Thank you in advance for any responses. I've decided that the trim method labiaplasty would be better for me, because of very dark edges and extreme asymmetry. However I feel there is less information on this compared to the wedge method, and I don't fully understand it. My questions: Is it possible that the leftover pink labia will darken again in future? If the incision is along the length of the labia doesn't this leave an exposed scarred edge? How is the edge repaired? Is it longer to heal?
Trim Method Labiaplasty
Doctor Answers 10
Trim vs wedge method for labiaplasty
If you want to remove the darker skin edge of the labia than the trim method is better. The pink edge will stay pink and will not darken over time. The scar can make the labial edge more ripply and it is not hidden from view. The wedge method will have a tiny horizontal scar as it crosses from the mucosal side (inner pink side) to the outer skin side where the scar ends up in the groove between the labia minora and majora. This preserves the normal, somewhat darker skin edge.
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Not a fan of the trim
It is possible that a trim could leave a pink edge that would darken later, but if coloration is your major concern, a trim might address it better than a wedge. Trim patients do have more pain in my experience however. Wedge patients get better more quickly after surgery and have fewer problems with numbness afterward. On how things are repaired it depends upon the surgeon. We all do the surgery a bit differently.
John Di Saia MD
Labiaplasty trim method
The labiaplasty method where the edge is trimmed works great for many patients. Labia are highly variable in shape, so the procedure should be modified for the particular patient's needs. In general, I roll the darker outer labia skin across the edge to give a more natural appearance.
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Trim vs Z-plasty for Labial Reduction
If you simply trim off the edge of the labia, you will end up with scalloped edges once you are healed. This is why you hear about the wedge resection which is really a z-plasty (the incision is made zigzag so the tension on the scar is not in a straight line (which allows the scar to produce a normal looking labia, not scalloped). Plastic surgeons frequently do z-plasty closures on other areas for the same reason--it diffuses the tension on the scar (scar tissue is different than regular tissue and tends to contract some, not to mention that a straight line scar is usually more visible.) Your labia won't change color after the procedure. Everyone looks different, but what you have is what you have & it won't change. I wouldn't worry about the asymmetry-that can be fixed without doing the "trim" method that will leave your labia with scalloped edges. Also, go to someone who knows what they are doing because you don't want to injure the labial artery. When done well, this is a great procedure.
Trim method vs wedge resection in labiaplasty
If the problem with the labia minora is one in which the labia are thin but darkly colored and excessively long, then the trim method, in which the excess dark skin is trimmed and the incision closed, will probably work well. The dark coloration usually will not return to the remaining labia. If the labia are also thick or bulky, then a wedge resection will be required, this procedure is somewhat more extensive, may require general anesthesia, and will result is more swelling that may take a few weeks to resolve.
Labiaplasty - Trim versus Wedge Methods, Pink Edges, Scars
Both methods of this procedure are widely used and accepted; of course the "best" approach (there isn't really a best approach but, instead, a preferred approach) is something you'll have to decide in consultation with your surgeon.
If your primary concern is the elimination of the dark area at the leading edge (?front) of the labia, then it would appear that the best approach is the trim method, in which that front portion of the labia is trimmed off. This leaves a relatively fine scar that fades well over time (up to a year or longer). At least in theory, the remaining tissue will not change in its color. Nothing, of course, can be guaranteed with that, but it would not normally turn dark later.
However, a lot of changes in the overall contour can be achieved with the wedge method, and leaving the anterior (font) portion intact as some advantages in that you don't affect the ability of the labia to engorge (swell) to the same degree. Furthermore, there is only one relatively thin scar on that leading edge although additional scarring is produced farther inward (toward the introitus, or vaginal opening). And if you want the bulk of the labia reduced then you'll need an additional incision several cms back - it's a little hard to describe, but easier to draw.
At any rate , there is no single correct method and the best thing is for you to sit down with your surgeon, ask him or her to describe and possibly even draw the differences, and explain what's recommended. That way, you'll be able to make an informed decision.
I hope that this helps, and good luck,
Trim Method for Labiaplasty Surgery
The trim method will remove some or all of the pigmented tissue depending on the location. The pink part of the labia will not darken over time. During the trim method, the entire edge of the labia is trimmed and the pigment part is removed. The incision heals very well and is based mostly on surgical technique. The incision should not expose the scar and recovery may take longer if the entire length of the labia needs to be trimmed. The area is closed with a very fine suture.
Scars and Labiaplasty.
The scaring from the trim method Labiaplasty is barely visible when it is completely healed. This tissue has no underlying structure or intrinsic forces on it and therefore heals extremely well. Remember it takes a full year for scars to heal completely and mature.
Labiaplasty trim method
Surgeons may use a variety of approaches to close the wound and this may have an effect on the appearance. In answer to your question, yes, it does leave an exposed scarred edge but it is typically a thin barely visible scar. Generally speaking the dark color may be genetic but it can be due to constant irritation and inflammation, similar to children's knees when constantly scrapped. IF the labiaplasty can successfully reduce the projection of the labia minora to be less than the labia majora so that they protect and cover the underlying minora, it is not likely that they will darken again.
Wedge vs. Edge labioplasty
I am not certain what you mean by "trim" method, but I believe you mean when the exposed edge of the labia is simply removed. If that is what you mean, then you are correct-there will be a pink scarred margin to the labia. The wedge excision only has a very short scar along the edge and the remainder of the scar is better hidden. Asymmetry can readily be corrected with the wedge excision. I hope this helps clarify some issues for you. Obviously, a complete exam would be necessary before making a final decision about what is best for you.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.