The "Y technique": Redefining the Surgical Approach to Combined Labia Minora and Clitoral Prepuce Reduction.

INTRODUCTION

Labiaplasty is the most frequently performed female genital cosmetic surgery worldwide, with indications extending beyond aesthetics to functional and psychosocial concerns. Labia minora elongation is frequently accompanied by clitoral prepuce prominence, yet this remains overlooked in surgical planning. This study describes a surgical technique integrating labia minora reduction with clitoral prepuce contouring and reports outcomes in a retrospective cohort.

METHODS

Women who underwent labiaplasty between 2018 and 2023 were contacted, and 132 of 185 (71.3%) returned anonymous questionnaires addressing motivations, perioperative experience, satisfaction, self-esteem, body image, and sexual function. The procedure was performed predominantly in an outpatient setting under local anesthesia. Excision and hemostasis were performed using the Fraxx System with ultrafine cutting and bipolar tips.

RESULTS

The "Y technique" was employed in 103 cases, particularly when clitoral prepuce prominence accompanied labia minora elongation. In the remaining 29, labiaplasty was performed without prepuce correction or with an alternative technique. Motivations included dissatisfaction with aesthetics, discomfort, and embarrassment; over one-third reported all three. The perioperative experience was favorable, with most patients reporting the procedure as less painful and more tolerable than expected. No major complications occurred; postoperative effects included minor wound dehiscence and occasional requests for aesthetic revision procedures. Patients reported significant reductions in dissatisfaction with genital appearance.

CONCLUSIONS

Outpatient labiaplasty under local anesthesia is safe, feasible, and well accepted, offering privacy and comfort. The "Y technique" adds value by being simple, reproducible, and delivering excellent functional, psychosocial, and aesthetic outcomes through simultaneous correction of labial and clitoral prepuce prominence.