Approximately 70% of women with labia minora enlargement may often have some degree of clitoral hood excess. The excess skin in this area is often excised at the time of a labiaplasty to: 1) improve aesthetic results of the labiaplasty and 2) to sometimes improve clitoral sensitivity. Nerves involved in orgasm are deep beneath the clitoral hood and are sensitive to sexual stimulation and result in arousal and orgasm. Surgeons need to be expert anatomists and need to avoid these nerves during surgery.
Clitoral hood reduction surgery is performed at the request of the patient on women who complain of excess skin clitoral hood. There are two conditions that patients inquire concerning the size of their clitoral hood: 1) width of the clitoral hood and 2) the length of the clitoral hood. The width of the clitoral hood can be addressed by addressing the often-present lateral redundant prepuce. This lateral prepuce can be excised to decrease the bulkiness and width of the clitoral area. Clitoral hood reduction surgery can be performed alone or in conjunction with other cosmetic vaginal surgical procedures such as labia minora or labia majora reduction surgery, clitoropexy, or clitoral hood lift.
If the patient complains of an elongated clitoral prepuce (ie hood) a double inverted V-incisions performed to remove the excess skin and the new incision is closed (using sutures) which will give the appearance of lifting the clitoral hood thus shortening its length. Care must be taken not to remove too much clitoral hood skin as this may overexpose the clitoris which can sometime result in a hypersensitive clitoris i.e. overly sensitive clitoris.
In experienced hands prepuce reduction surgery is a readily accomplished surgical procedure with minimal morbidity or pain. The scar resulting from a clitoral hood reduction is usually very difficult to see as it blends into the groove between the clitoral hood and the labia majora. This procedure alone usually takes approximately 30 minutes and patients can return home the same day and go back to work the following day depending upon the nature of their work. Post operatively, it is recommended waiting 3 weeks before exercising, and 6 weeks before having sex.