Hello doctors I consider having prepuce fold reduction and labiaplasty (posterior or inferior wedge). I read that there is combined thechnique of de-epithelization and wedge. Is de-epithelization a common method? Is it safer in terms of nerve damage (both lost of sensation and pain)? Can it be perform on the prepuce fold? Thanks a lot
July 16, 2023
Answer: Labiaplasty 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. It has a better blood supply than a posterior or inferior wedge. With this technique, I do de-epithialize the wedge, which helps the closure to be more secure and prevents it from falling apart. It does not affect the nerves at all. 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. 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
Helpful
July 16, 2023
Answer: Labiaplasty 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. It has a better blood supply than a posterior or inferior wedge. With this technique, I do de-epithialize the wedge, which helps the closure to be more secure and prevents it from falling apart. It does not affect the nerves at all. 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. 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
Helpful
July 14, 2023
Answer: Labiaplasty techniques Your anatomy, your outcome ideals, and your surgeon's experience in specific techniques will dictate the best technique for you personally. Both curvilinear + separate elliptical hood excision; "straight-Shot labiaplasty; central V-Y wedge incorporating redundant hood, and posterior wedge incorporating de-epithelialization are viable techniques. Drs. Rafal Kuzlik and Dawid Serafin in Poland are the 2 experts I know in Europe who specialize in the technique you mention. They are both masters at this technique and would serve you well for a "natural-appearing" result and decompression of large prepucial folds. . RealSelf's Web reference below will give you additional information. Best wishes, Michael P Goodman, MD, FACOG, IF, AAACS Sacramento, CA, USA
Helpful
July 14, 2023
Answer: Labiaplasty techniques Your anatomy, your outcome ideals, and your surgeon's experience in specific techniques will dictate the best technique for you personally. Both curvilinear + separate elliptical hood excision; "straight-Shot labiaplasty; central V-Y wedge incorporating redundant hood, and posterior wedge incorporating de-epithelialization are viable techniques. Drs. Rafal Kuzlik and Dawid Serafin in Poland are the 2 experts I know in Europe who specialize in the technique you mention. They are both masters at this technique and would serve you well for a "natural-appearing" result and decompression of large prepucial folds. . RealSelf's Web reference below will give you additional information. Best wishes, Michael P Goodman, MD, FACOG, IF, AAACS Sacramento, CA, USA
Helpful