Labiaplasty - What technique if only One Side needs "work"?

I didn't use to feel that way, but either technique in the right hands will work.you can do an edge removal and a separate lateral hood removal and stay very very far away from the clitoris.If you want to keep the normal labial edge and contour, I would use the wedge approach and one continuous incision. you can watch that exact surgery above in a lady I helped with the exact same problem on the same side.

Please keep in mind that an in person consultation with physical exam is first necessary before any final surgery recommendations are made. Nonetheless your story and concerns are in good company with almost ever other patient that undergoes labiaplasty and/or clitoral hood reduction (aka hoodectomy). Based upon your photos, your anatomy is very typical of someone who seriously considers having these procedures and experiences a major boost in (sexual) self-confidence and pleasure thereafter. Labiaplasty, which most commonly involves surgical reduction of the labia minora (inner/thinner lips) but not infrequently trimming or tucking of the labia majora (outer/thicker lips), has become a relatively common procedure over the last ten and even more so last five years. Most commonly it is done under light sedation (aka twighlight sleep) with local anesthesia, in which case the patient should feel no pain during the operation. 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, just like yourself, 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. Finally, 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.  One unique potential complication after Wedge Method is that the clitoris gets pulled downward which sometimes is annoying and sensory changing to women.  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. Typical (all inclusive) fee at my office/surgery center is $4500. Although there is no guarantee, women frequently do seek clitoral hood reduction (Hoodectomy) to improve exposure of the clitoris and hence better stimulation during sexual activity. By removing some of the excess &/or redundant skin concealing the clitoris, it becomes more readily exposed to sexual stimulation and hence a heightened sexual experience/orgasm is possible. Sometimes I recommend adding hoodectomy to labiaplasty to better harmonize the aesthetic outcome. Again, the key is seek consultation with a board certified plastic surgeon or gynecologist who performs this procedure regularly (>2-3 x/month) so that just the right amount of tissue is removed and just the right amount remains such that the clitoris is not constantly exposed and rubbing on clothing, etc... Typical fee for a hoodectomy is ~$3000 but reduced to about half that price if done along with a labiaplasty. Now for recovery, because the labia tissue is so robust with blood supply it has an amazing ability to heal relatively quickly. Most patients are sore for 4-5 days before things start to get a lot better from there. Some patients can resume work before this time depending upon their occupation. No exercise for two weeks, no baths/jacuzzi or swimming for 3 weeks, and no sexual activity for typically 4 weeks. My patients are given an oral pain medication such as Vicodin or Percocet but icing the area for the first 48 hours and applying some custom made take-home topical local anesthetic cream seems to work the best. Glad to help.

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. 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.

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!

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.  If performed by a labiaplasty surgeon you should not suffer any sensory loss from the tissues once fully healed.  Hope this helps.

after your surgeon has thoroughly explained the pros and cons of each technique as they result in very different outcomes but both will 'reduce' the amount of protruding labia that is present.  So schedule consultations and get a couple to be safe and choose the right surgeon for you and you should be able to achieve improved (not perfect) symmetry.  And as said before, I don't think you need any hood work done.

Yes! It may be "...your time")  I laud you for doing the kind of research BEFORE you just have your "...general Ob/Gyn just "...cut it off." If you will check the weblink below, you will get an idea of the work I do in Davis, CA, near Sacramento. The bulk of my patients are from the Bay area. I have performed > 650 LPs, many of these one-sided to match the other...Now, for you personally. To give a personal recommendation,I  should examine you to see what exactly you wish, your personal exact anatomy, and then design a procedure fit to match the 2 sides, and diminish the left-sided dominant clitoral hood. I cannot be sure, without your labia in my fingers, which procedure would suit YOU best ( I am facile with either, and do ~ 50-50, depending on your exact anatomy & your goals. As it takes the same time, same equipment, and costs the same (our "out-the-door: NO additional costs) fee for unilateral LP including facility & local anesthesia is $3500). I have never (>650 cases...) had a patient of mine complain of sensation loss, as I am very careful to stay away from the clitoral glans if I operate on the frenular fold, and to not take too much off, violating Harts'line and the mucosa, or getting too close to the inter-labial fold if a curvilinear resection. (Also look under the Blogs for a recent Blog comparing Linear with V-Wedge...)Please call our office & speak with "Nicole" for further info...Best wishes,Michael P Goodman, MDDavis, CA,USA

Thank you for sharing.   Based on the pics I would recommend either a trim or wedge.  The technique is only as good as the surgeon, so please make your selection carefully.  I would also recommend a small resection lateral to the clitoral hood to optimize and achieve the best overall look.

For unilateral labiaplasty, either the wedge (Alter) or edge trim technique can be considered.  The wedge technique removes tissue from the central third of the labia and can also shorten an excessively long labia.  The edge trim technique is better suited for labia which hang excessively throughout their entire length.  From your photos and concern about sensation around the clitoris/clitoral hood, you may be a better candidate for the wedge resection.  Seek out a board certified plastic surgeon who has extensive experience with both techniques.  Best wishes,  Dr. Lepore.

I would recommend a posterior wedge technique which will give you the best chance of seeing symmetry between the two sides. Click on link for further information.