With the increased demand for the labiaplasty procedure, there has been a continuous debate about which technique is better for achieving the desired results: the trim labiaplasty and its modifications vs. the wedge labiaplasty and its modifications. However, it all narrows down to the fact that the ideal technique is the one the surgeon is more experienced and comfortable with and produces the most consistent results considering each patient’s vaginal rejuvenation goals and requirements.
Trim/Edge Technique for Labiaplasty?
The trim technique for labiaplasty, also known as the Edge/Linear or Amputation technique, is a surgical procedure aimed at achieving a more symmetrical and cosmetically appealing labia minora appearance. It is done by excising and removing excess/redundant tissue from the outer edges of the labia minora, thereby reducing its length and size.
Indications for a Trim Labiaplasty
The trim technique for labiaplasty is best opted for in the following scenarios.
- When the patient has significantly redundant labia minora.
- When the labia minora is excessively thick, the trim technique is ideal as it can help reduce the volume of tissue while preserving the natural contour of the labia minora.
- Where the labial edges appear pigmented, this technique can be used to create a lighter-coloured, smoother and more even labia.
- When the labia minora are asymmetric, this technique can be used to remove excess tissue from one side, thereby creating a more symmetrical appearance.
- Where the surgeon has the requisite skill and expertise needed for performing the procedure.
Procedure for the Trim Labiaplasty Technique
To ensure a successful labiaplasty procedure, adequate measures must be taken preoperatively, intraoperatively and postoperatively.
Preoperative Assessment
This includes:
- A detailed and recorded discussion between the patient and the surgeon to ensure they both agree on the same objectives and medico-legal reasons;
- Photographs of the perineum before the procedure;
- Carrying out the procedure after menstruation;
- Shaving of the perineum to reduce the risk of infection;
- Preoperative antibiotics administered 30 minutes before the procedure;
- Informed verbal and written consent.
Intraoperative Procedure
This procedure can be performed as an in-office vaginal rejuvenation procedure under conscious sedation and/or with local anesthetics or as an outpatient surgery in a theatre under general or regional anesthesia.
The patient is placed in a lithotomy position, and routine cleaning and draping is done. Using a sterile marker, the areas of the labia minora to be trimmed are marked from the frenulum to the posterior labia and infiltrated with a local anesthetic mixed with adrenaline to prevent bleeding. A scalpel, scissors, laser or radiofrequency is used to make a longitudinal incision along the marked area of the labia minora. The excess tissues are trimmed off to achieve the desired sizes and symmetry on both sides.
Following this, the surgeon stitches the connective tissue of the labia minora continuously and horizontally with absorbable 3/0-5/0 sutures such as Vicryl or Chromic sutures, although surgical glue can also be used. This can be done in 1 or 2 layers to help secure hemostasis, prevent wound dehiscence and create an appealing shape. Finally, a sterile dressing is applied over the surgical site to protect it and promote healing.
The above image depicts the trim labiaplasty technique.1
Postoperative Care
Analgesics and antibiotics may be prescribed to help deal with pain and prevent infection. The patient is advised to:
- Avoid strenuous activities and prolonged standing as this encourages swelling of the surgery site;
- Apply ice packs to the surgical site to help reduce edema;
- Use a squirt bottle to help keep the perineum clean and dry;
- Avoid tampon insertion for at least eight weeks following surgery;
- Avoid sexual intercourse for about six weeks following surgery;
- Avoid tight clothing for several weeks after the surgery.
Advantages of Trim Labiaplasty
- When performed by an expert, the trim technique has a shorter operation time compared to other techniques.
- Because the trim technique excises the pigmented edges of the labia minora, it creates a light-coloured labial edge which may be more desirable to some people.
- It has a shorter recovery time compared to the wedge technique, which involves more extensive tissue excision.
- Has the lowest risk of complications when compared to other techniques.
- Produces more consistent and predictable results in the hands of an experienced surgeon.
- Has minimal scarring as it involves the removal of redundant tissue from the labial edges.
Disadvantages of Trim Labiaplasty
- This technique only allows for limited tissue removal, which may be insufficient for patients with asymmetry or markedly redundant tissue.
- The placement of a longitudinal scar line along the outer rim of the labia minora is often irregular and scalloped and may result in decreased sensation along the scar line.
- Sometimes, patients complain of asymmetry from over-resection, and this may be difficult or impossible to correct with a revision procedure.
- It is tricky to retain the normal transition between the frenulum of the clitoris, the clitoral hood and the labia minora with the trim technique. This commonly results in dog ears’ superiorly and inferiorly, which are cosmetically unappealing.
- This technique does not address excess tissue in the clitoral hood area, which may be a concern for some patients.
Risks/Complications of Trim Labiaplasty
The possible risks/complications associated with trim labiaplasty are similar to all other techniques used for labiaplasty, and these include;
- Pain and discomfort
- Infection
- Bleeding
- Hematoma formation
- Poor wound healing, wound dehiscence and separation
- Scar formation
- Asymmetry
- Loss/diminished sensation around the labia minora
- Unsatisfactory results, which may require a revision procedure.
Recovery Timeline Following Trim Labiaplasty
This varies based on an individual’s healing ability, the extent of surgery and the adherence to postoperative care.
- Immediately after surgery, you should be able to move around; however, you may have pain, swelling, discomfort and slight bleeding. You may have to use a pad or panty liner to manage the bleeding or effluent from the surgical site.
- In the first week, avoid strenuous activities and prolonged standing. You will also be required to be consistent with your medications (analgesics and antibiotics). Swelling and bruising start to subside by the end of the first week.
- By the second week, you can return to your regular activities, but avoid strenuous activities and exercises such as riding a bicycle or running.
- By the third week, most of the swelling should have resolved, and a clearer picture of what the labia minora should look like begins to emerge. Still avoid any penetrative activity, e.g. sex and tampon insertion.
- By the fourth week, you can resume light exercise, but you must receive clearance from your doctor.
- By the sixth week, penetrative activity, e.g. sex and tampon insertion, can commence. However, you must seek clearance from your doctor.
What is the Cost of Trim Labiaplasty?
The cost of a trim labiaplasty procedure varies depending on the location, surgeon’s expertise and the extent of the surgery. At Alinea Labiaplasty & Vaginoplasty Michigan, this procedure’s costs start at $3,000. Some health insurance plans may be able to cover the fee for this procedure if it is deemed medically necessary.
Schedule an appointment with us today if you are considering this procedure and one of our experts will answer all your queries.
Reference
- Mahmoud, Ammar. “Best Labiaplasty Surgeon in New York City.” Labiaplasty NYC, 22 Mar. 2023, https://labiaplastynewyorkcity.com/labiaplasty-nyc/
