In brief
Clitoropexy (clitoral repositioning) is a female intimate surgery procedure, performed under local anaesthesia with sedation, that repositions and fixes the clitoris higher up when it appears too low, prominent or poorly supported. It does not reduce the clitoris: it brings it back to a more harmonious position in relation to the hood and the labia minora. It is indicated in selected cases, often together with clitoral hood reduction or labiaplasty.
What clitoropexy is
The clitoris is much larger than what can be seen. The visible part, the glans, is only the tip of an organ that continues inside the body with the shaft and two roots (the crura), and it is held in position by a suspensory ligament anchored to the pubic bone. Above the glans is the clitoral hood, a fold of skin that protects it and continues into the labia minora.
Clitoropexy works on the supporting tissues: the clitoris is lifted and fixed in a higher, more "tucked in" position. No erectile tissue is removed and the structure of the organ is not changed; only its position changes.
When it is indicated
It is not a procedure for everyone. After a careful specialist consultation, it is indicated mainly in three situations:
- Low or prominent clitoris (clitoral ptosis): the glans appears displaced downwards or protrudes beyond the hood, with aesthetic concern or discomfort from rubbing against clothing and during sport.
- After an isolated hood reduction: if the hood is reduced without considering the support of the clitoris, the glans may remain more exposed and poorly supported, with a disproportionate appearance.
- Asymmetry or disproportion between the clitoris, hood and labia minora, assessed across the vulva as a whole, often in patients who also want a labiaplasty.
How the procedure is performed
I perform clitoropexy under local anaesthesia with sedation; the procedure takes about an hour. There is no single technique valid for everyone: I use three different techniques, chosen at the consultation according to the anatomy and the problem to be corrected, and sometimes combined.
1. Fascial or periosteal anchoring (direct clitoropexy)
This is the most widespread "pure" pexy technique for correcting ptosis, that is, a clitoris positioned too low.
What it involves. Through a concealed incision above the clitoris or along the fold of the hood, I isolate the supporting tissues of the clitoris. The clitoral complex is lifted and fixed with slowly absorbable or non-absorbable sutures to Gallaudet's fascia (the deep fascia of the perineum) or to the periosteum of the pubic symphysis.
Main indication. A clitoris that is too low, hypermobile or prominent in relation to the vulvar cleft.
Advantage. It leaves the key anatomical structures intact and offers a solid anchor point.
2. Pexy by plication of the suspensory ligament
This technique acts directly on the ligament that supports the clitoris from above, to shorten the distance between the clitoris and the pubic bone.
What it involves. The suspensory ligament of the clitoris is folded back on itself with sutures (plication). By shortening it, the glans is brought upwards and slightly towards the deeper plane.
Main indication. A prominent glans or "pseudo-hypertrophy" of the clitoris, when the clitoris looks larger but the volume of the corpus cavernosum has not increased.
Advantage. It is a minimally invasive procedure that allows precise control of clitoral protrusion.
3. Pexy combined with hood reduction (hoodoplasty or wedge pexy)
Clitoral ptosis is often accompanied by a lax or excess hood. In these cases the pexy is performed through the same incision used to reduce the skin.
What it involves. A small wedge of skin, or an inverted "A"-shaped diamond, is removed above the clitoris. While the hood is reshaped, the deep subcutaneous tissues are repositioned and anchored upwards to support the clitoris: the glans is freed from the excess skin and, at the same time, suspended.
Main indication. After reduction labiaplasty, where the hood and clitoris look deflated, disproportionate or unsupported.
Advantage. It adds no scars and promotes a harmonious transition between the mons pubis, hood and labia minora.
| Technique | Mechanism | Indication | Result |
|---|---|---|---|
| Fascial or periosteal anchoring | Fixation suture to Gallaudet's fascia or to the periosteum of the pubic symphysis | True ptosis, low, hypermobile or displaced clitoris | Deep lifting and stabilisation |
| Plication of the suspensory ligament | Shortening and folding of the ligament | Prominent glans, pseudo-hypertrophy without a real increase in volume | Reduction of external projection |
| Combined pexy (hoodoplasty) | Wedge skin resection and anchoring of the deep tissues | Lax hood, disharmony after labiaplasty | Combined reshaping of hood and clitoris |
Other variants are also described in the literature: some authors combine the pexy with labiaplasty in the same operation, while others have proposed minimally invasive techniques to shorten an elongated clitoris without removing part of it, such as the clitoropexy described by Miklos and colleagues in 2024.
