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Elkhatib Extended running W-plasty

A B

Figure 3: A 34-year-old female, appearance of the labia minora Figure 5: Immediate postoperative view of the 34-year-old female
after reduction. Note the interdigitating triangles. The excision (A) and the 27-year-old female (B). The procedure is completed by
extended to involve the clitoral hood suturing the interdigitating small flaps

Figure 4: Tissue excised from both labia minora (the 34-year-old female) Figure 6: One-year postoperative result of the 34-year-old female
plastic surgeon. numbness, sensitivity, or scar pain during intercourse.

RESULTS DISCUSSION

Because the W-plasty technique conserves tissue, The use of the extended running W-plasty technique is
over-resection was avoided, and the shape and size required for the simultaneous reduction of hypertrophied
of the labia minora were acceptable in all patients. In labia minora and prominent clitoral hood. The central
addition, the vertical length of the labia was preserved. wedge resection removes a full-thickness wedge of
All patients were noted to have symmetry with a and skin from the thickest portion of the labia minora. [11]
[12]
natural color and contour of their labia minora [Figure 6]. Giraldo et al. add a 90-degree Z-plasty to the central
wedge procedure; this modification produces a refined
Small hematomas occurred in one patient and were surgical scar that is less tethered and has less tension.
treated conservatively. Wound dehiscence (1-2 cm in The W-plasty previously described by Maas and Hage
[3]
length) developed in one patient and was also treated and Solanki et al. is limited as it does not simultaneously
[4]
conservatively [Table 1]. address the redundant hood of the clitoris.
Based on the results of the Likert scale and the The technique described in the current report
evaluation questionnaire [Table 2] provided during addresses both the hypertrophied labia and clitoral
the follow-up period, the aesthetic outcomes were hood with an appropriate skin resection. The extended
very satisfactory in all patients. Patients experienced W-plasty has the same principles of the conventional
improvement in their daily activities, including sexual W-plasty in thatthe angles of the “W” vary between 50
intercourse and physical exercise. Hygiene became and 55 degrees, but are further extended to involve
easier, and patients stated that they did not need another aesthetic unit which includes the defect
to apply antifungals or local steroids after surgery. resulting from the reduction of the enlarged clitoris.
All patients were able to wear bathing suits without The technique divides the scar into small triangles to
embarrassment. No patients experienced scar break up the scar contracture and providing a more
Plastic and Aesthetic Research ¦ Volume 3 ¦ November 22, 2016 361