ARTICLE | INVASIVE SURGERY | Figures 1–4 Pre-operative examination
establish and estimate, as it is often the case that some women consider what other might find ÔnormalÕ to be
ÔabnormalÕ. Therefore, a little problem (i.e. a minimal hypertrophy) may be very frustrating, while a big problem (i.e. a large hypertrophy) may simply be considered a normal variation. This is the reason for the ÔgradingÕ system proposed by Davison2
, for example. However, the number of labiaplasty procedures has
steadily increased over recent years, along with the number of physicians offering the procedure to patients. Indeed, the authors believe that this is an evolving field in plastic and gynaecologic surgery. With regard to aetiology,
measures that are difficult to compare owing to individual variations. Other authors2–4
refer to the Ôclinical appearanceÕ of the
hypertrophy in a simple and reproducible manner: ■ No hypertrophy: labia minora are concealed within, or extend to, the free edge of the labia majora
■ Moderate hypertrophy: labia minora extend 1Ð 3 cm beyond the free edge of the labia majora
The number of labiaplasty procedures has steadily
some women are born with a protruding labia minora, while others may experience this later in life as after mechanical or chronic irritation, or lymphatic stasis. At present, however, no universally accepted aetiology is recognised in the literature. Indeed, hypertrophy of the labia minora is a multifactorial issue.
30 ❚
Grading The labia minora are usually measured between their base and free edge, from the middle of each. Grading of the hypertrophy of labia minora has been classified with regard to their measured size by some authors (as opposed to Davison), but this has led to unsettled
September 2012 |
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increased over recent years, along with the number of physicians offering the procedure to patients.
■ Severe hypertrophy: labia minora extend more than 3 cm beyond the free edge of the labia majora.
Indications Labia minora plasty is indicated in women who present with hygiene difficulties, discomfort when wearing tight clothing, experience pain when riding a
bicycle, experience the labia catching in zippers, and when the labia minora are perceived as Ôtoo visibleÕ. The goal of treatment is to obtain a more aesthetic appearance of the external genitalia, without adding scars or distorting them. The authorsÕ technique ® adapted from the experiences of other authors, and Davison2
in particular ® is a more
refined variation of the simple ÔbullÕs eyeÕ technique, as discussed in the remainder of this article. The bullÕs eye technique is the full thickness resection of the central part of the labia minora. For example, in Figure 6 (de-epithelisation), the bullÕs eye technique would have resected the area,
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