Table 1.

Clinical and Surgical Pearls and Pitfalls of Edge Labiaplasty with Clitoral Hood Reduction

Clinical and Surgical Pearls	Pitfall/Outcome
Observe and discuss the implications of a large or long clitoris, or a wide gap between the labia majora	A simple cleft outcome for the labia majora is not always possible
Inquire about a patient’s history/frequency of yeast infections	Postoperative antifungal medication should be taken routinely in people with chronic, recurrent yeast infections
Avoid postoperative antibiotics and use baby shampoo to prep the vulva	Antibiotics and antibacterial skin preparations (eg, betadine) can result in yeast infections
Leave a 1-cm bridge over the dorsal clitoral hood	This avoids over-exposure of the clitoral body, which can lead to persistent sensitivity
Carefully incise around the clitoral frenulum	A sharp right-angle resection may cause neuroma formation at the clitoral frenulum. This is more likely when the native frenulum takeoff angle is more acute
Identify and cauterize the posterior labial arteries	Failure to do so will lead to postoperative hematoma formation
Running subcuticular sutures improve postoperative aesthetic outcomes	Simple running sutures will result in track marks, channels, ridges, and sinuses due to swelling and strangulation
The junction between the hood and minora excisions can present technical challenges	Debulk the submucosa at the junction of the hood and labia ellipses and place a key suture at the offset-Y to facilitate alignment and closure
The labia minora must not be pulled when resecting, and should not be cut straight, especially with scissors	A tension or straight cut will result in a scalloped, over-resected, concave central curve, the inverse of the desired ogee curve, or convex S-curve