Labia Minora Reduction Research Articles

A Modified Wedge Resection Technique to Achieve Natural Results in Labia Minora Reduction

AbstractAesthetic genital surgeries are on the rise globally. Labia minora reduction, the most common aesthetic genital surgery, can be done either by the edge resection or by the wedge resection techniques. The edge resection technique trims the edge of the labia minora and leads to unnatural results as it does not maintain the color gradation that is naturally present on the inner surface of the labia minora or the minor irregularities that are naturally present in the labia besides posing problems like scar pain at edges during intercourse and chances of overresection. Wedge resection has the advantage of retaining the color gradation and the minor natural irregularities on the edge of the labia minora and is considered to be a better technique than the edge resection technique. However, the classical central wedge reduction technique suffers from a deformity in long term in the form of a visible notch at margins of the labia minora at the site of suturing. The author suggests a modification of this technique to overcome this problem to give better natural long-term results.

Labia Majora Lift. for Whom? When? How? What Is Next?

<h3>Study Objective</h3> The study aims to present our technique of wedge excision(lifting) labia majora,how the first important step in the sequence of rejuvenating procedures in this area. <h3>Design</h3> prospective cohort study since July 2018. <h3>Setting</h3> A wedge excision technique (fotos and video step by step). <h3>Patients or Participants</h3> The total number of the procedures was 127, including: 78 (65%) combined procedures with labia minora reduction; 51 (40%) combined procedures with skin lightening. A wedge excision technique with subsequent suturing was used (photos and video will be demonstrated) under intravenous or pudendal anesthesia. <h3>Interventions</h3> the aesthetic treatment of labia majora is as relevant and demanded as labia minora enhancement. Our patients notice tissue sagging, laxity, wrinkling and hyperpigmentation in this area and seek its improvement. These goals can be achieved in a number of ways, the most common of which are lipoplasty, treatments with HA fillers and laser-assisted rejuvenation. We believe that surgical treatment of labia majora is of great interest, and it opens opportunities for obtaining predictable aesthetic outcome and higher satisfaction with this procedure in general. <h3>Measurements and Main Results</h3> The mean duration of the procedure was 45 minutes. There were no serious complications. The recovery period lasted 2-3 weeks. Postoperatively, edema was observed in 32 % of cases. There were no cases of hematomas, bleeding, or purulent/septic complications. Antimycotic agents were used. During the next 1-3 months, additional correction with fillers was used in 20 cases (15%), which was indicative of high satisfaction with the procedure outcome among the majority of the patients and of proper strategy choice in each individual case. <h3>Conclusion</h3> Surgical labia majora lift is a promising technique, which gives long-lasting and, most importantly, predictable outcomes. Good aesthetic results can be obtained using this technique alone or in combination with other rejuvenating procedures. It provides high satisfaction along with low complication rates.

Labia Minora Repair.

Labia minora reduction has become part of the treatment spectrum offered by most plastic surgeons. The author has performed many corrective procedures involving the outer female genital region, most of which involved reducing the labia minora of approximately 4300 women. Over the years, the number of corrective procedures to rectify poorly performed initial operations increased significantly at the author's practice. The most common iatrogenic deformity is the overresection of the labia minora below the clitoris, leaving behind excess tissue in the area around and above the clitoral hood (small penis deformity). Two basic procedures may be used to reconstruct the labia minora below the clitoris: reconstructing the labia minora by redundant labial tissue above the clitoris to form bilateral preputial flaps being rotated downward into the defect and reconstructing the labia minora by vaginal skin advancement. Other reconstructions depend on the deformity itself. The postoperative outcome was assessed in an anonymous questionnaire answered by 544 patients. The outcome showed a significant improvement in functional and psychological impairment as a result of the deformities caused by the initial operation. Even if the reconstruction of the labia minora did not produce the desired initial result, overall satisfaction with the corrective surgery was very satisfactory. The increase of iatrogenic deformities after the initial labia reductions is alarming. The causes of this growth are manifold: underestimation of the procedure, misjudgment and a lack of detailed knowledge. This has a heavy psychological and physical impact on patients. Reconstruction of excessively shortened labia minora is often not easy and not always satisfactory. Training and the establishment of surgical standards should be used to avoid errors and achieve the best result. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A New Modified Labiaplasty Combined with Wedge De-Epithelialization on the Medial Side and Edge Resection.