Associated procedures
The pexy is often performed together with clitoral hood reduction and, when indicated, reduction of the labia minora: the vulva is assessed as a unit, because correcting a single element can make the others more noticeable.
What the literature says, honestly
Clitoropexy is little studied. There are descriptions of techniques and small case series, but no randomised studies and no solid data on long-term results or on the frequency of complications. The most robust information concerns related procedures, such as hood reduction: a prospective study (Placik and Arkins, 2015) found no reduction in pressure sensitivity after labiaplasty and hood reduction. These data are useful, but cannot automatically be transferred to the pexy. For this reason you will not find success percentages on this page: there are no reliable ones.
«Prima comprendere» ("Understand first"): the consultation
In the first consultation, which lasts from half an hour to an hour, I first ask you what bothers you and since when: a physical discomfort, an aesthetic concern, the result of a previous operation. Then we assess together the anatomy of the whole vulva, because the position of the clitoris can only be judged in relation to the hood and the labia minora. If expectations are not realistic, or if the problem cannot be solved with surgery, I prefer to tell you so openly.
Risks and complications
General risks, common to every procedure
- Bleeding or haematoma
- Infection, wound dehiscence (partial reopening of the wound)
- Complications related to anaesthesia or sedation
Specific risks
- Changes in clitoral sensation, generally temporary; more rarely lasting, if the nerve structures are involved.
- Asymmetry or insufficient correction, sometimes correctable with a touch-up.
- Recurrence: over time the clitoris may partly return to its starting position.
- Discomfort or pain during intercourse in the first few weeks, while the tissues heal.
- Dissatisfaction with the result, especially when expectations were not clarified beforehand.
Recovery
In the first few days, swelling and soreness are normal. The timings I give my patients are approximate and are confirmed at the consultation, also depending on any associated procedures:
- Work: after about 7 days
- Sport: after about 30 days
- Sexual intercourse: after about 30 days
Frequently asked questions
What is clitoropexy (clitoral repositioning)?
It is a female intimate surgery procedure that repositions and fixes the clitoris higher up when it appears too low, prominent or poorly supported. It does not reduce it: it changes its position in relation to the hood and the labia minora.
Is it the same as clitoral hood reduction?
No. Hood reduction removes the excess skin above the clitoris; clitoropexy repositions the clitoris itself. The two procedures are often combined in the same operation.
When is it indicated?
When the clitoris is low or prominent, after a hood reduction that has left it poorly supported, or in cases of disproportion with the hood and labia minora. It is indicated only after a specialist consultation.
Is it performed alone or together with labiaplasty?
It can be performed alone, but it is often combined with hood reduction and labiaplasty, because the vulva must be assessed as a unit.
Does clitoropexy reduce sensitivity?
The procedure is planned so as not to touch the dorsal neurovascular bundle, which carries sensation. Temporary changes are possible; the risk of lasting changes is not zero and is one of the points we discuss at the consultation.
What anaesthesia is used and how long does the procedure take?
Local anaesthesia with sedation; the procedure takes about an hour.
Is there only one technique?
No. I use three techniques: fascial or periosteal anchoring, plication of the suspensory ligament, and pexy combined with hood reduction. The choice depends on the anatomy and is made at the consultation.
How long does recovery take?
As a guide, you return to work after about 7 days; for sport and sexual intercourse about 30 days are needed. The timings are confirmed at the consultation.
Are there data on long-term results?
Few. The literature consists mainly of descriptions of techniques and small case series, without randomised studies. For this reason it is not possible to give reliable success percentages.
