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CC BY-NC-ND 4.0 · Arch Plast Surg 2023; 50(01): 017-025
DOI: 10.1055/a-1938-0991
Breast/Trunk
Review Article

An Algorithm for Labia Minora Reduction Based on a Review of Anatomical, Configurational, and Individual Considerations

Maurits Lange
1   Departments of Plastic and Reconstructive Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
,
J. Joris Hage 
1   Departments of Plastic and Reconstructive Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
,
Refaat B. Karim 
2   Department of Plastic Surgery at the A-Klinieken, Huis ter Heide, The Netherlands
,
Frédéric Amant 
3   Departments of Gynecology at The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
4   Department of Gynecology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
5   Department of Oncology, KU Leuven, Belgium
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Funding None.
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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

Research Involving Human Participants

This article does not contain any studies with humans performed by any of the authors.


Research Involving Animals

This article does not contain any studies with animals performed by any of the authors.


Patient Consent

Informed consent was obtained from the individual participants of whom photographs were included in the study.


Ethical Approval

The Institutional Review Board confirmed that no ethical approval is needed for this review study.


Authors' Contributions

M.L. contributed to the conceptualization, investigation, data curation, methodology, and formal analysis of the study, and to the visualization and writing of the original draft and final manuscript. He accepts full accountability for all aspects of the work.

J.J.H. contributed to the project administration, conceptualization, investigation, methodology, formal analysis, and supervision of the study, and to writing the original draft and final manuscript. He accepts full accountability for all aspects of the work.

R.B.K. contributed to the conceptualization, formal analysis and interpretation of data, and to the writing of the original draft and final manuscript. He accepts full accountability for all aspects of the work.

F.A. contributed to the project administration, the conceptualization, resources, investigation, methodology, formal analysis and supervision of the study, and to writing the original draft and final manuscript. He accepts full accountability for all aspects of the work.




Publication History

Received: 07 April 2022

Accepted: 17 August 2022

Accepted Manuscript online:
07 September 2022

Article published online:
06 February 2023

© 2023. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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