Preserving the front side of the prepuce, do you think it's possible? (Photos)

Question

Hello doctors, I am on my labiaplasty and CHR research. I want to reduce the prepuce folds- not a full trimming, just a reduction. The skin on the front side of my prepuce (picture 2) is much more sensitive than the skin on the back side (picture 3), and I want to preserve this sensation. Is there a technique that enables removing the backed skin (and a little bit of the front) superficially? I tried drawing on myself the parts I think should be removed, do you think it is possible? thank you

Mark N. Scheinberg, MD · Answer

Thank you for your questionYes , the prepuce can be removed from the labia minor. To review- There are two pair of inner labia: a lower pair that inserts into the clitoris and an upper pair, called prepuce, that forms the hood, that t can enter into and even overwhelm the lower pair. a skilled surgeon can remove the excess prepuce and free up the lower pair. Don your homework and look at before and after photos to see how the surgeon handles this area. Also look at reviews.

Adam J. Oppenheimer, MD, FACS · Answer

Your drawings are the drawings for a clitoral hood reduction! I perform a hood reduction on every one of my Labiaplasty procedures. It is standard. If this area is not also reduced—as you call it, the prepuce, or as I generally say the clitoral hood— then you will have an imbalanced look with puffiness and fullness on the top part of the vulva. An experienced surgeon will understand all of the nuances of your unique anatomy and will be able to perform an expert Labiaplasty. Having performed over 600 of these procedures I would be honored to help and have patients from all over the country in the world come into Orlando, Florida For my expert care.

Michelle Jones Singer, MD · Answer

A clitoral hood reduction involving the lateral side of the prepuce can be done. An experienced cosmetic gynecologist is able to do this expertly. Be certain to consult an experience Cosmetic Gynecologist or Urogynecologist.

Christine Rodgers, MD · Answer

HI Ninny,

Thank you for your question and photos. I think that it is certainly possible to preserve the front of your 
prepuce int he hands of an experienced labiaplasty surgeon. I agree with your desire to conduct a search. Discuss this issue with several surgeons and ask how they would preserve your sensation to these areas. One can set back the prepuce with superficial skin incisions and leave the top alone.

Again, check with several surgeons in your area to discuss further.

Best Wishes,

Dr. Christine Rodgers

Burcak Tok, MD · Answer

Hello, yes this is possible. With the right technique, we can remove excess tissue from the sides of the clitoral hood. We do not touch the more sensitive areas on the front.

Gary J. Alter, MD · Answer

Your labia minora and clitoral hood can be reduced to improve the appearance. A labiaplasty with a clitoral hood reduction can reduce your hood size. However, it must be performed by a surgeon with experience. 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 labiaplasty 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. 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 rarely a sign that the woman has had surgery.

Since you have extra tissue on your clitoral hood, it can be reduced at the same time. Your clitoral hood can be reduced at the same time. The tissue of the hood that you want removed can be done while preserving the tissue that you wish.

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.​​ Approximately 40% of the female genital surgeries that I perform are reconstructions of other women's botched labiaplasties and hood reductions.

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NYC

Lori Warren, MD · Answer

Hello, thanks for your questions, we would love to help. Dr Warren is an expert in this area and has reviewed your photos, we have assisted other patients with these concerns & they were pleased with the outcomes. Please call our office at 502-425-5258 to schedule a consult to discuss your personal surgery options.

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

No two clitoral hoods are exactly the same. Clitoral hood reduction is tailored to your exact anatomy and your personal requests. Your request is reasonable and achievable in expert hands. I recommend that you seek out a virtual consultation to determine which experts feels like the right fit for you.

Oscar A. Aguirre, MD, FPMRS · Answer

Hello Ninny11,
Thanks for your excellent question and accompanying photos. You have prominent redundant lateral prepuce, bilaterally, which extend down towards the lateral aspect of each labia minora. This combination is what gives your labia so much volume and likely why you are so displeased with it. The best and only only way to reduce those folds, is to surgically excise them at the time of a labiaplasty. Your central prepuce, seen clearly in Picture 2, is perfect and would not be altered which means you should expect to see wonderful results following a clitoral hood reduction (of the lateral prepuce) and labiaplasty. I perform this combination of procedures on a weekly basis.
Go to the link below to see hundreds of before and after photos where you will find many examples that are 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,

Andrew M. Ress, MD · Answer

Goal of labiaplasty is to reduce excess skin and reshape in a way that maintains function and improves hygiene and appearance. In your case  the area that you have circled can be removed joining those 2 skin edges together while preserving the more sensitive area. Care should be taken not to rotate the sensitive area outward where would be subject to stimulation from clothing in everyday activities. Labiaplasty can be performed under local anesthetic with or without sedation and success rate in my hands is 100%.