Several months ago, Dr. Sheth decided that his masterpiece was due for an overhaul and asked if we would be so kind as to update our chapters. He also asked if there was "anything new" that might add to the appeal of the book. Ergo, a chapter on cosmetic gynecology, to be released early next year. We hope you'll like it.
(1) linear excisions parallel to the labial edge,
(2) wedge excisions perpendicular to the labial edge, and
(3) partial-thickness excisions.
All of these approaches have been described with variations on the shape and extent of the basic concepts.
Linear Labia Minoraplasty
If there is a marked color discrepancy between lateral and medial labial skin, this style of labiaplasty may leave an unnatural color transition line along the new labial edge if an aggressive excision is performed. In a full-length excision, 3 to 4 small arterioles will be encountered and require surgical control.
Wedge Labia Minoraplasty
In fairness to Alter, I was unable to find Laufer's paper in any medical database using 2013 search technology with a copy of Laufer's paper right in front of me. So how did I find Laufer's obscure paper? He self-referenced it in a 2011 article on pediatric labiaplasty.
Partial-Thickness Labia Minoraplasty
A cosmetic error, frequently seen with improperly designed linear excisions, is the abrupt termination of the labiaplasty scar at the clitoral hood, leaving a loose redundant mass of periclitoral skin. These require revisionary surgery to essentially complete the procedure.
If you want more, you'll have to buy the book or see me in person.