A Novel Technique for Mapping the Vascularity of Labia Minora Prior to Labiaplasty: Cold Light Illumination

Abstract

Objective Aim of the study was to assess the feasibility of a novel technique to determine the vascularity of labia minora prior to labiaplasty. Methods A cold light source employed in laparoscopic procedures was used to illuminate the outer surface of the labia minora as described in this prospective descriptive study. Results Of the patients, 46.1% (n = 41) had upper third prominence, 36% (n = 32) had middle third prominence, and 18% (n = 16) had lower third prominence according to the Banwell classification of morphologies. Right labia minora width was 0 – 2 cm in 51.7% (n = 46), 2 – 4 cm in 47.2% (n = 42) and > 4 cm in 1.1% (n = 1) of cases. Left labia minora width was 0 – 2 cm in 52.8% (n = 47), 2 – 4 cm in 41.6% (n = 37) and > 4 cm in 5.6% (n = 5) of cases. The incidence of Anterior 2 and Posterior 1 vessels in the different morphologies were statistically significantly different (p = 0.007, p = 0.018). The Anterior 2 vessel was higher in the lower morphology group whereas the Posterior 1 vessel was higher in the upper morphology group. A central vessel was observed in 93.3% (n = 83) of patients in the left labium minus and the right labium minus. The incidence of the Posterior 1 vessel was significantly higher in the left labium minus than in the right labium minus (p = 0.021). Discussion This novel technique to assess labial vascularity using a cold light source could be very useful to reduce dehiscence by avoiding excessive resection of highly vascularized tissue. Most units can easily access a cold light source, which can be used to assess labial vascularity prior to labiaplasty.

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

“…Because all have their advantages and limitation, no single one technique will offer the optimal solution for every patient. (5)(6)(7)(8)(9)(10) Rather, the technique should be chosen in accordance to the expectations and anatomical features of each individual patient. (5,(10)(11)(12)(13)(14) To date, some classifications have been presented to guide this choice, most of them based on labia minora width measurement,(15) labial configuration, (10,13,16) or a combination of both.…”

“…(6,28,42,43) In heavy smokers and other women at risk, pre-operative cold light assisted labial translumination may be helpful to assess and map the labial vascular supply. (9) The sensory innervation of the labium minus may be a point of more concern. Internal and external pudendal nerve branches innervating the labium minus accompany the vascular ramifications and tend to course most readily along the free rim of the labium.…”

“…In cases where this is not accepted, preoperative labial translumination may help designing a safer resection. (9) In non-vascular compromised women in whom the intended width reduction is more than 1 cm, on the other hand, the risk of loss of labial sensitivity associated with central excisional techniques has to be weighed against the risk of labial thickening associated with de-epithelialization techniques.…”

“…Because all have their advantages and limitations, no single one technique will offer the optimal solution for every patient. 5 6 7 8 9 10 Rather, the technique should be chosen in accordance with the expectations and anatomical features of each individual patient. 5 10 11 12 13 14 …”

Surgical Technique and Outcomes of Inverted-Y Plasty Procedure in Clitoral Hoodoplasty Operations

“…(2) Labiaplasty is the most common procedure requested by women who are concerned with the appearance of their vulvar area. (3)(4)(5) It is mostly performed with the aim of reduction of hypertrophic genital labia or/and correction of asymmetry. Enlarged or deformed labia may diminish self-esteem, may cause sexual inhibition, and maybe a reason for discomfort with the clothes, exercise, and/or sexual activity.…”