This is a very common, but important question. In my opinion, there are multiple factors that determine the best surgical approach for labiaplasty. First, find a physician that is comfortable performing a labiaplasty using different techniques such as Linear, Curvilinear, V- Wedge and V-Y wedge. This gives you and the physician the ability to actually design the best labiaplasty based on your particular anatomy and your individual cosmetic choice. I will tell you that this is going to be a difficult find as there are very few surgeons capable of performing these two different techniques proficiently and interchangeably.
There are two major camps: the followers of the V-Wedge and the enthusiast of the linear/trim method. Unfortunately, surgeons who insist on only performing one of the two methods may not truly understand that a labiaplasty requires an elegant design process, that should be personalized for each individual. Most practitioners stick with one method or the other, either because that is the only one they have learned or are comfortable with, or that they have had a couple of bad outcomes with a particular method and ever since energetically prefer the other.
The reality is that no one method holds the sacred key. The overriding goal of labiaplasty for a given woman should, in my opinion, be the right procedure for the right woman for the right reason. Given this philosophy and the fact that each woman’s labia are different, an ideal surgeon is one who is capable of and willing to perform different techniques so they can choose the proper approach for a given patient. I have never seen two women who look exactly the same (or, for that matter, two sides on the same woman that look exactly the same.) I favor individualizing technique dependent on a woman’s individual anatomy and her choice of post-surgical appearance. I can certainly perform either a linear ( “trim” and “curvilinear”) or V-Wedge, V-Y wedge, on any patient. It is not at all rare to find that either because of anatomy, individual patient choice, or different recovery realities for different patients, one procedure choice stands out as best. The wedge is very artistic and provides a very natural appearance and does not alter the edges of the labia. If you are wanting to get rid of dark tips or have lighter skin edges, Wedge is definitely not appropriate in this scenario. However, the wedge keeps the natural color and in many instances provides a more natural appearance. Wedge can decrease the appearance of a “gaping vagina” and correct any “sag” that might be present. In comparison, Trim/ Linear we are able to remove more tissue as well as darkened tips of the labia allowing for uniformity of color throughout the labia. Linear also works well for corrugated edges of the labia to have a more smooth appearance.
***In an ideal world, your genital plastic/cosmetic surgeon should be an artist, and your individual labia his or her palette.***** This calls for your surgeon to be adept with more than one technique. When counseling patients as to their choice of surgeon, I always suggest that the surgeon should be comfortable performing linear, wedge, and their modifications so as to choose his or her technique based on your desires and your anatomy, not solely on what technique he or she knows how to perform.
An extremely important issue involves the clitoral hood. While there are dependable techniques for encompassing enlarged and redundant clitoral hoods in either linear or wedge modifications, it is important that your surgeon be both experienced and comfortable with reducing an aesthetically or functionally robust clitoral hood. Avoid any surgeon who cannot prove to you by his/her knowledge, backed by many photos, that he/she is savvy and experienced with hood reduction.
You can begin to get an idea why it is important for your surgeon to be both an architect and an artist, to be savvy in alternative techniques, and to be able to design the procedure to specifically fit your anatomy.
So… “which technique is best?!”As you can see, it is the technique that best fits the circumstances of the individual woman. In experienced hands, both V-wedge and linear resection modifications can fare well, but it takes patience, experience, and knowledge of alternative techniques to adequately service all patients individually.
I have always had a vision to provide women with awareness, options, and solutions. I take pride in providing a safe space for women to explore choices for their sexual health, rejuvenating their appearance, and improving their lives. I understand the intensely personal and sexual health issues involved in these surgeries and am dedicated to patients having the best outcomes with the highest levels of safety and comfort. If you have questions, please contact my office and make arrangements for a personal consultation!