Susceptible to scarring: what is the best type of incisions for labiaplasties?

Thank you for your question Natural edge labia reduction will hide any potential scarring as the suture lines are in the creases out of view. In general I have found scarring in this area usually very minimal even with patients who keloid.See the video below

This type of procedure is always individualized and requires a consultation in advance. Post-op scarring in Asian patients is called Hypertrophy and often can be avoided or treated if it occurs.

Hello, scar formation depends entirely on genetic predisposition. and the type of incision to be made has nothing to do with it. However, from my own experience, I see that wound healing is better in surgical transfer labia plasty results.

The beauty of Labiaplasty surgery is that there is almost no visible scarring. That means that no one will know if you had a labiaplasty performed. I perform the edge technique with a hood reduction. This leaves a very smooth edge where the pigment of the darker and rough labia is removed and replaced with smooth lighter colored tissue. Scarring is quite invisible. Please visit my photo gallery for examples. With the wedge labiaplasty, on the other hand, sometimes there is a notch or a step off or even a color transition and so I never perform the wedge labiaplasty.

Best to find a doctor with great before and after photos and videos of healed results that you like, and this will ensure that you have a virtually scarless labiaplasty. The worst scarring happens when doctors use a baseball stitch or a running over and over stitch to close the labia. This technique leaves multiple firm areas notching grooving and a painful scar. You can find many examples of this, sadly, here on Realself from patient uploads.

Hello, thank you for your question. There is a certain genetic predisposition to how we heal wounds and surgical incisions. Amongst those genetic predisposition, it is true about how asians scar and that they are most susceptible to hypertrophic scars. However with labiaplasty in asian women, the scars have great outcomes. This is base on the location, under low tension and kept moist. Of course it is best to speak to your plastic surgeon to see what their experience has been like with previously asian patients that have undergone a labiaplasty.

Hello and thank you for your question.
Both Trim and Wedge are reliable techniques used to perform Labiaplasty in the experienced hands.
Trim Labiaplasty is more commonly performed than Wedge Labiaplasty and has slightly lower risk of wound healing issue because the blood supply disruption is less than in Trim Labiaplasty. But generally speaking, depending on patient's anatomy, either technique can be used successfully to achieve cosmetically pleasing results.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Labiaplasty to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.
Best wishes and good luck.
Best regards,
Dr. Irena KaranetzFellowship-TrainedBoard Certified Plastic Surgeon

Hi generous,

I think that the type of scarring that one could possibly have from a labiaplasty is more dependent
on the skill of the surgeon rather than the type of incision. I have done many labiaplasties on Asian
women and I have not found that they scar any differently than Caucasians or other ethnic populations.
I think that the major reason is that the labial tissue has such a great blood supply that it allows for a better result than if one is excising tissue that is more epithelial in nature. Endothelial tissue is like the tissue in your mouth and like labial tissue. Epithelial tissue is like on the the labia Majora.
I agree with you that Asian skin can have a propensity for raised scars, but not on the labia minora ,
again due to the great blood supply there.
Again, surgeon technique and skill also play a major part in how you heal.

Hope this helps a bit.

Best,

Dr. Christine Rodgers

A labiaplasty must be performed by a surgeon with experience. One of the two most common 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 can lead to scallops and irregularities. 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. The scars are usually minimal and are located inside and outside of each labium. If you have extra tissue on your clitoral hood, it can be reduced it at the same time. 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 the female genital cases I perform are revisions of labiaplasties and clitoral hoods botched by other doctors.

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NY

Labiaplasty, which most commonly involves surgical reduction of the labia minora (inner/thinner lips) but not infrequently trimming or tucking of the clitoral hood (aka “hoodectomy “) or labia majora (outer/thicker lips), has become a relatively common procedure over the last 15+ years. Most commonly it is done under light sedation (aka twilight sleep) with local anesthesia, in which case the patient should feel no pain during the operation and experience a more speedy recovery. 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. Most women prefer to have as much of the darker pigmented edges removed as possible. 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 - typically ~10 mm or so of the dry part of the labia. I have found the scar along the edge of the labia after "Trim Method" to be much more imperceptible compared to the scar running perpendicular through the entire labia minora after "Wedge Method". Thus to achieve these four most important elements, I have found that the Trim Method satisfies best and most consistently. Additionally, one unique potential complication after Wedge Method is that the clitoris gets pulled downward which sometimes is annoying and sensory changing to women. Another much more common complication with Wedge method is wound separation and splitting of the suture line leaving dents or holes in the middle of the labia minora and/or complete separation between the top and bottom halves. Because the type of skin of the labia is unique compared to the skin on the rest of the body, patients of darker pigment, including Asians, fortunately seem to have relatively few scar thickening issues in this area. Thus 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 is this type of result you will want to live with for the rest of your life.

Thank you for sharing your question. Due to the thin nature of the tissues, incisions for a labiaplasty, whether trim or wedge, tend to heal extremely well. Hope this helps.