Review of Linear Reduction Labiaplasty

How I do it. Originally for publication in 2014. Little has changed in my technique.

How I Do It

Linear Reduction Labiaplasty by Radiofrequency (RF)

Red Alinsod, MD

A viable labiaplasty should allow preservation of both the contour of the lips when requested by the patient and the color/texture match of the labial edge, or removal of the labia minora, ifrequested. In-office local anesthesia (1/4 % Marcaine or 1% lidocaine with 1:100,000 epinephrine), conscious sedation, or traditional general anesthesia may be administered to patients undergoing a labiaplasty.

In the past decade there has been a rise in the use of radiofrequency (RF) energy for vulvovaginal aesthetic surgery. RF labiaplasty was first performed in 2005 and presented in 2006 at the meeting for The American Academy of Cosmetic Gynecologists (AACG). The technique is quite suitable for LP as the minimal lateral thermal spread is only 20 – 40 microns when the procedure is done with a ceramically shielded fine wire electrode. No discernable edge burn or scarring is visible and no bubbling of skin occurs. Both of these features lead to improved safety when performing surgery proximal to the glans clitoris. RF technology also allows for “feathering” of irregular edges via “airbrushing” with the electrode and allows the surgeon to perform micro-adjustments to eliminate “dog ears.” Radiofrequency incisional/excisional surgery can be performed in conjunction with other surgical techniques described within this chapter.

In 2005 I reported on the minimally invasive surgical procedure popularly termed the “Barbie Look.” This is a slang term used by his patients in Los Angeles who requested removal of all or almost all of the labia minora.13 Also described were the “Rim Look” and the “Hybrid Look.” The Rim Look is a curvilinear vertical excision that extracts only the dark edges of the labia minora to smoothen and even out the edges and have labia protruding past the labia majora. The Hybrid Look refers to the finessed middle road approach involving removal of nearly all of the labia minora but leaving a petite “peekaboo” (below or to the level or the labia majora) amount of tissue that appears more attractive to some patients. This degree of precise excision of labial tissue is made possible with the use of radiofrequency slender wire tips.

SUMMARY OF SURGICAL STEPS