Labiaplasty (labia minora reduction) has been increasingly requested in recent years. The surgical procedures previously reported in the literature may have some complications that affect patient satisfaction. Patients who underwent a new bilateral labiaplasty procedure that combined wedge de-epithelialization on the medial side with edge resection on the lateral side were retrospectively reviewed. Satisfaction rates were assessed, and questionnaires, namely the Female Sexual Function Index (FSFI) and Genital Appearance Satisfaction (GAS) scale, were distributed and analyzed. The data from the study group were compared with data from cases who underwent traditional labiaplasty with wedge resection (control group). From October 2015 to February 2020, fifty-one women underwent modified labiaplasty, while 26 women underwent traditional labiaplasty. A total of 94.1% (48/51) of patients in the modified group were satisfied with the genital appearance. Compared with the 96.2% (25/26) satisfaction rate in the control group, the difference was not statistically significant. A total of 43/55 valid questionnaires were returned, including 29 in the modified labiaplasty group and 14 in the control group. There was a significant improvement in the postoperative GAS scale compared to the preoperative scale in both groups (P<0.05). The new modified method had a significant FSFI improvement after the operation compared with preoperative scores (P<0.05), while the FSFI improvement was not significant in the control group (P>0.05). There was no significant difference in the FSFI score improvement, postoperative GAS score or postoperative FSFI between the two groups (P>0.05). This new modified labiaplasty is a satisfying and safe method with low risks, and it may result in better sexual sensitivity for the patients LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .

Surgical Technique and Outcomes of Inverted-Y Plasty Procedure in Clitoral Hoodoplasty Operations

Labia minora reduction is the most common operation requested by women concerned with the appearance of their vulvar area. In most cases, a concomitant clitoral hoodoplasty (CP) should be performed to achieve better esthetic outcomes. There are different surgical methods for removing excess tissue in the clitoral hood area. This study aims to describe the surgical technique of inverted-Y plasty as with central longitudinal excision in CP and to elaborate on different hoodoplasty techniques in the literature. Case series. Private practice. A total of 63 patients who underwent labiaplasty with curvilinear labial excision and concomitant CP with the inverted-Y plasty technique. The operations were performed by a single senior surgeon between May 2017 and December 2019. The inverted-Y plasty technique is described in detail regarding its advantages and important issues. The patients' median age was 33.2 (19-47) years. Of the patients, 57 (90.5%) requested the operation because of dissatisfaction with the esthetic appearance. Furthermore, 60 (95.2%) patients requested minimum remaining labia. The median operation time was 45 (35-62) minutes in labiaplasty and 34 (25-42) minutes in CP. No major complications occurred. At the postoperative second month, 96.9% of the patients were satisfied with the esthetic results. CP with the inverted-Y plasty technique is extremely safe and highly satisfactory in most patients, allowing maximum trimming of the excess tissue and providing lifting of the clitoral hood area.

Cosmetic gynecology—a systematic review and call for standardized outcome measures

Cosmetic gynecology, a field which has garnered substantial attention over recent years, lacks a universally accepted nomenclature. The aim of this systematic review is to evaluate techniques, outcome measures reported, and adverse events in patients undergoing cosmetic gynecology procedures and offer recommendations to improve reporting metrics. A systematic literature search was performed using electronic databases from inception to April 2019. The search was based on 51 unique cosmetic gynecology keywords such as: "labiaplasty," "vaginal rejuvenation," and "liposuction mons pubis." All English full-text prospective and retrospective observational and interventional studies with at least five subjects that describe a cosmetic gynecology procedure were included. Only full-text articles were included. This protocol has been registered with PROSPERO (CRD 42019131860). A total of 1837 articles were identified from the search strategy with 42 included in the quantitative synthesis. Procedures described included: labia minora reduction with or without clitoral hood reduction, labia majora augmentation, surgical vaginal caliber reduction, mons pubis reduction/suspension, and energy-based therapy for vaginal laxity or vulvar laxity. Efficacy and satisfaction metrics were highly variable ranging from validated questionnaires to no outcome subjectively or objectively quantified. Complication rates varied by procedure but were generally low and ranged between Clavien-Dindo grades I-III. Although there is a breadth of literature on cosmetic gynecology surgical techniques and short-term complication rates, the terminology and outcome measures utilized are heterogeneous. To address this, standardized terminology along with uniform cosmetic and functional endpoints must be developed.

