Given the wealth of information available in this digital age, patients considering cosmetic surgery are more educated than ever when presenting in consultation.  Labial reduction has increased in popularity over the last several years.  Women are increasingly aware that a surgery may be performed to address concerns regarding their labia minora, whether feeling uncomfortable in tight-fitting clothing or wishing to address insecurity relating to physical appearance.  Patients commonly ask regarding the trim vs wedge labiaplasty, which are the two most common techniques of labial reduction.  What is the difference between the trim vs wedge labiaplasty and what determines the most appropriate technique for a given patient?

          Trim labiaplasty

A trim labiaplasty involves “trimming” the redundant labia minora, accomplishing exactly what the name suggests.  Excess labial length is removed along the entire length of the labia minora.  It is an effective technique for removing the darkened tissue at the leading edge of the labia.  After the hyperpigmented tissue is removed, this generally restores healthy pink tissue at the new labial edge.  The trim technique is the most common method of labiaplasty.  It is a powerful technique for changing the shape and size of the entire labia minora.  It may address excess length, asymmetry, as well as hyperpigmentation.  The main disadvantage of trim vs wedge labiaplasty is that a scar is placed along the entire length of the labia minora.  This scar is distant to the clitoris and vaginal introitus, which reduces risk of altered sensation post-operatively.  The scar is generally inconspicuous once scar maturation is achieved.  For patients also wishing to proceed with clitoral hood reduction, this surgery may be combined with trim labiaplasty through one continuous incision.

       Wedge labiaplasty

During wedge labiaplasty, a central wedge of the labia minora is removed in a V-shaped pattern.  The front and back portions of the labia minora are then stitched together.  This may be an effective technique for patients presenting with asymmetry or excess length of the central third of the labia minora.  It is less effective in reducing excess tissue at the other sites.  Wedge labiaplasty also does not remove the pigmented tissue at the leading edge of the labia minora.  Whether a trim vs wedge labiaplasty, both techniques involve resorbable (dissolving) sutures to reduce discomfort associated with stitch removal.  Occasionally a stitch or two may fall out prematurely.  If this occurs following a trim labiaplasty, any small wound opening will generally heal on its own without further surgery.  The main disadvantage of the wedge technique of labiaplasty is that a notch or full thickness wound gap may develop in this case.  A second procedure may be required to correct the notching or associated wound healing complications.  Results following wedge labiaplasty may appear more natural since the pigmented edge of labial tissue is preserved, however this tissue is the reason many women wish to proceed with labial reduction.

Studies have confirmed high satisfaction rates following labiaplasty regardless of technique employed.  During consultation, Dr. Power will carefully listen to your concerns and make recommendations regarding the most appropriate technique of labiaplasty based on your clinical presentation.  If you are interested in discussing labial reduction in the Toronto area, please contact us to schedule a consultation with female plastic surgeon Dr. Stephanie Power.

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