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Composite Reduction Labiaplasty



The demand for surgery to treat the external female genital area has increased significantly in recent years. Since 2001, the author and his colleagues have performed more than 2,100 surgical procedures to enhance the shape and function of the female genital area. The majority of these procedures were aimed at reduction of the labia minora. Drawing on the technique for labia minora reduction (labiaplasty) that the author first described in 2007 (Gress S, Gynäkologisch-Geburtshilfliche Rundschau 47:23–32, 2007), the technique was advanced such that in addition to an even reduction of the labia over their entire length (i.e., not only the part below the clitoris but also the part of the clitoral hood and above), it currently is possible to achieve further tightening of the clitoral hood and correction of a protruding clitoris (clitoral protrusion). This technique creates separate labial segments, the composition of which allows for an optimal shaping and reduction of the labia minora. Since 2006, the author and his colleagues have managed 812 cases using this technique, which has been named “composite reduction labiaplasty.”


After removal of the excessive tissue in an S-shaped line along the internal and external aspects of the labium minus and after cutting of a cranial pedicle flap approximately 2–3 cm long (seen as the caudal extension of the clitoral hood), a crescent-shaped skin segment below the clitoris and a centrally pointed rectangular skin segment above the clitoral hood are removed. By joining the wound margins, a tightening and balanced reduction of the labia minora as well as a correction for the protruding tip of the clitoris (clitoral protrusion) is achieved.


All the patients received postoperative care and follow-up assessments during a period of 6 months. Except for a few cases of wound dehiscence requiring surgical correction, wound healing was without complications, and the outcomes were both aesthetically and functionally very satisfactory.


In contrast to most techniques published to date, the “composite reduction labiaplasty” technique ensures a balanced reduction and a tightening of all parts of the labia minora, especially in the region of the clitoral hood. In addition, this technique results in an optimal correction of clitoris positioning in cases of clitoral protrusion. Concerns regarding impairment of sexual sensation or the ability to be sexually stimulated are unfounded. Approximately 35 % of the patients even reported a postoperative increase in their ability to be sexually stimulated.

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  1. 1.

    Gress S (2007) Ästhetische und funktionelle Korrekturen im weiblichen Genitalbereich. Gynäkologisch-Geburtshilfliche Rundschau 47:23–32

    PubMed  Article  Google Scholar 

  2. 2.

    Kruk-Jeromin J, Zielinski T (2010) Hypertrophy of labia minora: pathomorphology and surgical treatment. Ginekol Pol 81:298–302

    PubMed  Google Scholar 

  3. 3.

    Alter G (1998) New technique for aesthetic labia minors reduction. Ann Plast Surg 40:287–290

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Chavis WM, LaFerla JJ, Niccolini R (1989) Plastic repair of elongated, hypertrophic labia minors: a case report. J Reprod Med 34:373

    PubMed  CAS  Google Scholar 

  5. 5.

    Choi HY, Kim KT (2000) A new method for aesthetic reduction of labia minors (the deepithelialized reduction labiaplasty). Plast Reconstr Surg 105:419

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Gilbert DA (1999) Female aesthetic genital surgery. In: Ehrlich RM, Alter GJ (eds) Reconstructive and plastic surgery of the external genitalia. WB Saunders Co., Philadelphia, p 471

    Google Scholar 

  7. 7.

    Giraldo F, González C, De Haro F (2004) Central wedge nymphectomy with a 90-degree Z-Plasty for aethetic reduction of the labia minors. Plast Reconstr Surg 113:1820

    PubMed  Article  Google Scholar 

  8. 8.

    Hodgkinson DJ, Hait G (1984) Aesthetic vaginal labiaplasty. Plast Reconstr Surg 74:414

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Honore LH, O`Hara KE (1978) Benign enlargement of the labia minora: report of two cases. Eur J Obstet Gynecol Reprod Biol 8:61

    PubMed  Article  CAS  Google Scholar 

  10. 10.