Do Genital Cosmetic Procedures Improve Women’s Self-Esteem? A Systematic Review and Meta-Analysis

The popularity of genital cosmetic procedures in women is increasing. These procedures are often assumed and promoted as having a positive effect on women's psychological well-being, particularly their self-esteem. Empirical support for these claims is lacking. The aim of this study was to conduct a systematic review and meta-analysis of the impact of genital cosmetic procedures on self-esteem in women. The authors performed a systematic literature review of MEDLINE, PreMEDLINE, Ebase, EMBASE, OVID, CINAHL, Cochrane, PsycINFO, and PubMed to identify articles that measured self-esteem in women after a genital cosmetic procedure. A meta-analysis was conducted to assess the pooled effect of these procedures on self-esteem. The authors identified 5 eligible studies for the meta-analysis, comprising 2 prospective and 3 retrospective studies. Labia minora reduction was the most commonly studied procedure. All 5 studies used different measures of self-esteem, with only 1 study employing a validated psychometric measure at both preoperative and postoperative time points. The meta-analysis results showed a pooled logit rate estimate of 1.230, indicating a positive effect of surgery on self-esteem. However, there was substantial heterogeneity across studies. Female genital cosmetic procedures, particularly labiaplasty, appear to have a positive effect on women's self-esteem. However, inconsistencies in study measures and methods limit our conclusions. Future research should involve the development of standardized outcome measures to more accurately assess the impact of these procedures on self-esteem, and on psychological well-being more generally.

Assessment of Female Genital Surgery Education in Plastic Surgery Training: Report of an Expert Opinion Survey.

Patient demand for aesthetic genital surgery has markedly increased. The International Society of Aesthetic Plastic Surgery reported 95,010 labiaplasties and 50,086 vaginal rejuvenation procedures in 2015. We performed an online anonymous survey to evaluate the teaching of female genital procedures in plastic surgery training programs worldwide. A total of 1033 board certified plastic surgeons answered the survey. Most respondents were from the USA, Brazil, Mexico and Colombia. The majority of plastic surgeons performing these procedures were in private practice (77.62%) and (22.38%) in academic settings. Most plastic surgeons (75.63%) did not receive formal education in female genital rejuvenation procedures however 54.31% did receive education in reconstruction procedures. During their training, most were exposed to vaginal reconstruction (15.94%), labia minora reduction (11.9%), vulva reconstruction (11.53%), flaps for vaginal agenesis (11.39%) and monsplasty (7.98%). Additional training for female genital procedures was mostly at meetings and shadowing experts. Sixty-two percent reported that patients seldom requested those procedures, and 63.73% reported these procedures comprised less than 5% of their practice. The most commonly performed procedures were labia minora reduction, labia majora augmentation or reduction and monsplasty. The materials used were mostly fat grafting, hyaluronic acid injections and lasers. Additional formal training during residency for aesthetic genital surgery would be beneficial. Additionally, courses at meetings would be useful for plastic surgeons who have had insufficient training. More studies need to be conducted on the different female genital rejuvenation procedures offered in order to evaluate patients' long-term outcomes and satisfaction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Labiaplasty procedure

Female cosmetic genital surgery is rapidly gaining popularity and acceptance, as both the functional and aesthetic benefits of these procedures are increasingly appreciated. The term labiaplasty refers to a procedure that reduces the length of the labia minora. It is the most commonly performed vaginal rejuvenation procedure and it can relieve functional symptoms women experience from twisting and tugging of the labia. Two predominant techniques exist in labia minora reduction: edge trim and wedge resection. In this article, aesthetic and reconstructive plastic surgeon Olivier Alexandre Branford provides an up-to-date overview of labiaplasty

Female Cosmetic Genital Surgery.

Female cosmetic genital surgery is rapidly gaining popularity. Patient demand is increasing, and female cosmetic genital surgery is becoming a subspecialty of plastic surgery. Two predominant techniques exist in labia minora reduction: edge trim and wedge resection. Dr. Hamori prefers the wedge resection for most clinical situations. This video vignette clearly describes aesthetic analysis, marking, and technical execution for an extended wedge procedure. Patient safety and the management of patient expectations are emphasized.

Labiaplasty: motivation, techniques, and ethics.

Labiaplasty (also known as labia minora reduction) is attracting increasing attention in the media and in online forums. Controversy exists among health-care professionals on how to manage a request for this surgery. Furthermore, the indications for and outcomes of labiaplasty have not yet been systematically assessed, and long-term outcomes have not yet been reported. Labia minora hypertrophy is defined as enlargement of the labia minora; however, the natural variation of labia minora size has scarcely been studied, with only one study suggesting objective criteria. Perception of the 'normal' appearance of labia minora is influenced by culture, exposure to idealized photographs in media, health-care professionals' opinions, and family, friends, and sexual partners (although this influence has not been substantiated by research). The desire for labiaplasty is predominantly based on dissatisfaction with genital appearance and not on functional complaints. Most health-care professionals believe that women seeking labiaplasty should be referred to a psychiatrist or psychologist for consultation before surgery, although whether counselling and education are effective at alleviating dissatisfaction or a low genital self-esteem is not clear. As the nature of patient motivation for this type of surgery is often psychological, counselling and education could be useful in reducing the demand for labiaplasty. However, current studies on surgical technique and outcomes include few patients, therefore, evidence on the results of different labiaplasty techniques and patient satisfaction is inconclusive. Further research is required to assess the value of this treatment and the appropriate indications for it. Improved understanding as to why women seek this treatment is needed and whether conservative treatments (such as counselling) are effective. Furthermore, systematic assessment of the surgical and patient-reported outcomes of labiaplasty is needed to assess whether it is safe and effective. Moreover, understanding the effect of cultural trends, for example, the way in which many women in Western society see any exception to the ideal body as a problem, will be insightful.

