First of all, click the link and go watch my April 17, 2024 video “The Barbie Look Labiaplasty for the Lay Public” to get a well rounded education on my labiaplasty techniques I have taught worldwide since 2005. It is by far the BEST Labiaplasty Education video for the general and lay public. It is 32 minutes long, detailed, and excellent. That newsletter has all the PowerPoint slides shown and explained.

I wrote this over a year and a half ago and it still applies today:

“Finally finished! Only took me 20 years to get all this content together and compacted into 30 minutes. My life’s work. My treatise on labiaplasty surgery. I dedicate this to all the women out there who have suffered pain and discomfort, humiliation and shame, embarrassment and ridicule. Quit listening to the naysayers that you just have to live with it. You have lots of choices now. Second chances are a blessing. Go grab it!

This Feminine Wellness Newsletter is more specifically diving into who the best candidates are for my Barbie Look Labiaplasty. Barbie Look is NOT for everyone.”

Exploring Labiaplasty Techniques: The Perfect Fit for Your Anatomy and Desires

Welcome to this special edition of my Feminine Wellness Newsletter, where I dive into the world of labiaplasty choices. I invented the Barbie Look and Hybrid Look Labiaplasty in Laguna Beach, California, in 2005, and have taught my methods globally, with emphasis on precision radiofrequency surgery for minimal scarring and optimal results.

In this issue, we'll break down how to choose the right labiaplasty technique based on your unique anatomy (like the size, shape, and pigmentation of your labia minora and majora) and personal desires (whether you want a dramatic change, natural preservation, or something in between). We'll start with the Big Picture: Linear Excision versus Wedge Excision. Then, we'll zoom in on linear excision options, including my signature looks—Barbie, Hybrid, and Simple Trim—to help you decide what's best for you. Remember, this is educational content; always consult a Cosmetic Gynecology Specific Board-Certified Specialist for personalized advice.

Step 1: Linear Excision vs. Wedge Excision—Which Base Technique Fits Your Needs?

Labiaplasty primarily addresses the labia minora (inner lips), which can become enlarged due to genetics, hormones, childbirth, or aging, causing discomfort during activities like exercise, sex, or wearing tight clothing. The two main techniques are Linear Excision (also called Trim) and Wedge Excision. Both aim to reduce length, create symmetry, and tuck the labia minora within the labia majora (outer lips), but they differ in approach, outcomes, and ideal candidates.

Linear Excision (Trim Technique): The Straightforward Edge Remover

This method involves a curved or straight incision along the outer edge of the labia minora to trim away excess tissue, often following the natural contour for a "Curvilinear" result. It's like sculpting the edges to shorten and thin the labia while removing pigmented or thickened borders. I use radiofrequency energy in most cases for precise cutting and sealing, minimize bleeding, swelling, and scarring—key for my advanced variants.

Pros:

- Safer healing with lower risk of wound separation or Swiss Cheese Holes

- Excellent for addressing pigmentation issues, as it removes the darker outer edges, resulting in uniform, lighter-colored labia.

- Highly customizable for asymmetry—surgeons can adjust the amount removed on each side independently. So much more choice and options on how much to remove.

- Versatile for dramatic or subtle changes, making it ideal for aesthetic goals like a "petite" or streamlined look.

Cons:

- The straight or curved edge may look less "natural" if not done artistically and not following the natural curves of the labia potentially creating a more uniform but less contoured appearance. It can look “Too Plastic.”

- Scalloped edges if sutured too tightly

- In most cases, Linear Excision will require a companion clitoral hood reduction if the hood appears prominent post-surgery. You have to avoid the “Top Heavy” look that can occur of you leave the top clitoral hood alone and then dramatically trim down the middle and bottom labia minora.

Who Should Get Linear Excision?

Opt for this if your anatomy includes uneven pigmentation, thickened edges, or significant asymmetry that needs targeted removal. It's best for patients desiring a cleaner, more uniform aesthetic—think women who want to eliminate dark borders or achieve a "hidden" look without preserving the original edge texture. Functionally, it's great for those with irritation from rubbing or pulling, especially if you prioritize quicker recovery and minimal complications. Athletes or active individuals often favor it for its reliability in high-movement lifestyles. Swimmers, bikers, horseback riders, volleyball and tennis players are examples. If your labia majora are fuller, linear excision ensures the minora stay tucked away seamlessly. The chance of having Swiss Cheese Holes is less than 1%.

Wedge Excision: The Natural Contour Preserver

This technique removes a V- or wedge-shaped piece of tissue from the widest part of the labia minora, then stitches the edges together to shorten without altering the outer border. It can be more complex and involving advanced modifications like Z-plasty for better blood flow and reduced tension. Variants include Central Wedge Excision, Superior and Inferior Wedge Excision.

Pros:

- Preserves the natural ruffled edge, color, and contour of the labia, leading to a more "original" appearance that blends seamlessly with the clitoral hood. In my personal practice and in clinical research done by highly respected friends of mine, only a very small percent of women actually want to keep that ruffled and dark edge. Only about 4-6% of women wanting labiaplasty want to keep the original edges. About 94-96% of them want those darker edges removed and made smoother. This is the perfect choice for women who want to keep that original edge appearance.

- Scarring can be less visible once healed in many but some may continue to have a pale white line at the site of suturing.

- Effective for reducing length without changing the labia's overall texture, can be ideal for subtle functional improvements. Most wanting labiaplasty are not looking for a subtle change and seek more dramatic changes.

Cons:

- Higher Tension on the closure site pulling the wedge edges apart, with a significant risk of dehiscence (wound reopening), Pac Man Breakdown, or Swiss Cheese Holes. In the very best of hands this wound breakdown rate averages 10-20%. Compare that to less than 1% Swiss Cheese holes and less than 5% dehiscence when the Linear Labiaplasty is done.

- Doesn't address pigmentation well—if your edges are dark or irregular, they remain. You keep those dark and ruffled or irregular edges.

- Can be more technically demanding, so outcomes vary by surgeon experience; poor execution can lead to bunching or narrowing or dehiscence and Swiss Cheese Holes. The dreaded Pack Man Look happens 10-20% of the time.

Who Should Get Wedge Excision?

This is ideal if your anatomy features a naturally pretty edge you want to keep, with hypertrophy mainly in the inner width rather than the borders. Choose it if your desires lean toward maximal preservation of your innate look—women who value a "seamless, untouched" aesthetic or have minimal pigmentation concerns. It's particularly suited for those with pain from labial hypertrophy but who prioritize natural contours over color uniformity. Avoid it if you have very redundant tissue, as it may not remove enough for dramatic results.

Key Decision Factors: Anatomy (e.g., edge quality, majora fullness) and desires (dramatic vs. natural) guide the choice. A 2021 survey showed curvilinear (trim variant) as the most common (52.7%), followed by wedge (36.1%), reflecting its versatility. In speaking with the most renown and exceptional labiaplasty surgeons around the world (pr