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Very few women have minora that can be considered abnormally large. Those seeking surgery, in my experience, have labia minora that, albeit large, fall within the normal minora size range.
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6, 15 LABIA MINORA ALTERATIONĪs previously stated, reduction of the labia minora is by far the most commonly requested female external genital cosmetic procedure (Figures 3 and 4). 2, 7, 12-14 Furthermore, to date no published operative technique has proven superior to the others described in the literature. 6, 11 It therefore appears that, when competently performed, most labiaplasty techniques result in high patient satisfaction rates and low complication rates. For labia minora reduction, reported patient satisfaction rates are remarkably high (greater than 90%) in published surveys involving various techniques. 9, 10Ī 28-year-old woman with thick, hyperpigmented labia minora and redundant labia minora tissue extending between the introitus and anus.Īccurate evaluation of anatomic issues, surgical planning, and technical execution are essential in achieving optimal aesthetic outcomes. Patient dissatisfaction and an augmented sense of genital embarrassment may occur. Prominent lateral clitoral hood folds or labial remnants between the introitus and anus (Figures 1 and 2), proportional to large labia minora before surgery, may appear more unnatural after a simple labia minora reduction, regardless of the labiaplasty technique employed. Simply reducing the labia minora in women with complex anatomic issues may result in unnatural-appearing genitalia and the perception of genital deformity as unintended consequences. 4, 9, 10 Such women need more nuanced procedures to achieve aesthetically acceptable, natural-appearing outcomes. 9 Labia majora redundancy, deflation and ptosis, vertical and/or horizontal clitoral hood excess, and redundant labial tissue posterior to the introitus (in addition to unlimited labia minora size, shape, and pigmentation variations) may be present and require attention. Many women, however, present with anatomic challenges that make achieving good aesthetic outcomes difficult. Key points of preoperative anatomic evaluation, technique selection, operative caveats, and perioperative care for labia minora, clitoral hood, and labia majora alterations are presented.įemale external genital cosmetic surgery procedures are viewed by many plastic surgeons and gynecologists as being technically simple operations. Rather, I offer what I have learned in performing over 600 labiaplasties.
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4-8 Therefore, a discussion of vulvar anatomy or a detailed description of the various operative techniques available are not the focus of this paper. It is therefore essential that the entire anatomic region-labia minora, labia majora, clitoral hood, perineum, and mons pubis-be evaluated in the preoperative assessment of women seeking labiaplasties.ĭescriptions, reviews, and illustrations of female external genital anatomy and labiaplasty procedures and techniques are abundant, and readily available in the recent literature. 4 Although the labia minora are usually the focus of patients’ concerns, achieving a desirable cosmetic outcome often requires additional external genital alterations. It is estimated that greater than 90% of female genital procedures performed involve alteration of the labia minora. 2 Labia minora reduction is the most commonly requested and performed procedure on the female external genitalia. There was a 44% increase in labiaplasty procedures performed in the US between 20. Labiaplasty competency should be part of the skill set of all plastic surgeons.Īlthough ranked relatively low on volume lists of overall cosmetic surgery procedures in the United States, 1 aesthetic alteration of the genitalia is increasingly sought by women unhappy with the size, shape, and appearance of their vulva. We present key points of the preoperative anatomic evaluation, technique selection, operative risks, perioperative care, and potential complications for labia minora, labia majora, and clitoral hood alterations, based on a large operative experience. The three basic labia minora reduction techniques-edge excision, wedge excision, and central deepithelialization-as well as their advantages and disadvantages are discussed to assist the surgeon in tailoring technique selection to individual genital anatomy and aesthetic desires. Labiaplasty is associated with high patient satisfaction and low complication rates. Although the labia minora are usually the focus of concern, the entire anatomic region-minora, labia majora, clitoral hood, perineum, and mons pubis-should be evaluated in a preoperative assessment of women seeking labiaplasty. Aesthetic alteration of the genitalia is increasingly sought by women unhappy with the size, shape, and appearance of their vulva.