Labiaplasty and hoodectomy for one side?

Question

Please see the attached photos. What method would you recommend for someone who only wants one side "done", and the other left alone? I also was wondering what level of hooded clitoris I have (Partially, full)? Do you think I would benefit from a hoodectomy?

Gary J. Alter, MD · Answer

Your left labium minora is enlarged compared to the right.  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. I can make you very symmetrical with a central wedge labiaplasty, while also removing the excess skin on the left side of your clitoral hood.  Symmetry is easier to achieve with the wedge, because it will keep your normal labial edge and allow it to match the right.  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

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

If you dislike the hood, then you need to do both sides because they look equally baggy. However, the excess is mild and hood contouring is optional. Hood levels are meaningless nomenclature unless you're doing a research study. A linear sculpted labiaplasty of the left side would give superior results and greater symmetry than all other approaches if you limit the work to one side only. A wedge would pull the left side of the hood downward and leave you with a crooked hood. Don't concern yourself with the loss of sensation with an expertly performed procedure; it doesn't happen with trimming - it happens with any technique done by a non-expert. Also, don't use the term unhooding - that's a procedure to expose the head of the clitoris and is only done to treat disease usually cancer and is certainly not what you want. You want hood contouring, not unhooding.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Based on your photographs, you do have some moderate asymmetry which I think could be corrected or improved with surgery. In my hands, I think a small wedge on the larger side with a possible extension vertically to address hood excess would produce excellent results.

Hope this helps!

Hope this helps!

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Both a trim or wedge resection labiaplasty can be performed in order to achieve improved symmetry between your right and left labia minora and clitoral hood reduction.  Based on appearance I would favor a small wedge resection with an extension to address the left clitoral hood.  As far as your clitoral hooding you have a fully covered clitoris but only an in-person examination can help determine if a reduction in length is needed.  Hope this helps.

John R. Miklos, MD, FPMRS, FACS · Answer

It appears you have great uniformity throughout the length of the labia and you have lateral redundant prepuce on your left side. I personally would recommend a linear contouring of the left labia and a left sided lateral prepuce reduction ( this is not a hoodectomy). The key to this surgery is choosing a surgeon who has experience, expertise and one who can achieve great results. Please choose a surgeon wisely and do NOT limit yourself to surgeons due to convenience or costs. Do you due diligence

John R Miklos MD

Atlanta ~Beverly Hills ~ Dubai

John R Miklos MD

Atlanta ~Beverly Hills ~ Dubai

Curtis Wong, MD · Answer

you can certainly have a one sided labiaplasty procedure and your surgeon should be able to help you choose what would work best for you, depending on what outcome you want and what risks you're willing to accept.  As for your hood, its symmetrical and doesn't appear excessive and unless you think its excessive, you shouldn't do anything to it.  And I would disagree that you 'need' to have both sides doe as your right side is very minimal as it is and its easier to match it rather than attempting to achieve symmetry when doing both at the same time.

Michael P. Goodman, MD, FACOG · Answer

Sure: It's "...your time"! I have performed> 650 labiaplasties, most with hood reductions, and many "...one-sided." I perform bot V-wedge modifications & linear/trim (~ 50-50) and am always prepared to perform either, depending on the exact anatomy and wishes of my patient. When "matching an enlarged side to a smaller side, the method I choose depends on the anatomy and "curvature" of the smaller side, whether I am reducing the size of the hood, as well as the realities of my patient's recovery protocol and other experience-related issues. "...On paper" you should do quite well with a curvilinear reduction, bu tI wouldn't want to say until your labia "...were in my fingers..." so to speak.

The most impotent thing, wherever you go, is to be operated on a surgeon with much experience, and one who is savvy BOTH with Wedge and Linear reductions, so as to choose the technique best for your anatomy & your needs.

Best wishes,

Michael P Goodman, MD

Davis, CA (near Sacramento), USA

The most impotent thing, wherever you go, is to be operated on a surgeon with much experience, and one  who is savvy BOTH with Wedge and Linear reductions, so as to choose the technique best for your anatomy & your needs.

Best wishes,

Michael P Goodman, MD

Davis, CA (near Sacramento), USA

Robert L. True, MD, FACOG, FACS (in memoriam) · Answer

From your photos, the best procedure to give you the best symmetry would be a modified posterior wedge resection.

Labiaplasty and hoodectomy for one side?

Answers (8)

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