Labiaplasty

The external genitalia undergo a significant transformation during pubertal development when changes in the appearance and the prominence of the labia minora and majora arise.

Requests for surgical correction have been suggested based on the length, appearance and functional symptoms.

Depending on the cause for concern, conservative measures include:

  • Reassurance of normality for the individual, presentation of the concept of diversity
  • Steps to reduce discomfort and irritation such as the use of simple soaps, the avoidance of scented gels and the use of emollients
  • Use of comfortable, natural fiber underwear
  • Discouragement of vulval hair removal as this increases visibility and irritation to the vulva
  • Counseling or psychological support may also aid the adolescent if significant distress is present

Labiaplasty (defined as the surgical reduction of the labia minora) is the most common procedure under the umbrella of female genital cosmetic surgery.

The surgical techniques for labiaplasty can be divided into two main approaches:

  • Amputation, where the free edge of the labia is “trimmed” down to an acceptable size and over-sewn. This approach results in scarring of the free edge of the revised labia minora
  • The removal of a section of labial tissue either by a wedge resection or de-epithelization. This technique allows for the natural margins of the labia to be retained.
DIRECT CHAT
Amputation Technique. Illustration taken from the article "Aesthetic genital surgery in children and adolescents" by PL Wood.
Amputation Technique. Illustration taken from the article "Aesthetic genital surgery in children and adolescents" by PL Wood.
Excision Technique. Illustration taken from the article "Cosmetic genital surgery in children and adolescents" by PL Wood.
Excision Technique. Illustration taken from the article "Cosmetic genital surgery in children and adolescents" by PL Wood.

The American College of Obstetricians and Gynecologists states that labiaplasty should only be performed in minors with significant congenital malformations or persistent symptoms that the physician believes are caused directly by labial anatomy.

Labiaplasty could be considered in patients with persistent physical symptoms that are not resolved with conservative measures.

1.- The edge resection technique.

1.- The edge resection technique.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

2.- The wedge resection technique, as described by Alter in 1998.

2.- The wedge resection technique, as described by Alter in 1998.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

3.- The extended central wedge resection technique, as described by Alter in 2008.

3.- The extended central wedge resection technique, as described by Alter in 2008.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

4.- The inferior wedge resection technique.

4.- The inferior wedge resection technique.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

5.- The posterior wedge resection technique, as described by Kelishadi et al in 2013.

5.- The posterior wedge resection technique, as described by Kelishadi et al in 2013.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

6.- The posterior wedge resection technique, as described by Martincik and Malinovsky in 1971.

6.- The posterior wedge resection technique, as described by Martincik and Malinovsky in 1971.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

7.- The W-shaped resection, as described by Mass and Hage in 2000.

7.- The W-shaped resection, as described by Mass and Hage in 2000.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

8.- The de-epithelialization technique, as described by Choi and Kim in 2000.

8.- The de-epithelialization technique, as described by Choi and Kim in 2000.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

9.- The de-epithelialization technique, as described by Cao et al in 2012.

9.- The de-epithelialization technique, as described by Cao et al in 2012.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

10.- Composite reduction labiaplasty, as described by Gress in 2013.

10.- Composite reduction labiaplasty, as described by Gress in 2013.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.

11.- Custom flask labiaplasty, as described by Gonzalez et al in 2013.

11.- Custom flask labiaplasty, as described by Gonzalez et al in 2013.

CM Oranges, A Sisti, G Sisti. Labia minora reduction techniques: A comprehensive literature review. Aesthet Surg J. 2015;35:419-31.