Labiaplasty: What Is The Trim Barbie Method?

Labiaplasty, which most commonly involves surgical reduction of the labia minora (inner/thinner 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 (thus make sure not too much is removed in the "Barbie" method which aims to achieve completely concealed labia minora). To achieve these three most important elements, I have found that the "Trim Method" satisfies best. 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.

Sculpted linear labia minora reductions (minoraplasties) can be designed to leave progessively down-sized versions of the original labial margin or to remove the entire visible labial margin. In my practice, we refer to these choices as moderate profile, low profile, and ultra-low profile labia minoraplasties. The barbie would be synonymous with the latter. Although "trim" is a term that most accurately describes awkward choppy resections most often done with scissors, it certainly does not describe these more refined methods used to achieve customized labial profiles.

Hello and Thank You for your Question!

There are so many new names for surgical techniques, that it is real tough to keep up with them. To simplify this answer, let's start by describing the two most common techniques:

1. Wedge labiaplasty in which a triangular segment of the labia minora is removed

2. Trim labiaplasty in which an outer margin of labia minora is removed**

** In general, the goal of this procedure is to reduce the overall elongation of the labia minora so that it is covered in part, or entirely, by the labia majora.

The term "Trim Barbie" is in essence a marketing term describing the Trim Labiaplasty technique.

What does this mean for you and your preferences? It means that you should be careful in describing to your surgeon what it is that specifically bothers you so that all options of surgery- appropriate to meet your expectations- can be discussed.

Hope that helps!

In good health,
Ellen Mahony, MD