Utilization of Needles in the Surgical Reduction of Labia Minora: A Simple and Cost-Effective Way to Reduce Operating Time

Aesthetic surgery of the external genitalia is growing in popularity among women, with reduction of the labia minora (labiaplasty) being the procedure most commonly requested and performed. According to the American Society for Aesthetic Plastic Surgery, labiaplasty procedures in the United States increased by 44% from 2012 to 2013, and by 16.1% from 2014 to 2015.1 Increasing interest in the aesthetic appearance of female genitalia also has been observed in the field of cosmetic medicine. Hyaluronic acid can be injected during a simple outpatient procedure to augment labia majora, providing youthful and natural results.2 In a recent comprehensive literature review by Oranges et al,3 8 labiaplasty techniques were identified, all of which had similar clinical outcomes, patient satisfaction, and morbidity. Wound dehiscence was the most common postoperative complication of all 8 techniques.3 Patients typically desire labiaplasty to improve aesthetics and functional impairment. Labiaplasty procedures can improve pain and discomfort. The primary goals of this surgery are reduction of labia minora hypertrophy with maintenance of …

Response to “Clitoral Hood Reduction”

I thank Zeplin1 for agreeing with the assertion of myself and others2-4 that failure to address clitoral hood redundancy, if present, at the time of labia minora reduction may result in an unacceptable aesthetic result requiring revision. Zeplin asserts that “most” women with “labia minora hypertrophy” also have “clitoral hood hypertrophy.”1 Although hypertrophy is not defined, and this contention may be true, it has, to my knowledge, not yet been validated …

Commentary on: The Safety of Aesthetic Labiaplasty: A Plastic Surgery Experience

This is another study showing the relative safety of aesthetic labia minora reduction (labiaplasty). The authors perform an edge or trim technique to reduce the labia and then close the wounds with a running vertical mattress suture.1 It is reassuring that the authors had such seemingly good results. However, there are many questions that are unanswered by this paper. The results must be evaluated more closely to put their conclusions in perspective. After seeing many labiaplasty complications referred to me, many issues come to light. Success rate is determined by many factors, including the technique chosen and the precision of the surgeon. Other surgeons perform trimming labiaplasties using a variety of techniques, including excising the labia with a scalpel, scissors, laser, or radiofrequency. The authors rightly make the markings with patient approval to determine the amount of residual labia remaining. I am glad that they emphasize the necessity of conservative reduction, especially since many women present to me with partial or total amputation of the labia minora from an edge or trimming technique.2 In these women, the labia may have been pulled out and cut on tension. When released, …

Commentary on: Labia Minora Reduction Techniques: A Comprehensive Literature Review.

Labiaplasty procedures, especially those that reduce the size of the labia minora, have increased in popularity and acceptance within both the lay and medical communities over the past decade. Surgical reduction of the labia minora, for various indications and employing assorted techniques, has been described in peer-reviewed medical literature with increasing regularity since the early 1970s. Alter's publications in the late 1990's and early 2000's, describing his novel wedge excision labiaplasty technique,1 coincided with multiple articles about female genital cosmetic surgery in popular magazines and a heightening of public awareness about this type of surgery. Subsequently, there has been a veritable explosion of labiaplasty-related publications in the scientific literature. Numerous technical “improvements,” virtually all iterations of three basic techniques—edge excision, wedge excision, or central deepitheliation/excision—have been described as ways to achieve a seemingly straightforward surgical goal: reduction of the size of the labia minora. Desiring to distill and summarize the current state of affairs regarding published labia minora reduction techniques, Oranges and colleagues2 conducted this interesting, comprehensive review of the extant world labiaplasty literature. Excluding review articles, book chapters, and discussions/commentaries, they indentify and discuss 38 studies detailing operative …

