Labiaplasty Technique: Wedge vs. Trimming

Typically, labiaplasty and clitoral hood reduction combines both the trimming and the wedge technique.

In the image above, the trimming technique was used to reduce the majority of the overgrown labia. The top part of the labia that also forms part of the clitoral hood is removed with the wedge technique. This combination approach allows for a more natural transition from the clitoral hood to the labia. Care is taken to leave the frenulum intact so that the opening into the vagina is not narrowed. This is especially applicable to women who are post-menopausal and have less tissue elasticity in this area.

In the image above, the clitoral hood is not enlarged, and the trimming technique alone is used to reduce the labia. This allows for a natural appearing contour to the labia.

In the image above, the labia extend into the perineum past the posterior fourchette. Removal of the excess skin in the perineal and posterior fourchette area is done using the trimming technique. Care is taken to avoid over tightening of the opening to the vagina when removing enlarged labia in this area. This is achieved by excising the skin to the sides of the opening, which leaves the caliber of the vagina unchanged. This is especially applicable in younger women who have not delivered vaginally, and women who are post-menopausal and have less tissue elasticity in this area.

Some of our patients who are undergoing labiaplasty also have anal skin tags removed. The anal or hemorrhoidal skin tags are removed by excising in a wedge fashion and then closing the skin edges with dissolvable sutures.

For the labia majora reduction, the excess skin and fat is removed using an elliptical incision. The goal of this technique is to improve the appearance of the outer labia, especially when the patient is standing.