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Vaginal Labiaplasty

Current Practices and a Simplified Classification System for Labial Protrusion

Motakef, Saba M.D.; Rodriguez-Feliz, Jose M.D.; Chung, Michael T. M.D.; Ingargiola, Michael J. M.D.; Wong, Victor W. M.D.; Patel, Ashit M.B., Ch.B.


The authors of the March 2015 article titled “Vaginal Labiaplasty: Current Practices and a Simplified Classification System for Labial Protrusion” (Plast Reconstr Surg . 2015;135:774–788.) wish to make the following correction. The authors incorrectly attribute the most widely used classification system for labial hypertrophy to Franco, based on the article referenced (Felicio Yde A. Labial surgery. Aesthet Surg J . 2007;27:322–328). It has been brought to their attention that the classification system described in this reference should be attributed to Yhelda Felicio, M.D., as was published in the French-language publication La Revue de Chirurgie Esthétique de Langue Française , in 1992. As the authors’ search was limited to the English language, this original reference was not discovered. The corrected text should read, “The most widely used classification system, first described by Felicio in 1992 " (corrections in italics ).

Plastic and Reconstructive Surgery. 141(1):247, January 2018.

Plastic and Reconstructive Surgery: March 2015 - Volume 135 - Issue 3 - p 774–788
doi: 10.1097/PRS.0000000000001000
Cosmetic: Original Articles
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Background: Vaginal labiaplasty has been described for the management of functional and aesthetic problems associated with protrusion of the labia minora. Despite increasing numbers of procedures performed, there is a paucity of data to guide treatment paradigms. This systematic review aims to establish a simple, unifying classification scheme for labial protrusion and summarize current labiaplasty techniques and practices.

Methods: A systematic literature review was performed using the PubMed database. Additional articles were selected after reviewing references of identified articles.

Results: The search returned 247 articles. After applying inclusion criteria to identify prospective and retrospective studies evaluating different techniques, outcomes, complications, and patient satisfaction, 19 articles were selected. Labiaplasty of the labia minora was described in 1949 patients. Seven different surgical techniques were used for labiaplasty, including deepithelialization, direct excision, W-shaped resection, wedge resection, composite reduction, Z-plasty, and laser excision. Patient satisfaction rates for each technique ranged from 94 to 100 percent. The most common postoperative complication for all techniques was wound dehiscence (4.7 percent). Key areas for perioperative patient management were defined.

Conclusions: Labiaplasty is safe and carries a high satisfaction rate. However, current practices remain exceedingly diverse. The authors propose a simplified classification system based on the distance of the lateral edge of the labia minora from that of the labia majora, rather than from the introitus. Key areas for perioperative patient management include patient anesthesia, resection technique used, wound closure, and postoperative care. Further randomized studies using a standardized classification system are required to better compare different techniques and establish best practices.

Loma Linda, Calif.; Albany and New York, N.Y.; Durham, N.C.; and Baltimore, Md.

From the Department of Plastic Surgery, Loma Linda University; the Division of Plastic and Reconstructive Surgery, Albany Medical Center; the Division of Plastic, Maxillofacial, and Oral Surgery, Duke University; the Division of Plastic and Reconstructive Surgery, Mount Sinai Hospital; and the Department of Plastic and Reconstructive Surgery, Johns Hopkins University.

Received for publication June 1, 2014; accepted July 1, 2014.

Presented at Plastic Surgery The Meeting 2014, in Chicago, Illinois, October 10 though 14, 2014.

Disclosure: None of the authors has a financial interest in any of the products or devices mentioned in this article.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to and click on “Plastic Surgery Hot Topics” in the “Videos” tab to watch.

Ashit Patel, M.B., Ch.B., Division of Plastic Surgery, Albany Medical Center, 50 New Scotland Avenue MC-190, 1st Floor, Albany, N.Y. 12208,

©2015American Society of Plastic Surgeons