Trim vs Laser vs Wedge: A Comparison of Labiaplasty Techniques

Labiaplasty is a cosmetic surgery procedure that reshapes or reduces the labia minora (the small inner lips of the vagina). This is done to perfect the appearance of the vagina, reduce discomfort and pain and enhance sexual gratification. Depending on your anatomy and desired results, as well as the experience and preference of your surgeon, there are three different techniques that can be used.

The trim technique simply removes excess tissue by cutting away the edges of the labia minora. In general, this method is most useful when the goal of the procedure is to remove rough and/or discolored outer edges from the labia. This technique is also used when the labiaplasty is being performed in conjunction with a clitoral hood reduction because both procedures can be completed using a single incision. While this technique can successfully reshape and renew the labia minora, it can also lead to stiffness and discomfort along the incision, as well as a loss of sensation1-7 if not done by an experienced surgeon

Oftentimes lasers are used to trim the edge of the labia minora, a technique known as laser labiaplasty.8 Using the lasers instead of the traditional trim technique has some advantages: shortens the time needed to complete the procedure, reduces bleeding, but can lengthen recovery time. However, this method removes the normal labial edges and can result in an unnatural appearance. The heat generated by the laser can also damage tissue and nerve endings, leading to other complications.

In cases that do not involve issues along the labial edge, only an excess of tissue or asymmetry, the wedge method is often used. This method removes a wedge-shaped section of tissue from the middle third of the labia and then stitches the top and bottom sections back together.2 This technique preserves the normal appearance of the labial edge. The interior incision also means that less stress is placed on the stitches, reducing complications. However, occasionally this closure breaks down, causing a gap in the labia and requiring a second surgery to fix it.

As with all cosmetic procedures there are positives and negatives associated with undergoing any type of labiaplasty. However, by choosing an experience, certified plastic surgeon you can minimize the risks and finally achieve the results you desire.

References:
1. Hodgkinson DJ, Hait G. Aesthetic vaginal labioplasty. Plast Reconstr Surg. 1984;74(3):414-416.
2. Alter GJ. A new technique for aesthetic labia minora reduction. Ann Plast Surg. 1998;40(3):287-290.
3. Alter GJ. Central wedge nymphectomy with a 90-degree Z-plasty for aesthetic reduction of the labia minora. Plast Reconstr Surg. 2005;115(7):2144-2145.
4. Rouzier R, Louis-Sylvestre C, Paniel BJ, Haddad B. Hypertrophy of labia minora: experience with 163 reductions. Am J Obstet Gynecol. 2000;182(1 Pt 1):35-40.
5. Choi HY, Kim KT. A new method for aesthetic reduction of labia minora (the deepithelialized reduction of labioplasty). Plast Reconstr Surg. 2000;105(1):419-422.
6. Munhoz AM, Filassi JR, Ricci MD, Aldrighi C, Correia LD, Aldrighi JM, et al. Aesthetic labia minora reduction with inferior wedge resection and superior pedicle flap reconstruction. Plast Reconstr Surg. 2006;118(5):1237-1250.
7. Maas SM, Hage JJ. Functional and aesthetic labia minora reduction. Plast Reconstr Surg. 2000;105(4):1453-1456.
8. Pardo J, Sola V, Ricci P, Guilloff E. Laser Labioplasty of labia minor. Int J Gynecol Obstet. 2006;83:38-43.


How is Sexual Sensation Affected by Labiaplasty Surgery?

Labiaplasty, sometimes referred to as female genital reshaping, is a cosmetic surgical procedure designed to reduce the size of one or both sets of labia. The procedure is requested by women for functional or cosmetic reasons [1]. In the many cases, labiaplasty is performed to correct a functional impairment [1]. In other cases, women have the surgery to please a sexual partner or themselves.

Large inner labia can lead to pain during sexual intercourse or exercise. If the lips extend past the outer labia, they are constantly exposed which causes rubbing and chafing in this sensitive area. They can also be drawn inside the body during intercourse, leading to a painful sexual experience.

In a review of the records of all women who underwent female genital reshaping in a 27 month period, it was determined that 37% of those women underwent the procedure for purely aesthetic reasons [1]. There are two schools of thought on the safety and effectiveness of this surgery on women for whom it is not a medical necessity.

Labiaplasty is often advertised as a way for a woman to increase her sexual satisfaction. However, many doctors caution that there are no studies supporting this claim and if not performed by a careful and experienced plastic surgeon, the reverse can be true. It is claimed that the surgery can lead to nerve damage which reduces sensitivity in the genital area. Also a resulting tightening of the vaginal wall has also been mentioned by some doctors as leading to painful intercourse in some cases.

Although no controlled studies of the effectiveness of labiaplasty at increasing sexual stimulation were found, high levels of patient satisfaction was recorded in all reports discovered between 1950 and 2009 [2]. In a study performed over a nine year period, 163 patients were asked to rate their satisfaction with the outcome of the procedure. 89% were satisfied with the aesthetic results [3].

Sexual sensation and satisfaction is not all physical. There is also the mental component. If a woman is embarrassed by her labia because they are much larger than average or misshapen and this embarrassment means she can not experience any pleasure, she should talk with a doctor honestly regarding the pros and cons of undergoing labiaplasty. The mental and emotional benefits of the surgery can outweigh the risks. Plus, the risks can be minimized if surgery is performed by an experienced surgeon.

