Dr. Larry Schlesinger: Hi! I'm Larry Schlesinger, and I'm a board certified plastic surgeon from Honolulu, Hawaii. And today's question is about labiaplasties. What is the difference between the trim and the wedge technique?

Well, the trim technique has been around for a long time. It's very obvious, any part of the labia that's sticking outside of the labia majora, you trim off and you saw up the raw edge. The problem is, one, it tends to be painful and sometimes it can create pain on intercourse. Two, the labia are important parts of the vagina because they're there to hold moisture in to keep the vagina moist.

The problem is when you trim. The labia are very kind of delicate and somewhat wiggly little pieces of tissue and if you're trying to trim them, and you're not-- Either you're not lucky or you're not totally moving in the right plane, you can literally amputate them. It's not all that difficult and when you do you create a problem for the patient that is difficult to rectify.

The second technique, the trim technique was invented by Gary Alter from Beverly Hills, California. What a great name for a guy that does the transsexuals, Dr. Alter. At any rate, Gary came up with the idea that earlobes and labia look a lot alike. He's a board certified plastic surgeon. He's a board certified urologist. And having crossover between the two, he saw the connection in the appearance in earlobes versus labia.

You would take a wedge out of an earlobe to make it smaller. You take a wedge out of a labia to bring the part that's offensive away and make the labia smaller. You never can amputate when done correctly by a board certified plastic surgeon.

And there's an added benefit. The opening to the vagina is called the introitus. After having multiple children, the opening tends to be big enough to put multiple fingers inside, usually about five. When you do the wedge technique, normally we're able to reduce the size of the vagina from the opening of five fingers to the opening of two and therefore, giving a smaller entrance into the vagina. The labia, when done by the wedge technique come out more attractive by today's standards, more functional. I've never had any complaints about a labiaplasty that's done by the wedge technique.

Trim vs. The Wedge Labiaplasty Techniques

When considering a labiaplasty, it is important to know the difference between a trim and wedge technique. Dr. Larry Schlesinger shares his experience with both techniques and his preferred approach.