Abstract
A variety of reduction labiaplasty techniques have been introduced to date, but no
single technique will offer the optimal solution for every patient. Rather, the technique
should be chosen based on anatomical, configurational, and technical considerations,
as well as on patients' personal preferences regarded maintenance of the labial rim,
maintenance of labial sensitivity, and prevention of iatrogenic thickening of the
labium. We reviewed, defined, and assessed labial configurational variety, neurovascular
supply, reduction techniques, and patient's preferences as the considerations relevant
to the choice of labiaplasty technique. Based on this review, an algorithm was constructed
that leads to a choice of reduction technique through five decisions to be made regarding
(1) resection or (partial) retention of the labial free rim, (2) the measure of required
labial width reduction, (3) labial vascular status, (4) prevention of iatrogenic labial
thickening, and (5) preservation of labial sensibility. The choice of techniques includes
edge trimming, central spindle form de-epithelialization or full-thickness resection,
and three modifications of the wedge resection or de-epithelialization technique.
These three modifications comprised a modified anterior resection or de-epithelialization
combined with posterior flap transposition, a custom flask resection or de-epithelialization,
and a modified posterior wedge resection or de-epithelialization combined with anterior
flap transposition. Use of the five decisional steps and the inclusion of modifications
of all three conventional reduction techniques offer an improved algorithm for the
choice of labioplasty technique.
Keywords
algorithm - female - vulva - cosmetic surgery - review