References:

1. Miklos JR, Moore RD. Labiaplasty of the Labia Minora: Patients’ Indications for Pursuing Surgery. Journal of Sexual Medicine. 2008; 5(6): 1492-1495.
2. Liao LM, Michala L, Creighton SM. Labial surgery for well women: a review of the literature. BJOG. 2010;117(1):20-25.
3. Rouzier R, Louis-Sylvestre C, Paniel BJ, Haddad B. Hypertrophy of labia minora: experience with 163 reductions. Am J Obstet Gynecol. 2000;182(1 pt 1):35-40.
lasty, sometimes referred to as female genital reshaping, is a cosmetic surgical procedure designed to reduce the size of one or both sets of labia. The procedure is requested by women for functional or cosmetic reasons [1]. In the many cases, labiaplasty is performed to correct a functional impairment [1]. In other cases, women have the surgery to please a sexual partner or themselves.

Large inner labia can lead to pain during sexual intercourse or exercise. If the lips extend past the outer labia, they are constantly exposed which causes rubbing and chafing in this sensitive area. They can also be drawn inside the body during intercourse, leading to a painful sexual experience.

In a review of the records of all women who underwent female genital reshaping in a 27 month period, it was determined that 37% of those women underwent the procedure for purely aesthetic reasons [1]. There are two schools of thought on the safety and effectiveness of this surgery on women for whom it is not a medical necessity.

Labiaplasty is often advertised as a way for a woman to increase her sexual satisfaction. However, many doctors caution that there are no studies supporting this claim and if not performed by a careful and experienced plastic surgeon, the reverse can be true. It is claimed that the surgery can lead to nerve damage which reduces sensitivity in the genital area. Also a resulting tightening of the vaginal wall has also been mentioned by some doctors as leading to painful intercourse in some cases.

Although no controlled studies of the effectiveness of labiaplasty at increasing sexual stimulation were found, high levels of patient satisfaction was recorded in all reports discovered between 1950 and 2009 [2]. In a study performed over a nine year period, 163 patients were asked to rate their satisfaction with the outcome of the procedure. 89% were satisfied with the aesthetic results [3].

Sexual sensation and satisfaction is not all physical. There is also the mental component. If a woman is embarrassed by her labia because they are much larger than average or misshapen and this embarrassment means she can not experience any pleasure, she should talk with a doctor honestly regarding the pros and cons of undergoing labiaplasty. The mental and emotional benefits of the surgery can outweigh the risks. Plus, the risks can be minimized if surgery is performed by an experienced surgeon.

References:

1. Miklos JR, Moore RD. Labiaplasty of the Labia Minora: Patients’ Indications for Pursuing Surgery. Journal of Sexual Medicine. 2008; 5(6): 1492-1495.
2. Liao LM, Michala L, Creighton SM. Labial surgery for well women: a review of the literature. BJOG. 2010;117(1):20-25.
3. Rouzier R, Louis-Sylvestre C, Paniel BJ, Haddad B. Hypertrophy of labia minora: experience with 163 reductions. Am J Obstet Gynecol. 2000;182(1 pt 1):35-40.


Labiaplasty: Is it unsafe?

Labiaplasty is a cosmetic procedure that reduces the amount of tissue that extends from the lips covering the vagina. Most cosmetic surgeons consider labiaplasty to be a relatively minor surgery with few complications. However, there are many other experts who feel labiaplasty is medically unnecessary and puts the patient at undue risk.

According to the American College of Obstetricians and Gynecologists, there is a lack of evidence supporting the effectiveness of vaginal cosmetic procedures and few studies documenting the long-term risks (like infection, altered sensitivity, pain and scarring).1 A recent review published in the British Journal of Obstetrics and Gynaecology also reached the same conclusion. After reviewing all of the existing published literature on labiaplasty, the authors concluded that “medically nonessential surgery to the labia minora is being promoted as an effective treatment for women’s complaints, but no data on clinical effectiveness exist.” 2

In an interview with BBC News, Dr. Creighton, one of the study’s lead researchers, also suggested that women who undergo labiaplasty could potentially experience similar problems in childbirth as women who had gone through types I and II female genital mutilation. These risks include a higher risk of tearing and bleeding.3

Because the practice of medicine, cosmetic or otherwise, is based on clinical evidence, the lack of data from prospective, randomized, controlled trials is a serious mark against labiaplasty in the eyes of many doctors. However, from Dr. Rajagopal’s clinical experience and own (as of yet unpublished) outcome study, the results of the procedure outweigh the potential risks. In her study, conducted from 2006 to 2007, Dr. Rajagopal surveyed 77 patients about their labiaplasty experience and found that about 95% of them were overwhelmingly satisfied with the results.

Dr. Rajagopal’s results compliment many other published outcome studies. One of these studies was conducted in a Chilean clinic and surveyed 55 labiaplasty patients. Two months following surgery, 91% of the patients said they were “very satisfied” with the results and none said they were dissatisfied.4 Another study of 163 patients in France found that 89% were satisfied with the aesthetic results of the procedure and 93% were happy with the functional outcomes.5

Although more studies of this sort need to be completed, Dr. Rajagopal is convinced that excellent outcomes are possible with labiaplasty when you have an experienced plastic surgeon using good surgical techniques in a safe manner.

References:

1. Committee on Gynecologic Practice, American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 378: Vaginal “rejuvenation” and cosmetic vaginal procedures. Obstet Gynecol. 2007;110(3):737-738.
2. Liao LM, Michala L, Creighton SM. Labial surgery for well women: a review of the literature. BJOG. 2010;117(1):20-25.
3. New warning on ‘perfect vaginas’. http://news.bbc.co.uk/2/hi/health/8352711.stm. Updated Nov 11, 2009.
4. Pardo J, Sola V, Ricci P, Guilloff E. Laser labioplasty of labia minora. Int J Gynecol Obstet. 2006;93(1):38-43.
5. Rouzier R, Louis-Sylvestre C, Paniel BJ, Haddad B. Hypertrophy of labia minora: experience with 163 reductions. Am J Obstet Gynecol. 2000;182(1 pt 1):35-40.