We have discussed reduction labiaplasty surgery here before. Some women consider this small but delicate operation due to the size of their Labia minorae. Others do it for aesthetic concerns. A woman with large labia can experience pain in tighter clothing. It is all relative of course.

The key to a maximizing safety with this operation is choosing the right method and focusing on the outer structures using an experienced surgeon.

There are many ways the inner lip reduction operation can be performed, but the two most common techniques are called the “Trim” and “Wedge.”

The Trim is a simple operation in which the unwanted portion of the Labia minora is simply cut off and sutures are used to close the openings. “Simple” does not necessarily translate to “better.” The PROs of the Trim procedure include that it is easy to teach and learn and can easily be performed under local anesthesia. Amongst the CONs are the facts that pain after surgery can be severe and longstanding and it is common for “too much to be removed” leaving a pretty unnatural appearance. This is the most commonly performed version of labiaplasty surgery at present.

The Wedge operation involves the removal of a “pie shaped” piece of the labia. This tends to leave the appearance of the remaining “lip” looking untouched. This version of the operation is harder to learn and is harder to perform under just local anesthesia. The sensation of the remaining tissue is normal in the vast majority of cases if the operation is done well. Wedge patients tend to return to physical and sexual activity earlier than Trim patients.

My opinion is that a well-performed Wedge is the way to go in most cases and has a lower risk profile. There are some cases in which the anatomy lends itself better to one technique as opposed to the other, but that is where a surgeon’s experience comes into play.

Best Regards,

John Di Saia MD