Trim vs Wedge - can I request the wedge technique?

It depends on the skill set of your surgeon. I ask my patients what the look is that they are going for. Some say a natural look, some say a Barbie look, some say I want no dark tissue and some say I want it smooth! All of this determines the technique and often I find myself using a combination or modification in techniques to achieve the result my patient wishes for. As others have stated, look at your surgeons work and see if the results he’s presenting is what you like. Wedge done in an unskilled hand can go very wrong. Too much removed and tension created can cause a separation. And now you have PAC Man labia….so make sure you’re comfortable with the surgeon you pick.

You will need a consultation with a cosmetic gynecologist to determine the best technique for you. Most plastic surgeons are not trained in wedge resection and will stir you towards trim method because it is easier and less complicated procedure. If your plastic surgeon is not comfortable with the wedge resection, I would not push for a technique he is not good at. You can always seek a second opinion before you make the final decision.

Hello SyrNurse23,
You shouldn't focus your energy on the type of labiaplasty but rather on the expertise and experience of your surgeon. Look at their B&A results and read their reviews. Will your surgeon be accessible postoperatively to answer your questions, follow your progress, and be willing to revise your procedure to attain your desired outcome.
Go to the link below to see hundreds of before and after photos where you will find many examples that are similar to you. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. Women from all over the world travel to my Center for their Intimate Makeover.
Best of luck,

The labiaplasty technique selected should be based on your unique anatomy and surgical goals. If you do not feel comfortable with the technique proposed by your surgeon then I recommend getting a second opinion.

Thank you for your question. The most common labiaplasty techniques are the edge trim and wedge resection. There are advantages and disadvantages to each approach. It has never been shown that one approach is "better" than the others. The edge excision removes a portion of the labia minora edge. The wedge technique removes a wedge of tissue from the most protuberant portion of the labia minora. There is significant variability in genital anatomy and each patient has different concerns and goals. All of this is discussed in detail at the consultation and taken into account when creating the surgical plan. In some patients the edge trim may best address their concerns and in others the wedge is preferred. However, I do tend to favor the wedge in many patients as the scars are short and well concealed, and the natural labial edge is preserved. Despite the approach, the surgical plan should be designed to address the patient's concerns and result in aesthetic proportion and balance of the vulvar structures.I think you should discuss your concerns with your surgeon. It may help for you to understand why they chose that approach for you. I find that reviewing before and after labiaplasty photos with your surgeon to show what your aesthetic preference is can be very helpful.

It’s great that you’re learning about the different labiaplasty techniques for the labia minora. Understanding your options is a key first step. Just as important is knowing how your cosmetic surgeon chooses the right approach for your specific goals. Labiaplasty isn’t one size fits all, and a thoughtful decision-making process really matters.

Be sure to consult a surgeon who has extensive labiaplasty experience and truly takes the time to hear your concerns. Take a close look at their labiaplasty before and after photos, too. This will give you a feel for their aesthetic style and results.

Remember, labiaplasty is as much about artistry as it is about precision. Choosing the right technique for your labiaplasty can make all the difference in how confident and comfortable you feel with your outcome.

And just look at the results of the doctor. Choosing a surgeon is like commissioning a piece of artwork. Arguably the most important and finest piece of artwork you will ever behold: yourself and your own beauty. So that makes this easy. Look at the work. Does it look pretty to you? Would you want your own body to look like that? Once you decide that the doctor has an excellent understanding of universal beauty (and there is such a thing, though I’m not sure exactly why god chose certain elements of beauty—despite some evolutionary-based and reproductive fitness clues) then the pressure is off you and on THEM. They have to do the worrying about how they are going to make you beautiful happy and safe.

That’s a great and very thoughtful question.

While both the trim (linear) and wedge techniques are commonly used for labiaplasty, the key to a beautiful, natural result isn’t just the technique — it’s the surgeon’s experience and aesthetic approach.

In our practice, we most often perform refined linear resections (also known as trim techniques), but with meticulous contouring and attention to natural anatomy. The goal is never to create a “Barbie” look, but rather a balanced, soft, and natural appearance that respects your unique features. Our patients consistently report high satisfaction and confidence with their results.

That said, the wedge technique can be a great option in certain cases, especially where pigmentation and contour allow. However, it’s not always ideal for every anatomy or desired outcome.

Since labiaplasty is a very specialized procedure, we highly recommend consulting with a cosmetic gynecologist—we focus specifically on this area, understand both function and aesthetics, and can guide you toward the technique that will give you the best, most natural result for your body.

If you’d like to schedule a consultation, we’d be happy to walk you through everything and create a plan that aligns with your goals and comfort. You're asking all the right questions — and we’re here to help you feel confident in your decision!

I invented the central wedge labiaplasty surgery in 1995 and only reported the seminal article in the plastic surgery literature in 2007. It is also known as the "V" or wedge technique. Gynecologists and most plastic surgeons perform a labiaplasty 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, I remove 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, I can reduce it at the same time. My technique is performed with magnification to ensure an accurate approximation of the normal labial edges, whereas the other technique takes 15-30 minutes and results in a linear scar as the labial edge. That scar can cause chronic discomfort and aesthetic disfigurement.

The surgery is relatively minor and is not very uncomfortable. It is performed as an outpatient in a fully accredited surgical center. General anesthesia is usually used, but sedation with local anesthesia is possible.

Above all, choose an experienced surgeon as over half of my surgeries are for reconstructing women, who have been botched by other doctors.

Sincerely,

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NY

Hello and thank you for your question. An experienced surgeon performing vaginal rejuvenation surgery should be comfortable with both techniques and should consistently be able to deliver natural results with both. It is certainly reasonable and, in fact, strongly encouraged for you to discuss your preferences. There may be a reason that your surgeon has preference for one technique over the other. Good luck on your journey!