Alter Labia Contouring Procedure: 
“The New Labiaplasty”

Overview

Labiaplasty (Labioplasty) or labia minora reduction is a procedure that reduces the size of the labia minora. Some women are born with enlarged labia, whereas others develop the enlargement as a result of childbirth, hormonal changes, or age. Enlarged labia minora can cause discomfort in tight clothing, during physical activities, and with sexual intercourse. Many women are very self-conscious with their labial appearance, as large labia can cause loss of self-esteem and lack of intimacy.

Traditionally, gynecologists and plastic surgeons perform labia minora reduction by trimming the protuberant labia minora and stitching along the excised edge. This procedure is the same whether performed with a scalpel, scissors, laser, or radiofrequency device. It is less than ideal since the natural contour and color of labia minora edges are eliminated. The labial edge is replaced in most instances by an irregular scar line of more lightly colored inner labial tissue.

It is very difficult to achieve symmetry, to avoid scallops, to prevent unsightly scars, and to make a normal transition from the upper labium to the clitoral frenulum and clitoral hood with this procedure. In fact, many cases of inadvertent over-resection, and even amputation of the labia minora are a result of the trim technique. It has also been associated with a higher incidence of chronic discomfort along the scar line. The advantages of the trim are that it takes less time and can achieve a lighter labial edge.

Twenty-five years ago, Dr. Alter developed a new technique of labia minora reduction called the “Alter labia contouring” procedure. Most commonly referred to as the “central wedge” or “V” labiaplasty, this advanced technique preserves the normal contour, color, and anatomy of the labia minora edge. He published the seminal article on his technique in the prestigious plastic surgical journal, “Plastic and Reconstructive Surgery in 2008.

During the procedure, the most protuberant portion of the labium is excised in a “V” or “pie-slice” manner, which disconnects the upper and lower labium. The labium is then repaired by suturing these edges together in a four-layer closure. This results in normal labia minora appearance with only a small, rarely visible transverse scar across the edge normal labia minora appearance. Also, unlike the posterior wedge labiaplasty favored by some surgeons, the most thick and protuberant portion of the labium is removed. Excess skin on the sides of the clitoral hood can also be reduced without visible scars.

The disadvantages of the Alter wedge labiaplasty is a small chance of a minor wound opening, a longer operating time, and a greater surgical skill required. In untrained or cavalier surgeons, large disruptions in the suture line can occur, which can give the procedure a bad reputation. However, this is very rare if done by a skilled, meticulous surgeon.

The advantages of the wedge labiaplasty are a preservation of normal anatomy with normal labial edges (even though the darkest portions of the labia are usually removed), a higher incidence of symmetry, difficulty in over-resection, and less chance of chronic discomfort.

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The Procedure

The Alter central wedge labiaplasty is a relatively minor surgery with minimal discomfort. It takes about 2 hours and is performed with magnification to assure an accurate approximation of the normal labial edges and tissue. In contrast, the trim technique often takes 15-45 minutes and results in a scar line replacing the normal labial edge.

The labiaplasty is often combined with clitoral hood reduction with or without clitoropexy, labia majora reduction, perineoplasy, etc.

The surgery is performed in a fully accredited surgical center. General anesthesia is typically used, but sedation with local anesthesia is possible. The complication rate with labiaplasty is extremely low. If you have a relatively sedate job, you can likely return to work in 4-5 days. If you travel here, Dr. Alter and his team will see you on the day before surgery, and you should plan on staying in the area for about 2-3 days after the operation.

Post-surgical care is very simple. Ice and antibiotic ointment are used for two days, and women can shower on the day after surgery. Patients can resume sexual intercourse in about 6 weeks post-labiaplasty. None of Dr. Alter’s labiaplasty patients have complained of any loss of sensation or any decline in the ability to have orgasms.

Insurance may cover the cost of surgery if you have any discomfort. Our team will be happy to assist you in obtaining preauthorization.

Patient-First Policy

Dr. Alter and the entire team are dedicated to providing every patient with exceptional individualized care—from consultation to recovery. We take the time to learn about your concerns, goals, and desires, so we can build a plan that addresses your concerns and gets you the
results you deserve.

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