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Elkhatib                                                                                                                                                                                                Extended running W-plasty

           Table 2: Summary of 5-point Likert scale
           Questionnaire                   Very satisfied  Satisfied    Unsatisfied  Very unsatisfied  Not sure
           Improvement of hygiene           All patients     _              _              _            _
           Improvement of sexual intercourse  All patients   _              _              _            _
           Painful scar                     All patients     _              _              _            _
           Improvement in appearance and shape  All patients  _             _              _            _
           Elimination of fungal infection  All patients     _              _              _            _
           Improvement of physical exercise  All patients    _              _              _            _
           Improvement in sense of well-being  All patients  _              _              _            _
           Ability of patients to wear a fitted size  All patients  _       _              _            _

           can occur with other techniques, including wound   REFERENCES
           contracture and dehiscence. The extended running
           W-plasty technique is ideal for closure of the     1.   Kato K, Kondo A, Gotoh M, Tanaka J, Saitoh M, Namiki Y.
           secondary defect created following excision of both the   Hypertrophy of labia minora in myelodysplastic women. Labioplasty
                                                                 to ease clean intermittent catheterization. Urology 1988;31:294-9.
           redundant labia minora and the redundant clitoral hood   2.   Radman HM. Hypertrophy of the labia minora. Obstet Gynecol
           because it maintains the vertical length and provides   1976;48:S78-9.
           tensionless scars. The reduced labia minora remains   3.   Maas SM, Hage JJ. Functional and aesthetic labia minora reduction.
           sensate and painless. This technique avoids the over-   Plast Reconstr Surg 2000;105:1453-6.
           or underresection of the labia, and all patients in our   4.   Solanki NS, Tejero-Trujeque R, Stevens-King A, Malata CM.
                                                                 Aesthetic and functional reduction of the labia minora using the Maas
           series were relieved of the functional problems related   and Hage technique. J Plast Reconstr Aesthet Surg 2010;63:1181-5.
           to an enlarged labia minora and clitoris.          5.   Capraro VJ. Congenital anomalies. Clin Obstet Gynecol 1971;14:988-
                                                                 1012.
           In conclusion, the extended running W-plasty       6.   Hamori CA. Aesthetic labia minora and clitoral hood reduction using
           technique is a viable alternative to the conventional   extended central wedge resection. Plast Reconstr Surg 2009;124:337;
           W-plasty, central wedge resection, edge resection,   7.   author reply 337-8.
                                                                 Choi HY, Kim KT. A new method for aesthetic reduction to the labia
           de-epithelialization excision, laser de-epithelialization,   minora (the deepithelialized reduction labioplasty). Plast Reconstr
           and other techniques. It is a modification of the     Surg 2000;105:419-22; discussion 423-4.
           W-plasty design reported in literature, and can be   8.   Pardo J, Solà V, Ricci P, Guilloff E. Laser labioplasty of labia minora.
           used to simultaneously reduce both the hypertrophied   Int J Gynaecol Obstet 2006;93:38-43.
           labia minora and the redundant clitoral hood.      9.   Gonzalez F, Dass D, Almeida B. Custom flask labiaplasty. Ann Plast
                                                                 Surg 2015;75:266-71.
                                                              10.  Ostrzenski A. Fenestration labioreduction of the labium minus: a new
           Financial support and sponsorship                     surgical intervention concept. ISRN Obstet Gynecol 2014;2014:671068.
           None.                                              11.  Alter GJ. Aesthetic labia minora and clitoral hood reduction using
                                                                 extended central wedge resection. Plast Reconstr Surg 2008;122:1780-9.
           Conflicts of interest                              12.  Giraldo F, Gonzalez C, de Haro F. Central wedge nymphectomy with
                                                                 a 90-degree Z-plasty for aesthetic reduction of the labia minora. Plast
           There are no conflicts of interest.                   Reconstr Surg 2004;113:1820-5; discussion 1826-7.
                                                              13.  Hong ZJ, Wang J, Yuan SM, Wang Y, Hu XB, Jiang HQ. Central
           Patient consent                                       wedge resection and asymmetric Z-plasty for minor labia reduction.
                                                                 Zhonghua Zheng Xing Wai Ke Za Zhi 2009;25:268-70. (in Chinese)
           All patients gave informed consent.                14.  Cao YJ, Li FY, Li SK, Zhou CD, Hu JT, Ding J, Xie LH, Li Q. A
                                                                 modified method of labia minora reduction: the deepithelialised
           Ethics approval                                       reduction of the central and posterior labia minora. J Plast Reconstr
                                                                 Aesthet Surg 2012;65:1096-102.
           The study followed the ethical rules of Alkhor Hospital   15.  Oranges CM, Sisti A, Sisti G. Labia minora reduction techniques: a
           and was approved.                                     comprehensive literature review. Aesthet Surg J 2015;35:419-31.
















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