    Laub D (2000) A new method for aesthetic reduction of labia minors: the deepithelialized reduction labiaplasty (discussion). Plast Reconstr Surg 105:423

    Article  Google Scholar 

  11. 11.

    Maas SM, Hage JJ (1998) Aesthetic labia minors reduction. Ann Plast Surg 41:685

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Maas SM, Hage JJ (2000) Functional and aesthetic labia minors reduction. Plast Reconstr Surg 105:1453

    PubMed  CAS  Google Scholar 

  13. 13.

    Radman HM (1976) Hypertrophy of the labia minora. Obstet Gynecol 48(Suppl):78

    Google Scholar 

  14. 14.

    Rouzier R, Louis-Sylvestre C, Paniel BJ, Haddad B (2000) Hypertrophy of labia minora: experience with 163 reductions. Am J Obstet Gynecol 182:35–40

    PubMed  Article  CAS  Google Scholar 

  15. 15.

    Krizko M, Krizko M, Janek L (2005) Plastic adjustment in hypertrophy of labia minora (Slovak). Ceska Gynekol 70:446–449

    PubMed  CAS  Google Scholar 

  16. 16.

    Trichot C, Thubert T, Faivre E, Fernandez H, Deffieux X (2011) Surgical reduction of hypertrophy of the labia minora. Int J Gynaecol Obstet 115:40–43

    PubMed  Article  Google Scholar 

  17. 17.

    Miklos JR, Moore RD (2008) Labiaplasty of the labia minora: patients’ indications for pursuing surgery. J Sex Med 5:1492–1495

    PubMed  Article  Google Scholar 

  18. 18.

    Solanki NS, Tejero-Trujeque R, Stevens- King A, Malata CM (2010) Aesthetic and functional reduction of the labia minora using the Maas and Haage technique. J Plast Reconstr Aesthet Surg 63:1181–1185

    PubMed  Article  CAS  Google Scholar 

  19. 19.

    Ellsworth WA, Rizvi M, Lypka M, Gaon M, Smith B, Cohen B, Dinh T (2010) Techniques for labia minora reduction: an algorithmic approach. Aesthet Plast Surg 34:105–110

    Article  Google Scholar 

  20. 20.

    Miklos JR, Moore RD (2012) Postoperative cosmetic expectations for patients considering labiaplasty surgery: our experience with 550 patients. Surg Technol Int 21:170–174

    Google Scholar 

  21. 21.

    Cao YJ, Li FY, Zhou CD, Hu JT, Ding J, Xie LH, Li (2012) A modified method of labia minora reduction: the deepithelialised reduction of the central and posterior labia minora. J Plast Reconstr Aesthet Surg 65(8):1096–1102

  22. 22.

    O’Connell HE, Sanjeevan KV, Huston JM (2005) Anatomy of the clitoris. J Urol 174:1195–1198

    Google Scholar 

  23. 23.

    Papageorgiou T, Hearns-Stokes R, Peppas D, Segars JH (2000) Clitoroplasty with preservation of neurovascular pedicles. Obstet Gynecol 96:821–836

    PubMed  Article  CAS  Google Scholar 

  24. 24.

    Platzer W (1985) Atlas of topographical anatomy. Thieme Stuttgart, New York, pp 302–307

    Google Scholar 

  25. 25.

    Shaw A (1992) Subcutaneous reduction clitoroplasty. J Pediatr Surg 12:331–338

    Article  Google Scholar 

  26. 26.

    Malionovsky L, Sommerova J, Martincik J (1975) Quantitative evaluation of sensory nerve endings in hypertrophy of labia minors pudendi in women. Acta Anat 92:129

    Article  Google Scholar 

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The author declares that he has no conflicts of interest to disclose.

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Correspondence to Stefan Gress.

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Gress, S. Composite Reduction Labiaplasty. Aesth Plast Surg 37, 674–683 (2013).

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  • Clitoral hood
  • Clitoral protrusion
  • Labia minora
  • Labia reduction
  • Labiaplasty