Can a labiaplasty be done using a combination of both the wedge and trim technique?

Question

Would it be possible to use both techniques during a labiaplasty? I've researched that the wedge technique is great to get natural look but since I have really dark edged labia I feel a trim would really help me get the pink tucked in look. Please give me any advice on what could be best for me as I would love to get the very tucked in look and also have the pink edged labia. Thank you!

Steve Laverson, MD, FACS · Answer

Absolutely YES, the wedge and trim patterns of labia minora reduction may be combined for the result you want.  Most important is the components, color, and characteristics of labia minora that remain after removal of your excess.  Our approach has been successful, which is to create the size, shape, color(s), and appearance desired from existing labia and to remove the rest.  Sometimes combination of techniques are required that rearrange and remove tissue accordingly to produce the labia and vulvar situation she wants.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

You could wedge the left side and trim the right side. Or vice versa. Realistically, NOT. If you're looking for a natural appearing edge, both techniques can achieve this...assuming they are done in expert hands. In non-expert hands, neither technique will leave you looking natural. If it's the color of the edge that bothers you, a curvilinear sculpted labiaplasty would give the best result...in expert hands. The wedge would keep the color you don't like. If you want more details, schedule a virtual consult and share some photos.

Christine DiEdwardo, MD · Answer

Thank you for your question. The general answer is yes, depending on your concerns, goals and labia minora anatomy. Following a wedge labiaplasty, if the patient is also bothered by pigmentation of the labial edge, those specific areas can then be superficially excised with a very conservative edge trim. However, because there is so much variation in genital anatomy, it would be important to discuss your concerns and goals in detail with your surgeon to know if your specific goals can be achieved. I find that reviewing before and after photos with your surgeon of patients who have had labiaplasty (especially those of patients with similar anatomy) is very helpful in conveying your aesthetic preference.

Richard Bloy, MD, FACOG · Answer

Each surgery is designed for each patient’s individual desires and needs, including other techniques.

Mark N. Scheinberg, MD · Answer

Thank you for your question If you do not like your edges then a trim technique will eliminate the edges and can create a length and height per your preference. There is no benefit to the wedge technique when doing a trim and it puts you at risk for the complications (holes and notching) inherent to the wedge technique. Do your homework and review before and after photos of patients with your appearance. See the video below for more info

Ebru Unal, MD · Answer

Labiapalsy is a challenging operation. Wedge and liner techniques are prevalent procedures, but they do not produce optimal results for all types of inner lips. Therefore, your inquiries are vital and your concerns have been heard. In my practice, I never use wedge resection because it leaves a perpendicular incision at the liner tissue. resulting in separation of the scar margins, or a defect in the healing process at the center of the scar, resulting in a hole in the inner lips. This is why the lineer technique was first implemented. With the liner technique, the dark areas of the inner lips will be eradicated, but the harmony of the clitoral glans, phrenilum, and clitoral shaft will be poor, and some women may complain of a hanging clitoral shaft that resembles a pipi. I am pleased to report that with composite reduction labiaplasty, regardless of the curvature of your inner lips, you will achieve the same result as advertised on the internet. Very few side effects or complications are observed.

Gary J. Alter, MD · Answer

One of the two most common labiaplasty techniques is the central wedge technique, which I invented in 1995 and published in the plastic surgery textbooks. It is also known as the "V" or wedge technique. Gynecologists and most plastic surgeons perform a labioplasty very differently. They essentially trim the labia minora (inner vaginal lips) and leave a long suture line instead of the normal labial edge. Their technique is the same whether a scalpel or a laser is used. This often causes asymmetry, scallops, and a wide suture line. In contrast, the central wedge removes triangles of tissue and bring the normal edges together. Thus, the normal labial edges, normal color, and normal anatomy are preserved, but the darkest labial tissue is usually removed. There is no technique which is perfect as there are positives and benefits of each. The central wedge usually removes the darkest area whereas the trim may remove the dark color but commonly causes other abnormalities which are even more negative. No matter the technique, an inexperienced or unskilled surgeon can lead to a high rate of complications, chronic scar discomfort, labial deformities, and further surgery. About 40% of my labia cases are reconstructions of other surgeons' labiaplasties.

Gary J. Alter, M.D.
Beverly Hills, CA - Manhattan, NY -

Gary J. Alter, M.D.
Beverly Hills, CA - Manhattan, NY -

Oscar A. Aguirre, MD, FPMRS · Answer

Hello Kparm,

Every patient needs her own personalized labiaplasty to achieve a natural, aesthetically pleasing appearance. Most women I've operated on prefer a lighter color to their labial edge which is why a wedge reduction alone would not be sufficient.  Many also have have redeundant lateral prepuce which requires reduction. Addressing both concerns can be achieved via a combination of procedures. 
Go to the link below to see hundreds of before and after photos where you will find many examples that may be similar to you. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. Women from all over the world travel to my Center for their Intimate Makeover.
Best of luck,

Zoran Potparic, MD · Answer

Depending of the shape of labia and the goals of surgery two basic excision techniques can occasionally be combined. This should be done in specific situations to avoid compromise blood supply and loss of tissue with bad scars. In person consultation with a surgeon familiar with both techniques would give you opportunity to discuss this issue further.

Erika Sato, MD, FACS · Answer

Yes the two techniques can be combined as all vaginas look different and need different techniques. BUT not in the way you are describing. This would lead to a lot of scar and risk of making things too small. If a wedge is done properly the labia minora are small and no further tissue should be excised even if the tissue is dark. They are usually combined when one method is need anteriorly and the other posteriorly etc.

Can a labiaplasty be done using a combination of both the wedge and trim technique?

Answers (13)

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