Scientific bibliography
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Vázquez IM, Buendía GG, Vega AR, Oña CGR – Labiaplasty with clitoropexy
Source: Plastic and Reconstructive Surgery – Global Open, 2019 – PRS Global Open
What it covers: describes a technique that combines reduction of the labia minora and clitoropexy in the same operation.
Why it matters: it is one of the few papers dedicated specifically to clitoropexy and shows why it is often planned together with labiaplasty.
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Miklos JR, Moore RD, Maron CS, Batalha AC – The Batalha clitoropexy: shortening an elongated clitoris, a minimally invasive technique
Source: Surgical Technology International, 2024 – PubMed
What it covers: proposes a minimally invasive technique to shorten an elongated or prominent clitoris without removing part of it; the case described goes from 5 to 1.5 cm.
Why it matters: it documents the shift towards conservative techniques, which reposition rather than reduce. However, it is a technical description, not a study of outcomes.
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Alter GJ – Aesthetic labia minora and clitoral hood reduction using extended central wedge resection
Source: Plastic and Reconstructive Surgery, 2008 – PRS
What it covers: describes a technique that reduces the labia minora and the clitoral hood together, treating them as a single aesthetic unit.
Why it matters: it is one of the key papers on hood surgery and explains why reducing a single element can create disproportion.
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Placik OJ, Arkins JP – A prospective evaluation of female external genitalia sensitivity to pressure following labia minora reduction and clitoral hood reduction
Source: Plastic and Reconstructive Surgery, 2015 – PubMed
What it covers: measures, before and after surgery, the sensitivity of the external genitalia in women undergoing labiaplasty and hood reduction, finding no reduction.
Why it matters: it is one of the few prospective studies on sensation after intimate surgery in this area; it concerns procedures close to the pexy, not the pexy itself.
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Hamori CA, Banwell PE, Alinsod R (eds) – Female cosmetic genital surgery: concepts, classification, and techniques
Source: Thieme, 2017 – Thieme
What it covers: a manual on female aesthetic genital surgery, with classifications and techniques for the labia minora, hood and clitoris.
Why it matters: it is a reference text for surgeons working in this field.
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The Aesthetic Society – Clitoral hood reduction (clitoropexy)
Source: patient information page – The Aesthetic Society
What it covers: the American society of aesthetic plastic surgery describes the procedure and indicates local anaesthesia or sedation as the most common approaches.
Why it matters: it also shows how, in English, the term clitoropexy is used for hood reduction: hence the note on terminology on this page.
For further reading on the whole field of female intimate surgery, including clitoropexy and clitoral hood reduction:
Medically reviewed by Dr Giulio Maria Maggi, Plastic Surgeon — last review:
Article written by
Dr Giulio Maria Maggi
Aesthetic Plastic Surgeon — Turin, Asti and Alessandria
Medical Director — Aesthetic Clinic (Turin)
Registered with the Turin Medical Council (Ordine dei Medici di Torino) no. 20595
Full Member of AICPE (Italian Association of Aesthetic Plastic Surgery) (verify)
Expertise and areas of interest
Dr Maggi gained his specific training in intimate medicine and surgery by working for 12 years alongside Prof. Renato Marten Perolino, urologist and plastic surgeon, at Villa Maria Pia Hospital and, privately, at Clinica Fornaca and Clinica Cellini in Turin. From him he learned male-to-female gender-affirming surgery and he was first operator in breast augmentation procedures on his patients in gender transition. He also trained internationally with Prof. José Guerrero Santos in Guadalajara and with Prof. Andrew A. Jacono in New York, for the Deep Plane facelift technique.
His main areas of focus are:
- Functional and aesthetic intimate surgery, male and female
- Deep Plane facelift
- Blepharoplasty
- Liposculpture and fat grafting (lipofilling)
- Breast surgery
- Body contouring
Clinical approach: «Prima comprendere» ("Understand first"). No promises of results: indications, risks and limits explained frankly, so that every patient can make a truly informed choice.
