Bidimensional labia minora reduction

A number of techniques for reduction of hypertrophic labia minora have been described. Some of them involve just a wedge resection to shorten the vertical dimension of the labia minora. Nevertheless, labial hypertrophy encompasses not only the length but also the width. Attempts to reduce a wider labium by a large inferior wedge resection usually results in a thin ischemic superior flap, which eventually leads to dehiscence problems and even tip flap necrosis. On the other hand, the deepithelialization technique effectively reduces the labial width, although it fails to shorten the labial length, which appears redundant and festooned. In this report, we present a technique for reduction of the labia in width and length dimensions by deepithelialization and a smaller inferior wedge resection. This association provides a tension-free closure and ensures adequate vascularization to the healing edges of the superior labial flap, which seems to reduce the chances of wound dehiscence. It also obtains excellent cosmetic results, preserving the labial border and avoiding a festooned appearance.