Aesthetic Labia Minora Reduction with Inferior Wedge Resection and Superior Pedicle Flap Reconstruction (original) (raw)
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Aesthetic plastic surgery, 2015
Esthetic surgery of external female genitalia remains an uncommon procedure. This article describes a novel, de-epithelialized, labial rim flap technique for labia majora augmentation using de-epithelialized labia minora tissue otherwise to be excised as an adjunct to labia minora reduction. Ten patients were included in the study. The protruding segments of the labia minora were de-epithelialized with a fine scissors or scalpel instead of being excised, and a bulky section of subcutaneous tissue was obtained. Between the outer and inner surfaces of the labia minora, a flap with a subcutaneous pedicle was created in continuity with the de-epithelialized marginal tissue. A pocket was dissected in the labium majus, and the flap was transposed into the pocket to augment the labia majora. Mean patient age was 39.9 (±13.9) years, mean operation time was 60 min, and mean follow-up period was 14.5 (±3.4) months. There were no major complications (hematoma, wound dehiscence, infection) foll...
Posterior Wedge Resection: A More Aesthetic Labiaplasty
Aesthetic Surgery Journal, 2013
Hypertrophy of the labia minora is of concern to a subset of adolescents and adult women. As a result of greater public awareness about problems with hyperplastic labia minora, an increasing number of women are seeking treatment not only for aesthetic concerns but also for functional and/or psychological reasons. A multitude of reduction techniques have been developed to alleviate noticeable projection of the labia minora beyond the boundaries of the labia majora. Although practitioners from different specialties have performed labia minora reduction surgery, the plastic surgical and gynecological literature dominates its evolution. Unless other concomitant procedures are being performed, the majority of labiaplasties are performed in the office setting under local anesthesia. Most of these procedures are a variation of 1 of 4 techniques: (1) deepithelialization, (2) edge excision, (3) inferior wedge resection, or (4) central wedge nymphectomy. In fact, Ellsworth et al 1 devised an algorithmic approach to these labiaplasty methods. With all of these approaches, overall patient satisfaction remains high, but plastic surgeons are constantly exploring ways to improve and build upon prior techniques; the patient seeking plastic surgery also desires perfection in the result. In this study, we describe an anatomic approach to labiaplasty that we believe yields the optimal aesthetic outcome while maintaining the functional achievements of prior techniques. Methods For this study, we retrospectively reviewed the charts of 22 patients who underwent posterior wedge resection
Background: Hypertrophy and variation in the size of labia minora have long been recognized. Hypertrophic labia minora can be bothersome for aesthetic, functional, and psychosocial reasons. Different techniques for labia minora reduction have been developed. Whatever the used technique is, the main principle is to have a hidden scar and to preserve the free edge of the labia minora. Patients and Methods: This study was done on 40 female patients asking for reduction of labia minora size. All patients were operated for labioplasty using inferior wedge resection and superior pedicled flap reconstruction under local anesthesia. Results: Dehiscence of the tip of the flap was noted in 12.5% of the cases, which was managed conservatively. The overall cosmetic result was assessed 6 months postoperatively, which was very good and excellent in 87.5% of cases, and good in 12.5% of the cased. No patients had unsatisfactory cosmetic results. Conclusion: Inferior wedge resection and superior ped...
Techniques for Labia Minora Reduction: An Algorithmic Approach
Aesthetic Plastic Surgery, 2010
Background Aesthetic reduction of the labia minora has gained popularity, and a number of different techniques have been described. Each procedure has its own set of advantages and disadvantages. However, no algorithm has been defined for pairing the degree of deformity with the optimal surgical procedure. Methods Patients were stratified into one of four groups based on labial size. The surgeon chose one of three reduction techniques based on the degree of labial hypertrophy and the patient's aesthetic preferences for labial edge color and contour. Three reduction techniques were used including the edge excision technique, the inferior wedge resection technique, and deepithelialization reduction labioplasty. The success of aesthetic reduction was evaluated, as was symptomatic relief. Results The 12 procedures performed included five deepithelialization techniques, four edge excision techniques, and three inferior wedge resection techniques. As reported, 92% of the patients were ''very satisfied'' with their aesthetic and functional results. The complications were minimal, with three patients experiencing minor wound healing difficulties that resolved spontaneously. One patient who underwent the edge excision technique was ''not satisfied'' and complained of overreduction.
Labiaplasty with Stable Labia Minora Retraction—Butterfly-like Approach
Plastic and Reconstructive Surgery - Global Open, 2020
Summary: Labiaplasty, referring to a surgical labia minora reduction, is the most commonly requested genital rejuvenation by women. The purpose of this article is to show an innovative maneuver in the technique for this increasingly demanded procedure. In this strategy, labia minora are attached temporarily to the internal thigh with stitches resembling an open butterfly wing. This maneuver stabilizes the redundant labia minora soft tissue, easing the evaluation of asymmetry and aiding precision in the treatment. The study investigated 12 patients, 10 presenting bilateral hypertrophic labia minora and 2 patients with only unilateral abnormal anatomy, n = 22. The mean age was 25 years. The postoperative follow-up was uneventful. All patients presented labia minora with anatomic configuration. In 1 patient, we registered immediate bleeding that needed revision. The butterfly-like maneuver with the labia minora temporarily attached to the inner thigh can ease labiaplasty with central a...
