Secondary Logo

Journal Logo

Comparison of Wedge versus Straight-Line Reduction Labioplasty

Murariu, Daniel M.D., M.P.H.; Jackowe, David J. M.D.; Parsa, Alan A. M.D.; Parsa, F. Don M.D.

Plastic and Reconstructive Surgery: March 2010 - Volume 125 - Issue 3 - p 1046-1047
doi: 10.1097/PRS.0b013e3181cb68a4

Department of Surgery, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii

Correspondence to Dr. Parsa, Department of Surgery, John A. Burns School of Medicine, University of Hawaii, 1329 Lusitana Street, Suite 807, Honolulu, Hawaii 96813-2421,

Back to Top | Article Outline


Patient demand for labioplasty—the surgical reduction of the labia minora—is growing. However, these procedures are not without controversy, among both the lay public and medical professionals. One reason for this controversy is a paucity of studies describing the natural course of potential complications.1 One such study was published by Alter in 2008 (Plast Reconstr Surg. 2008;122:1780–1789), where complications with wedge labioplasty were reported.2 We present one of the largest studies to date that follows the natural course of a multitude of complications associated with labioplasty, and also compares them between the straight-line and wedge techniques.

We analyzed a total of 24 consecutive patients (mean age, 36 years) requesting elective labioplasty between 1988 and 2008 with the senior author (F.D.P.). Before 1999, all 14 patients (58 percent) received straight-line excision with intradermal reapproximation; the rest of the patients [n = 10 (42 percent)] received a central wedge resection (Table 1). Follow-up at 1 week, 6 weeks, 3 months, and 6 months was 24 (100 percent), 22 (92 percent), 18 (75 percent), and 14 (58 percent), respectively. A large percentage of patients were lost to follow-up after 3 months. At 6 weeks, 21 of 22 patients (95 percent) reported being happy with the outcome (no other quantifying measures were undertaken). Complications were recorded as they developed from the time of the first follow-up at 1 week, and their natural course followed at 6-month intervals until resolution (Table 2). None of the complications required reoperation.

Table 1

Table 1

Table 2

Table 2

This study shows that the frequently encountered complications of reduction labioplasty such as partial wound separation and infection will respond to conservative therapy. None of our patients experienced any urinary symptoms, such as spraying, a complication reported by other authors.3 Although limited by a small cohort, our data may serve as a guideline for clinicians when treating complications of reduction labioplasty, and when educating patients both in the preoperative and the postoperative settings as to the natural course of potential complications. Based on our observations, we recommend central wedge reduction labioplasty as described by Alter4 as the method of choice because of better aesthetic outcome with absent hypopigmentation of the labia minora, and the lack of troublesome symptoms of pruritus that were only seen in women undergoing straight-line reduction (Table 2).

Daniel Murariu, M.D., M.P.H.

David J. Jackowe, M.D.

Alan A. Parsa, M.D.

F. Don Parsa, M.D.

Department of Surgery

John A. Burns School of Medicine

University of Hawaii

Honolulu, Hawaii

Back to Top | Article Outline


1. Goodman MP. Female cosmetic genital surgery. Obstet Gynecol. 2009;113:154–159.
2. Alter GJ. Aesthetic labia minora and clitoral hood reduction using extended central wedge resection. Plast Reconstr Surg. 2008;122:1780–1789.
3. Ryan KJ, Barbieri RL, Berkowitz RS, Dunaif AE. Kistner's Gynecology & Women's Health. 7th ed. St. Louis: Mosby;1999.
4. Alter GJ. A new technique for aesthetic labia minora reduction. Ann Plast Surg. 1998;40:287–290.

Section Description


Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article's publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor.

Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS' enkwell, at

We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and asignees to publish it in the Journal and in any other form or medium.

The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.

©2010American Society of Plastic Surgeons