How do the results differ for a wedge labiaplasty procedure compared to a trim method? Is sensitivity for one greater than the other? Is that why someone would choose one over the other?
Is Wedge Labiaplasty More Natural Looking Than Trim Method?
Doctor Answers (7)
There are a variety of techniques used for labiaplasty. It is very important to meet with a board certified plastic surgeon to discuss your issues so you can receive a treatment plan tailored to your needs. I mainly use a wedge technique because I feel this usually provides the most natural look, but this may vary depending on your situation.
I hope this helps and wish you all the best!
Wedge vs trim method
Though an exam can determine which method would work for you, in general, a wedge method provides a better aesthetic result with scars hidden away and less chance for hyper sensitivity associated with having your incision/scar at the front of your labia.
Hope this helps.
Wedge Labiaplasty vs Trim Method
My opinion is that the wedge is far superior to the trim method for most (85%) of patients. Close examination of the female perineum reveals irregular variation in surface skin and mucosal characteristics. Although there is a well known transition from outer cutaneous to inner mucosal surface, the roughness, pigmentation, hair distribution, and configuration of the frenula are highly individualized. Lopping off the entire distal end and suturing mucosa to skin, or even one type of skin to another, may provide smaller labia, and control the amount of reduction, but upon close examination does not really produce the most natural result. The normal transition in type and texture of skin to mucosa is disrupted, and becomes abrupt. On gross photography, this is not obvious. Websites that show photos of the female perineum in stirrups from a few feet away appear just fine. If the views were close up and more detailed, the difference between wedge method and trim method would be much more obvious. The wedge method lines up like skin to like skin and mucosa to mucosa. There is no disruption of the natural transition along the labial edge. Look at these results several months post op close up, and you see beautiful results, with absolutely NO sign of any surgery. There is no documented sensory difference between the two techniques, but I prefer the wedge method here as well, because nerve endings that supply the labial margin are not being cut.
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Wedge versus Trim Techniques
As you see here the best options in plastic surgery are a matter of opinion even between surgeons. I have found a modification of the wedge procedure to be the best in the majority of patients. My reasons are outlined on my YouTube video below.
John DI Saia MD
Labiaplasty, which most commonly involves surgical reduction of the labia minora (inner/thinner lips), has become a relatively common procedure over the last ten and even more so last five years. Whether the surgery is done using a laser, scalpel, or scissors does not really matter but what does matter is "symmetry". Symmetry is the most important aspect to the final aesthetic result. Also, it's not how much tissue is removed but how much is left remaining because a certain amount is necessary to maintain proper form and function. In my experience, the "Trim" method is more accurate and predictable in achieving these results. Additionally the "Wedge" method leaves more of a noticeable scar vertically oriented up the middle of the labia. Finally, it is extremely important to consult with a board certified plastic surgeon that specializes in this operation (does at least 1 - 2 per week). It may cost you a bit more but it this type of result you will want to live with for the rest of your life. Typical (all inclusive) fee at my office/surgery center is $4500. Best of luck...RAS
Labia minora reduction results?
I think the “natural look” after labia minora reduction surgery is more dependent on the experience and skill level of the surgeon then the exact technique used.
My routine involves meeting with the patient prior to surgery to mark the area. This marking is done with the patient’s assistance while she holds a mirror. This allows the patient to communicate her goals again. Sometimes, the markings extend above the clitoris and/or below to the perineum (closer to the anus). Pre-existing asymmetry of the labia minora is very common and this should be corrected as much as possible. Extreme care is taken to avoid over-resection during the markings or the procedure.
The procedure is usually performed under general anesthesia (although, local anesthesia may be used for select patients). Regardless, long acting local anesthesia is used to help with patient’s post-operative pain control. The exact technique used is individualized and depends on the patient’s anatomy. For some patients, a triangular segment of excess labia minora tissue is removed; for others, a gentle curvilinear excision is performed. Excess tissue on the sides of the clitoris may also be removed judiciously. During the procedure, certain principles are adhered to strictly:
1. Avoidance over-resection.
2. Avoidance of encroachment upon the clitoris, urethra, or vaginal opening.
3. Achieving as much symmetry as possible.
Closure is done with sutures that dissolve – no suture removal is necessary. Scars will be minimally or not visible after several months. Ice and surgical pad are applied immediately.
I hope this helps.
Labiaplasty techniques, which is better?
Labiaplasty surgery has been around for a long time, but with the open and free communication on the internet, the awareness was raised significantly. There are several techniques, the oldest is the trim or amputation method and more recently the wedge method. Even the trim method evolved from a straight amputation of the excess tissues to a lazy S curve to minimize contractures. This leaves a suture line closure of the entire length of the anterior labial edge. I've seen where this scar comes up superiorly and is scarred to the clitoral hood. The clitoral hood tissues are very fine and usually have two or three folds of skin. I've seen this anatomy oblitarated by the trim method. Another potential problem is overresection which leaves a very short or nonexistent labia, but a gapping whole buttressed on the two sides by the labia majora (outside lips). Proponents of the trim method state that patients want the darker skin edge removed and want their labia to be pink. The normal anatomy of the labia is pink on the inside, but is darker colored skin on the outside and anterior border. I personally prefer the wedge method. This preserves the normal labial edge and color and the suture line is hidden inside the vaginal opening on the inner aspect and between the major and minor lips on the outside. The clitoral hood anatomy is not altered or distorted. A recent large multicenter study looked at preservation of sensation comparing the 2 methods and overall patient satisfaction was 95% in both groups, complication rate was 8% for both. Regarding "enhancement of sexual function" 70% of wedge resection patients reported mild to significant enhancement as opposed to 56% of trim resection. Using a laser vs a scalpel for surgery is more a marketing issue and does not translate into better surgery and results or faster healing.