How common is wedge method splitting? Which is better, trim or wedge?

I don't know which one I will have the best results with. The first doctor insisted I do the wedge method. Haven't yet been to the other two consultations but I have been doing research and am a bit concerned as far as the techniques go or which doctor to choose for best results. Is the trim/wedge my preference, or the doctors suggestion for best results?

Doctor Answers 19

Wound separation following wedge resection labiaplasty is common

If you're interested in the best aesthetic outcome you should be more concerned about finding the right surgeon rather than the technique he/she will use. You should look for an experienced and competent cosmetic vaginal surgeon with proven results that listens to what bothers you and what you want. Be sure to look at their photo gallery for examples of their work. Be sure you are comfortable with the surgeon and staff and that you get all your questions answered. See link below for additional information in choosing the right surgeon. You should be prepared to travel. Women travel to Denver every week to have their in-office Intimate Makeover® at my Center. 

Complications are more a factor of the surgeon's experience, but some techniques are more prone to certain complications. Wedge resection Labiaplasty is an example of a technique which is prone to wound separation because of the tension that the tissues are placed under. Curvilinear or trim resection in inexperienced hands is associated with excess removal of labia. I perform labia reductions in the office under local anesthesia. Every woman is shaped differently and requires her own unique cosmetic correction.  What is often overlooked by most surgeons is the prepuce, or clitoral hood, which may require reduction and even lifting to achieve the optimal youthful appearance and enhanced sensation for ultimate pleasure.

I recommend you keep your appointments for the other consultations so you can better decide.

Best of luck,

Oscar A. Aguirre, MD

Pelvic Surgery & Intimate Aesthetics®

The Center for Female Pelvic Medicine and Cosmetic Surgery®

Denver Urogynecologist
5.0 out of 5 stars 34 reviews

How common is wedge method splitting? Which is better, trim or wedge?

Although I cannot evaluate your photos and make recommendations, I would like to offer you some education on labiaplasty surgery.  I have performed hundreds of these procedures and must say that it is not a "one size fits all" surgery.  As an experienced cosmetic-plastic gynecologist, I have lectured on the Pros and Cons of Labiaplasty in which I evaluated the different surgical techniques.  Of the eleven published surgical procedures (last time I checked it was 11) in our medical journals I perform four types.  An experienced surgeon knows how to perform more than one type of labiaplasty because different patients have different desires and no two labias are alike! In many cases I combine techniques in order to provide my patients with the best possible outcome, a result they are very happy with and a result I am proud of.  There are several factors in choosing the best technique for 'your labiaplasty' including such things as the thickness of the labial tissues, the skin color and length desired, any noted asymmetries, the relation of the labia to the clitoral hood, the risks for breakdown, etc.  Yes, the wedge resection does have a greater risk for breakdown or separation, but if you and your surgeon decide that is the best method to meet your needs and concerns, be comfortable with your decision. 

These are not simple procedures to perform 'well' and the best advice I can give you is to have your surgery performed by a surgeon with experience who can show you many before and after photos of their work, NOT another surgeons.  Consult with several surgeons and be comfortable with your decision.  I hope this was helpful and best of luck with your decision.

Dr. John Serrao
Cosmetic-Plastic Gynecologist 

How often does wedge labiaplasty split?

There are different reasons why a wedge splits. It will be more likely to separate if the surgeon is inexperienced in the technique; if the patient has been exposed to nicotine or other substance that squeezes blood vessels, like cocaine; if the patient doesn't follow postoperative instructions; if the area is subjected to trauma. Most importantly is what is the incidence of a wedge splitting in your selected surgeon's patients? If you choose an experienced surgeon who is familiar with the blood supply of the labia minora, your risk of splitting should be low. First choose a good surgeon, then choose the method.

For more information, click on the link below.

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 30 reviews

Which is better, trim or wedge?

Thank you for your question.  The most important thing is choosing a qualified surgeon.  I do both techniques.  In most cases, either technique can give you a good result.  Just make sure you discuss with your surgeon what your goals are and they should be able to advise you on which method to go with.

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.4 out of 5 stars 39 reviews

Wedge or trim labiaplasty?

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. 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 incidence of splitting with a wedge is very dependent on the surgeon. I personally have not had a major split in my last 1500 wedge labiaplasties. However, this type of success cannot be assured with all surgeons. A minor split that may need a more recision occurs in about 1-3 % of my patients.  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.

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

Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 21 reviews

How common is wedge method splitting? Which is better, trim or wedge?

Thank you for sharing your question.  In most cases the decision on which labiaplasty technique to use depends on your goal results.  Each can be performed on the same patient to lead to nice results so it is important that you voice your specific appearance desires.  I would recommend spending much of your time evaluating the surgeon and his/her work than the specific technique employed.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

Both techniques work well

the fact that there are 2 popular techniques means that they both work well. your surgeon may have a preference based on his/her experience but you should have a good result with either technique.

david berman md

David E. Berman, MD
Sterling Plastic Surgeon
5.0 out of 5 stars 109 reviews

Methods for labiaplasty

Your labiaplasty decision making should be made on the ultimate look you want to achieve not the technique.

Having a discussion with an experienced labiaplasty surgeon to discuss what your goals are important. I did the wedge technique for years and now do more of the trim technique for many reasons.  I find that many women do not like the darkened edges seen with the wedge method, and I can shape the labia better with the trim method.  It all depends on your goals and let the surgeon guide you on what options are available, so you can decide what is best for you. 

Cheri Ong, MD, FACS
Scottsdale Plastic Surgeon
5.0 out of 5 stars 11 reviews

Labiaplasty technique

Thanks for sharing your question. Both techniques that you mentioned are safe with usually minimal complication profile. Theoretically, wedge resection is more prone to wound dehiscence (splitting). There is lack of clinical studies comparing these techniques head to head. Please talk to your surgeon about his personal experience.

Armen Kirakosyan, MD, FACOG, FACS
East Aurora Urogynecologist
5.0 out of 5 stars 1 review

Wedge or trim?

It is the surgeon that is more important than the technique. The most critical decision to be made in achieving the best plastic surgical result is picking the most experienced with labiaplasty and most talented, that is the best, plastic or gynecologic surgeon possible. Too often, patients choose a physician based on a catchy ad, the brand name of a technique, the basis of one or two before and after photos, or their web site’s search engine ranking. These criteria will not find the most experienced and talented plastic surgeon. See the below link on suggestions on finding the most experienced plastic surgeon or gynecologist for your labiaplasty.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.