This calls for your surgeon to be facile with more than one technique. In an ideal world, your genital plastic/cosmetic surgeon should be an artist, and your individual labia his or her palette. But 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. I can certainly perform either a linear (and its ”sisters” “trim” and “curvilinear”) or V-Wedge (and its “sisters” V-Y wedge, Z-plasty, and superior/inferior flap rotation) on any patient. I have never seen two women who look exactly the same (or, for that matter, 2 sides on the same woman that look the same.) I favor individualizing technique dependent on a woman’s individual anatomy and her choice of post-surgical appearance. 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. 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. The reality is that no one method holds the sacred key. 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 studiously prefer the other.
“If all you have is a hammer, everything looks like a nail.” Unfortunately, those surgeons who insist on only performing one of the two methods may not truly understand that a labiaplasty is an artistic undertaking, one that should be personalized for each individual. There are two major camps: the acolytes of the V-Wedge and the proponents of the linear/trim method. The debate rages on among cosmetic gynecologic and plastic surgeons: which technique - linear/trim or V-wedge modification - is the best for performing a labiaplasty for excessive-sized, redundant labia minora, with or without redundancy of the clitoral hood? One has only to read popular, often-accessed, websites like RealSelf to realize that strong opinions abound.
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