Labia Minora Reduction – Patients Symptoms and Satisfaction in Short and Long Term

Labia minora reduction has gained more prominence in the recent decade and more women are seeking professional opinions. Unfortunately only a few studies have researched the long-term specificity and functional assessment endpoints. This study was a retrospective questionnaire study where we asked about complications, symptoms, labia sensitivity, influence on sex-life and patient satisfaction. Even though the general patient satisfaction was high, complications such as pain (23%), hematoma (11%) infection (9%) and healing problems (6%) were common. 36% experienced a change in sensitivity; less feeling/ numbness as the main complaint. Sex-life was reported to be better in 59%, while 39% experienced no change. It is important to know about possible complications and changes in sensitivity after reduction of labia minora. It is the responsibility of the consultant to inform women seeking operation in order to facilitate a well-informed decision.

Aesthetic surgery of the female genitalia: labiaplasty and beyond.

Vaginal rejuvenation has been on the rise for the past 10 years. Women seem to prefer no pubic hair and minimal if any labia minora dangling beyond the majora. Labiaplasty or labia minora reduction is the most common procedure requested by women concerned with the appearance of their vulvar area. Safe and effective surgical procedures exist to trim the labia minora and the labia majora and clitoral hood as indicated. In this article, patient selection and consent, surgical techniques, avoidance of complications, and adjunctive procedures to further enhance the aesthetics of the region are discussed.

Commentary on: Postoperative Clitoral Hood Deformity After Labiaplasty

Case reports usually do not merit commentary, but the primary topic raised by Hamori1 in this publication—namely, the consequences of failure to appreciate and appropriately address clitoral hood skin redundancy at the time of labia minora reduction—indeed warrants discussion. As labiaplasty has grown in popularity, the frequency of postoperative clitoral hood “deformity” complaints has, in my opinion, also increased. In my revision experience, clitoral hood skin redundancy is the most common reason women seek corrective surgery after labia minora reduction. Reporting 2 revision cases, Hamori highlights this often overlooked problem. Greater awareness is important as more surgeons who may be inexperienced in female genital cosmetic surgery increasingly market and perform labiaplasty procedures. Labia minora reduction is viewed as a simple procedure by many plastic surgeons and gynecologists. In some cases, it is. Unfortunately, many women possess complex genital anatomic variations, including …

Labia Minora Reconstruction Using Clitoral Hood Flaps, Wedge Excisions, and YV Advancement Flaps

Labia minora reduction (labioplasty, labiaplasty) is the most common female genital aesthetic procedure. The majority of labia reductions are performed by trimming the labial edges. Many of these women present with (1) asymmetry; (2) scalloping of the labial edges with wide, occasionally painful scars; and (3) abrupt termination and distortion of the clitoral hood at its normal junctions with the clitoral frenula and the upper labium. Reconstruction can usually be performed with wedge excisions, labial YV advancement, and touch-up trimming. Reconstruction of a labial amputation, however, required the development of a new clitoral hood flap. Twenty-four clitoral hood flaps were performed on 17 patients from June of 2006 through May of 2010. An island clitoral hood flap randomly based on the dartos fascia of the lower clitoral hood and medial labium majus is transposed to the ipsilateral labial defect to reconstruct a labium. Of the 10 patients with unilateral flaps, nine of the patients had previous bilateral labial reductions. Reconstruction of the opposite side in these nine women was performed using one or a combination of the following: wedge excisions, YV advancement flaps, or controlled touch-up trimming. All 24 flaps survived, with four minor complications. Five patients underwent revision of a total of seven flaps, but only two were for complications. As experience increased, revisions for aesthetic improvement became less common. Reconstruction of labia minora defects secondary to trimming labia reductions is very successful using a combination of clitoral hood flaps, wedge excisions, and YV advancements.

Deepithelized fasciocutaneous flap for labia majora augmentation during thigh lift

Labioplasty currently entails, other than labia minora reduction, labia majora skin excisional contouring and fat grafting. To restore fullness in a postbariatric patient, a technique was developed for labia majora augmentation using an anteriorly based adipofascial flap raised from the dispensable inner thigh lift crescent. The labiocrural crease delineated the flap medial border while the extent of the thigh redundancy determined its lateral border. A pocket in the labium was created and the flap was inserted. The procedure succeeded on one side and failed on the other, due to postoperative squeezing evacuation of a hematoma retracted the unattached flap. This labium was refilled later with fat grafting. Both for flap-insertion and fat-grafted labia showed almost symmetrical volumes after 1 year. Anatomical studies are necessary to accurately identify the flap blood supply. A large series is required to support the procedure as being safe and reliable.