Hello, I’m Dr. Gary Alter. I’m a board-certified plastic surgeon and board-certified urologist, which is very rare. Today, let’s talk about clitoral reduction. A lot of women complain about the protuberance of their clitoral hood when they stand up. Well, most of the time, it’s not that their clitoris is enlarged, it’s just that the hood is enlarged. However, there are women who have clitoris enlargement itself, that is caused by many different issues. It could be congenital. In other words, you’re born that way. It could be a hormonal malfunction, like polycystic ovarian syndrome. It could be caused by a woman taking testosterone supplements for bodybuilding, and it is now becoming more common in older women who are taking testosterone for sexual health to get their libido back, to make them feel better. So I’m seeing more and more women to come to me because their clitoris itself is enlarged, and very rarely will a doctor go anywhere near the clitoris because obviously they’re afraid of damaging the sensation.
As a urologist, during my training, I got some experience with clitoris reduction on little children that are born with ambiguous genitalia, where you had to reduce the clitoris to make them look like a normal female. Then, during my fellowship, I’d had a little bit more training, but in practice, I developed my technique to do a clitoris reduction. What that is, is I make an incision on the sides of the clitoral hood, and then across the lower hood, and I lift up the skin of the clitoral hood. Then I dissect the clitoris, which is right there, and I know where the nerves are, okay? So I do not injure the nerves that give sensation, but what I do is I make an incision in the body of the clitoris and remove all that tissue that can get erect, because that’s what the women complain about. When they get aroused, the clitoris gets big and looks like a little penis, depending upon the size. I mean, I’ve had some women that have very large clitoris when aroused.
So I remove that erection tissue, and then I close it up. But I’m very, very careful to preserve the nerves that go to the head of the clitoris. The head of the clitoris is also enlarged, so I know that there’s more sensation fibers at the 12:00 o’clock and 6:00 o’clock positions. So I can reduce the head of the clitoris by removing some of it horizontally from 3:00 to 9:00 o’clock and then stitching it together so it looks absolutely normal. And then I put some stitches in to push the clitoris up and in, reduce the clitoral hood, and then that woman looks normal again.