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Elkhatib Extended running W-plasty

A B METHODS

Six patients with unilateral hypertrophy and 17
patients with bilateral hypertrophy of the labia minora
presented for evaluation [Figure 1].

Within this group, 8 patients complained of irritation
and chronic infection while the remaining 15 patients
were concerned with the noticeable protrusion of the
enlarged labia minora and its associated psychological
and emotional distress.

Patients were admitted to the same day surgery unit
Figure 1: (A) A 34-year-old female with bilateral hypertrophy of
the labia minora and a redundant clitoral hood; (B) A 27-year-old after a complete examination. General endotracheal
female with bilateral incomplete hypertrophy of the labia minora and anesthesia was used in all patients. The procedure
a redundant clitoral hood commenced with marking the running W-plasty on
both sides of labia minora with an extension through
W-shaped resection technique avoids many potential the clitoral hood [Figure 2]. Excision of the pre-
problems which can occur with other techniques. determined amount of tissue was performed [Figure 3],
Capraro introduced the edge resection technique in followed by meticulous hemostasis and closure of the
[5]
[6]
which the labia is resected at its free edges. Hamori interdigitating small triangular flaps with absorbable
preserved the natural rugosity by performing the central 4-0 monofilament [Figures 4 and 5].
wedge technique. De-epithelialization is another tool
which has been used to reduce the size of the labia, A compression dressing was applied for several hours
and can be performed with either a scalpel or the CO 2 and removed prior to discharge. At the postoperative
[7]
[8]
laser. Gonzalez et al. reported the use of the custom visits, an outcome evaluation questionnaire based
[9]
flask labiaplasty technique in 50 patients, which permits on a 5-point Likert scale was administered. The
precise reduction of the labia minora. Ostrzenski [10] questionnaire evaluated the level of improvement in
described a fenestration labiaplasty technique in which physical exercise, improvement in sexual intercourse,
the inferior flap is transposed to reduce the height and improvement in appearance and shape of the labia
width of the labia. minora and clitoral hood, elimination of fungal infection,
ability of patients to wear fitted undergarments, and
improvement in sense of well-being.
The primary goal of the extended running W-plasty
technique, described in this study, is to achieve A 5-point Likert scale was designed with options of
an acceptable protrusion of both the labia minora 1 (very dissatisfied), 2 (dissatisfied), 3 (moderately
and the clitoral hood beyond the labia majora. The satisfied), 4 (satisfied), and 5 (highly or very satisfied).
design reported in this study is a modification of the
conventional W-plasty reported in the literature which The preoperative and postoperative photos were
is used for reduction only of the hypertrophied labia analyzed based on the extent of external genitalia
minora. exposure and analysis was performed by an independent

A B C

Figure 2: (A) A 34-year-old female, marked for an extended running W-plasty; (B and C) A 27-year-old female, marked with an extended
running W-plasty on both sides of the labia minora
360 Plastic and Aesthetic Research ¦ Volume 3 ¦ November 22, 2016