Total vaginal reconstruction with combined ?Split Labia Minora Flaps? and full-thickness skin grafts
Journal of Obstetrics and Gynaecology Research, 2007
Purpose: Vaginal reconstruction with split-thickness skin grafts is the most common method for total vaginal reconstruction. Although it has disadvantages like contraction of the graft, foreshortening, donor site morbidity and long-lasting periods of vaginal standing; its easy surgical technique makes it popular. A new method using split labia minora (LM) flaps and full-thickness skin graft is discussed in this study. Method: A 19-year-old female was presented with amenorrhea. A total absence of vagina was present and the patient underwent a total vaginal reconstruction for possible sexual intercourse. Results: We observed no contraction and no foreshortening with a patent vaginal cavity up to 11 cm and 4.5 cm width. The need for continuous standing period was as short as 4 weeks and for intermittent standing up to 4 months. Sexual intercourse was encouraged after 4 weeks. During sexual intercourse no external lubrication was reported to be needed. There was no need for further reconstructive intervention. Conclusion: Vaginal reconstruction in congenital vaginal agenesis with split LM flaps and full-thickness skin grafts is a simple and effective method, which shortens the standing period and decreases the contraction in neovagina. Total vaginal reconstruction with split LM flaps could also be possible; to achieve this goal, expansion of LM flaps could be a further alternative.
Star nymphoplasty: a surgical technique for labia minora hypertrophy
Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery, 2015
Introduction: In recent years, women have been frequently consulting the plastic surgeon concerning the shape and dimensions of the labia minora and other surrounding structures, not only for aesthetic but also functional reasons, e.g., dyspareunia. The authors present a technique for the aesthetic and functional treatment of the external female genitalia, the vulva, with the purpose of correcting hypertrophy of the labia minora (nymphs), without changing their form. Method: This technique consists in the incision in the shape of a star leading to a shortening of nymphs both anteroposteriorly and craniocaudally. This is a 15-year retrospective study, with clinical and surgical follow-up of 64 female patients with an age range between 14 and 58 years, all submitted to star nymphoplasty, the technique proposed in this study. Results: The results were obtained from the patients operated from January 1996 to December 2011, at the Hospital da Lagoa and at Interclínica-Centroplástica, Jardim Botânico, Rio de Janeiro, RJ. A high rate of patient satisfaction with the size and aesthetic shape of the genitalia was achieved. There was a low rate of complications and remaining complaints. Conclusion: This surgical procedure is done with the objective of reshaping the tissue structure of the hypertrophic labia minora. From a technical point of view, it can be considered as a simple and effective functional and aesthetic treatment of the female genitalia.
Classification of labia minora hypertrophy: A retrospective study of 100 patient cases
JPRAS, 2017
The purpose of this study is to establish a new classification system for labial hypertrophy based on shape and clinical symptom-atology, rather than on measurement of the length in centimetres. The aim of this classification system is to be able to select surgical strategies based on the type of labial hypertrophy. From 2005 to 2014, we undertook a retrospective study analysing 100 patient files, chosen at random from our database of 400 patient cases and pre-operational photographs to reduce the labia minora, also known as labiaplasty. The author analysed data from each individual patient file concerning the shape of the labia minora, patients' symptomatology and the chosen operational technique. We found three types of labial hypertrophy, constituting a new system of classification: Type I: the anterior one third form, called "flag". 11 patient cases were observed (11%). Type II: the middle third form, called "oblique". 29 patient cases were observed (29%). Type III: the posterior third form, called "complete". 60 patient cases were observed (60%). In symptomatology terms, Type I was characterized by an undesirable aesthetic appearance and discomfort in the crotch area caused by wearing tight clothing, but not by dyspareunia. Type II showed an overall fuller appearance. Type III presented frequent dyspareunia more often than Type I and Type II. For Type I, the surgical technique selected was a superior pedicule flap, with only a moderate labial resection, which follows the edge
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020
BackgroundDespite increasing numbers of labiaplasties being performed, there is little quantitative information on normal labial diversity to guide medical education, patient education and surgical treatment.AimThis scoping review will determine what is known in the published literature about the anatomical basis of normal for labia and female genital cosmetic surgery (FCGS).Materials and methodsThe scoping review identified ten population‐based studies that recorded labial dimensions by searching three electronic databases utilising a Preferred Reporting Items for Systematic Reviews and Meta‐Analyses search strategy. Strict inclusion and exclusion criteria were applied and then reference lists were scrutinised until no further articles that met the criteria were located.ResultsThese studies showed significant variation in labial length (range 5–100 mm) and width (range 1–60 mm). Labia minora were wider in pre‐menopausal women than in post‐menopausal women, protruding labia minora w...
Vaginal Labiaplasty: Defense of the Simple ''Clip and Snip'' and a New Classification System
Vaginal labiaplasty has become a more frequently performed procedure as a result of the publicity and education possible with the internet. Some of our patients have suffered in silence for years with large, protruding labia minora and the tissue above the clitoris that is disfiguring and uncomfortable and makes intercourse very difficult and painful. We propose four classes of labia protrusion based on size and location: Class 1 is normal, where the labia majora and minora are about equal. Class 2 is the protrusion of the minora beyond the majora.