Labiaplasty wedge split - do I have enough skin to improve the results? (Photos)

Question

I had a wedge labiaplasty 6 months ago, and experienced a complete split on my left labia 2 weeks post surgery. I had a revision on that side recently and it split again 3 days later. Asking for doctor opinions on whether I have enough skin left over to make this nice looking and if the trim method would be best? As I never want another wedge attempt again.

Mark N. Scheinberg, MD · Answer

Thank you for your questionYour labia can be repaired but how depends on the anatomy which is not demonstrated on your photos. There are actually two pair of inner labia: a lower pair that inserts into the clitoral glans which is not shown and an upper pair called prepuce that forms the hood(just the skin over the clitoral glans or clitoris) that can enter and overwhelm the lower pair. The prepuce appears to have NOT been addressed and if reduces correctly , which should be done bilaterally , can reduce the defect from the split caused by the wedge technique. The rest may be treated by simple repair or trim to be determined by viewing the frenulum (the connection of the lower pair that attaches to the clitoral glans).You really need to do your homework this time and find an experienced, well trained cosmetic gynecologist. Look at their reviews and before and after photos. The video below may be of help

Gary J. Alter, MD · Answer

As the inventor and innovator of the wedge technique in 1994, I reconstruct many women who have had labia reductions by other surgeons, both wedge and trimming techniques. Your present complication is probably a result of the specifics of the wedge technique used by your surgeon. The reconstruction technique depends on the deformity. However, no attempt to revise your labia should be done until you are at least five months after your past procedure as your appearance will improve, and the swelling will be less. You need to control your anxiety and wait. The reconstruction is more difficult than a primary labiaplasty and should be done by a plastic surgeon with extensive experience in labia reconstruction. I published the first and most extensive paper on labia reconstruction in the prestigious journal "Plastic and Reconstructive Surgery" about ten years ago. Approximately 40% of the surgeries I perform are revisions of other surgeons’ labiaplasties. I have reconstructed many women like you who have had failed wedge labiaplasties by other doctors. Your deformity can be fixed by a very skilled wedge labiaplasty surgeon. You have enough skin as your complication almost certainly technical. I have done thousands of wedge labiaplasties, and your complication is rare in very experienced hands. You only get one good chance to reconstruct you, so be patient and ask a lot of questions

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NYC

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NYC

George Marosan, MD · Answer

Thank you for your question and photos. You do have enough tissues to repair the separation, based on this limited view photo. I would wait 1 year before doing surgery again. It is hard to say, but the dehiscence could be due to too much tissue removal and closing it under tension or inappropriately. I use a two layered closure with interrupted and running dissolvable sutures. A trim resection at this stage, will leave you with no labia on the left side. See a board certified plastic surgeon or gynecologist who are experts in all aspects of female genital cosmetic surgery for an in person consultation. Remember, not all are well versed in this type of surgery. Good luck.

Adam J. Oppenheimer, MD, FACS · Answer

This is the reason why I no longer perform the wedge Labiaplasty. All of my Labiaplasty Surgery is done with the Edge approach and a hood reduction. Wedge Labiaplasty procedures tend to split. There is tension on the closure and friction leads to separation in many cases. The edge labiaplasty issuperior and the outcomes are better. from the photos above, there is sufficient tissue to perform a proper revision to get an excellent outcome.

Zoran Potparic, MD · Answer

It would be in your best interest to let it heal properly and do nothing for about a year. Deformity will become less visible and tissues will recover to the point that healing is more predictable due to natural tissue elasticity, vascularity, etc..  good luck.

Adam Ostrzenski, MD, PhD · Answer

A: Your surgeon performed an anterior wedge resection of the labia minora and included the partial excision of the right clitoral frenulum. According to the photographs, tissue ischemia (reduction in blood supply) has been observed. An interval of approximately 12 months, or potentially longer, is recommended to allow for the development of collateral blood circulation prior to undertaking corrective surgery. During this period, there exists a possibility that the complication involving your labial split may resolve spontaneously through secondary intention healing. Contrary to the guidance provided by numerous consultants here, corrective surgery is neither uncomplicated nor straightforward, and the success of the outcomes cannot be assured. Furthermore, a trimming procedure may introduce additional risks, including posterior labial nerve neuropathy and pudendal nerve reflective neuralgia, both of which are conditions that present diagnostic and therapeutic challenges. In this context, trimming would not be deemed the most suitable approach, as wedge resection involves excising wedge-shaped tissue from the free edge to the base of the labia minora, thereby partially removing both the superior and inferior neurovascular bundles, as well as the anastomosis between them.

In such a case, corrective surgery is highly demanding from a surgical skill point of view and requires a thorough understanding of the neurovascular bundle's anatomical distribution, which I studied and published the findings on it (Ostrzenski A. Preventing Severe Complications in Labium Minus by Preserving the Neurovascular Bundle: Anatomy and New Surgical Technique). Aesthetic Plast Surg. 2025 Dec 15. doi: 10.1007/s00266-025-05301-0. Epub ahead of print. PMID: 41398504).

I wish to inform you that I am not using RealSelf to promote my practice in cosmetic, plastic, and corrective surgery, and that I am offering this service free of charge to help women and assist surgeons.

I like to take this opportunity to congratulate one of the advisors in this case, who agrees with my clinical research findings and has stopped performing labia minora wedge resection (please access the full text via PubMed and use Ostrzenski A to find my page on this portal).

Kind regards,
Adam Ostrzenski, M.D., Ph. D.
Professor of Gynecology, FIU, USA

Labiaplasty wedge split - do I have enough skin to improve the results? (Photos)

Answers (6)

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