What is the procedure for the V technique in labiaplasty?

V Technique in Labiaplasty

The V technique (also called central wedge excision or V-plasty) involves removing a V-shaped or wedge-shaped segment of tissue from the most protuberant portion of the labium minus, preserving the natural labial edge and pigmentation while reducing excess tissue. 1, 2

Surgical Technique

Basic Wedge Excision

• A central wedge or V-shaped segment is excised from the most prominent portion of each labium minus, typically where maximal protrusion occurs 2
• The excision preserves the natural labial edge, maintaining the darker pigmented border that would otherwise be lost with traditional edge trimming techniques 1, 2
• The depth of resection extends through the full thickness of the labial tissue 2

Extended V-Plasty Modification

• The outer portion of the V excision is commonly curved lateral and anterior to simultaneously address redundant lateral labium and excess lateral clitoral hood tissue 2
• This "hockey-stick" design extension allows concomitant clitoral hood reduction in the same procedure, which is needed in approximately 44% of labiaplasty cases 3, 2
• The extended approach addresses both labial and hood excess through a single continuous excision pattern 2

Closure Technique

• After wedge removal, the superior and inferior edges are approximated with sutures 1, 2
• The closure creates a vertical scar line rather than the scalloped edge scarring seen with traditional edge trimming 4
• Suturing restores normal anatomic contours while maintaining the natural labial border 2

Key Advantages Over Edge Trimming

• Preservation of the natural pigmented labial edge prevents the unnatural appearance and wide scars associated with traditional longitudinal resection 1, 4
• The technique avoids abrupt termination and distortion of the clitoral hood at its normal junctions with the clitoral frenula 4
• Lower revision rates (2.9%) compared to edge trimming techniques that often require reconstruction 2, 4
• High patient satisfaction scores averaging 9.2 out of 10, with 98% of patients reporting they would undergo the procedure again 2

Clinical Outcomes

• Procedure duration ranges from 30-60 minutes 3
• Significant complication rates remain low at approximately 4% 2
• Patients report improvement in self-esteem (93%), sex life (71%), and physical discomfort (95%) 2
• The technique can be performed bilaterally in 97% of cases 3

Important Surgical Considerations

• Always assess and address clitoral hood excess during the initial consultation, as many patients focus solely on labial concerns but later recognize hood excess contributed to their dissatisfaction 3
• When extended central wedge is used, it can limit the extent of clitoral hood resection possible; edge resection techniques may be preferable when significant horizontal hood excess exists 3
• For patients ages 13-63 years, the technique demonstrates consistent safety and efficacy across age groups 2