the external genitalia is generally not recommended before the age of 18 due to ongoing tissue development and maturation.
Procedure
- The intervention is typically scheduled during the first week after the end of menstruation.
- Average duration is 30–60 minutes (longer if combined procedures are performed).
- Anesthesia: local (sometimes with sedation) or general/regional, depending on indications and surgical extent.
Steps:
- marking of excess tissue according to individual anatomy;
- controlled excision with meticulous hemostasis;
- closure with fine absorbable sutures to preserve anatomy and avoid excessive exposure or injury to sensitive structures.
Recovery/Restrictions
- Moderate swelling and increased sensitivity may persist for up to 4–6 weeks.
- Return to office-based work is usually possible within 5–7 days (individualized).
During the first 2–3 weeks, it is recommended to:
- maintain strict intimate hygiene;
- avoid sexual intercourse and masturbation;
- avoid baths, swimming pools, saunas;
- limit intense physical activity and follow a protective regimen.
Sports activities and sexual activity are usually permitted after 4–6 weeks, provided normal healing and after follow-up examination.
Sources:
https://www.isaps.org/fr/decouvrir/patients-home/info-on-aesthetic-procedures/body-procedures/hoodplasty-clitoris-hood-reduction/
https://www.plasticsurgery.org/cosmetic-procedures/aesthetic-genital-plastic-surgery/clitoral-hood-reduction
https://www.rightdecisions.scot.nhs.uk/shared-content/ggc-clinical-guidelines/gynaecology/female-genital-cosmetic-surgery-gynaecology-626/
https://www.bapras.org.uk/public/patient-information/surgery-guides/female-genital-tract-surgery
https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.70203
Preparation:
- A clinical examination is performed, including assessment of anatomical features, as well as discussion of indications, available alternatives, potential risks, and the expected outcome.
- If necessary, swabs and laboratory tests are performed. Any identified infectious or inflammatory conditions must be fully treated prior to the procedure.
- The scope of preoperative investigations and medical strategy are determined according to the clinic’s protocol and the selected type of anesthesia.
- Anticoagulant and antiplatelet therapy requires an individualized plan for temporary discontinuation or dose adjustment, strictly in coordination with the treating physicians. Certain dietary supplements, herbal preparations, and vitamin E are often recommended to be discontinued in advance (commonly around 2 weeks prior to surgery); however, the final decision is made by the surgeon and/or anesthesiologist.
- Discntinuation of smoking is strongly recommended at least 8 weeks prior to the intervention to reduce the risk of postoperative complications and impaired wound healing.
- A shower is recommended prior to hospital admission. The use of irritating products, harsh cleansers, and fragranced cosmetics should be avoided, especially in patients with sensitive skin.
- Strict adherence to the medical facility’s instructions is required. Fasting and fluid restriction intervals depend on the type of anesthesia administered.
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