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NJ Labiaplasty – Wedge or Edge?

By: Dr. Ganchi

Labiaplasty is a very popular procedure that has been growing in popularity over the past several years.  I have been performing labiaplasty in New Jersey for almost ten years and for hundreds of patients from all over the U.S. and even internationally.  These patients have consistently been some of our happiest patients.  They are impressed by how easy the procedure and the recovery are and how nice the results are.  They often remark that they wish they had done this sooner!

One of the questions that I have been asked repeatedly about labiaplasty is “Which technique is better – the wedge technique or the edge trim technique?”  One of the reasons that the wedge technique has become popular is that it was used on the popular TV show “Dr. 90210”.  However, as is usually the rule, what you see on TV is usually not real nor the best.  I have used both techniques and it is clear that the edge trim technique is more versatile for almost any shape labia and clitoral hood, heals better with fewer complications and has a great, more natural cosmetic result.  The real proof is that my patients love their results.

edge-vs-wedge

The main reason cited to support the wedge technique is that it preserves the “natural” edge of the labia.  This is clearly a misinformed concept.  The “natural” edge of the enlarged labia is usually dark, thick and irregular.  This is usually one of the reasons that my patients come for labiaplasty.  They want this thick, dark, irregular edge removed, NOT preserved!  They want their inner labia reduced to the same length or smaller than the outer labia.  The dark, thick, irregular edge would look completely unnatural in this position.  Furthermore, anyone who has examined women with naturally small labia minora will agree that the “natural” edges of the small labia minora are thinner and pinker in color.  This is what my patients are looking for; this is what is truly “natural” and this is what is achieved with the edge trim technique, not the wedge technique.  Preserving the edge is the main (and only) real reason provided to support the wedge technique and clearly, this is not most natural and not what my labiaplasty patients are looking for.

Some of the reasons used against the edge trim technique include the “bad” scar, that it doesn’t address the clitoral hood, and that it is somehow simple and less technically demanding.  First of all, being technically demanding doesn’t make a procedure better.  However, if performed PROPERLY, the edge trim technique is actually quite technically demanding because it DOES address the clitoral hood, leaves an INVISIBLE scar and gives the most natural result!  Many who perform labiaplasty, including those who use the edge trim technique, are inexperienced or undertrained.  In these cases, it is the surgeon who is causing the complications or poor results, not the technique.  This is why you should make sure you choose a board-certified plastic surgeon with impeccable credentials who has performed many labiaplasty procedures and who can show you the results.  Why a plastic surgeon and not a gynecologist?  Who do you think will give you that invisible scar and proportional result?  Plastic surgeons are experts at creating the best scars and contours all over the body, including the labia.

There are several disadvantages to the wedge technique that do not exist with the edge trim technique.  First, the wedge technique addresses fullness mainly in the central labia but doesn’t do well with enlargement further back or forward on the labia nor does it address the clitoral hood area.  This can leave many women with distorted labia.  Some surgeons using this technique will resort to the edge trim technique to make up for this deficiency of the wedge technique.  Second, the wedge technique depends on pulling together and “tightening” the labia front to back to make them smaller.  This creates an unnatural tension in the incision line that can lead to healing problems and longer recovery times.  Some of these patients develop a permanently visible notching of their labial edges (not very natural) because the wedge partially pulled apart during the healing process.  The other end of the wedge incision can sometimes cause distortion near the urethra (opening for urination).  If done poorly, it can cause problems with urination.  The edge trim technique doesn’t go anywhere near the urethra and almost never has a healing problem or notching.

In expert hands, the edge trim technique is superior to the wedge technique from both cosmetic and medical perspectives.  The edge trim technique addresses the entire labia fully including the clitoral hood when necessary while the wedge technique does not.  The edge trim technique scar is under no tension, heals under almost any condition, doesn’t cause notching deformities of the labial edges and is imperceptible.  The wedge technique has much higher rates of healing problems and visible notching deformities of the labial edges.  The edge trim technique goes nowhere near the urethra.  The wedge technique incision can go very close to the urethra and in some cases, cause complications with urination.  Finally and most importantly, the edge trim technique results in the most natural and aesthetically pleasing shape and edge while the wedge technique aims to un-naturally preserve the dark, thick, irregular edge.

Some sample labiaplasty before and after photos follow:

labiaplasty before after
Only 7 weeks after labiaplasty, notice the very natural color and shape over the entire length of the labia including the clitoral hood.  No scar is visible.

labiaplasty before after
6.5 months after labiaplasty.  This patient had very large labia from front to back and around the clitoral hood.  Notice the very natural and proportional reduction along the entire length of the labia.  The color of the edge is natural.  No scar is visible.

labiaplasty before after photo
3 months after labiaplasty.  This patient had enlargement along the entire length of the labia and clitoral hood.  She wanted her labia hidden within the outer labia (closed labia).  This required proportional reduction along the entire length of the labia and clitoral hood that would be impossible with the wedge technique.

Labiaplasty patients represent some of our happiest patients with most wishing they had done this sooner.  Having performed labiaplasty for almost 10 years for hundreds of patients from all over the country, it has become clear to me that the edge trim technique provides the best and most consistent cosmetic results with the least complications (see labiaplasty before and after photos).  As labiaplasty continues to grow in popularity, it becomes very important for prospective patients to research their surgeons and choose a board-certified plastic surgeon with significant experience in performing labiaplasty.  In the right hands, labiaplasty is a safe, minimally-invasive procedure with wonderful results.

If you are interested in learning more about our labiaplasty procedure, please visit our labiaplasty page to learn more.

*”Edge vs. Wedge image by Lamilli, based on: [1] / [2] / [3] / [4] (Own work) [CC BY-SA 3.0], via Wikimedia Commons

Harvard trained, board certified plastic surgeon, Dr. Ganchi and staff lavish you with attention and make your experience enjoyable and comfortable.

WE INVITE YOU TO CALL OUR NEW JERSEY OFFICE AT 973-942-6600.


3 Responses to “NJ Labiaplasty – Wedge or Edge?”

  1. ABHAY PRAKASH JOSHI says:

    it is a perfect guide to labioplasty for doctors and patients

  2. Roxana artiga says:

    I’m 35yrs old n I’m considering in having liabiaplastic done but just wedges.. How much does it cost n can insurance cover it, what’s the down time? It’s done on local anesthetic ?
    Thank you

  3. Chinu says:

    Its been long time I am looking for this. Thanks for providing such a valuable information.

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