The DOVE Surgery Technique vs Trim vs Wedge Labiaplasty

Labiaplasty may be performed using different operative techniques. Dr Georgina Konrat invented and developed the DOVE Surgery Technique for labiaplasty (Double Offset V-Plasty with Extended De-epithelialisation), officially published in the Journal of Cosmetic Surgery and Medicine in 2012. This article describes the operative design of trim, wedge and the DOVE Surgery Technique. It does not establish that one technique produces a better individual result. The labiaplasty anatomy guide explains the structures discussed below.

In short: Trim labiaplasty removes tissue along the labial edge. Wedge labiaplasty removes a V-shaped section through the labial tissue. The DOVE Surgery Technique uses superficial dissection within the outer tissue layers and places the closure within the body of the labia. These descriptions do not predict sensation, blood supply, healing, scarring, symmetry or appearance. Technique selection depends on individual assessment. The DOVE Surgery Technique is performed exclusively by Dr Konrat.

The Three Techniques at a Glance

Trim Labiaplasty

In a trim approach, tissue is removed along the edge of the labia minora and the resulting edges are sutured together. The suture line sits along what becomes the new labial edge.

Design features and limitations:

• Removes the natural labial border, including the pigmentation gradient
• Places the scar along the visible edge
• Involves full-thickness tissue removal
• Carries risks including bleeding, infection, scarring, asymmetry, altered sensation, wound problems and over-resection

Whether a trim approach is appropriate depends on the individual anatomy, concerns and clinical assessment.

Wedge Labiaplasty

The wedge technique was described by Dr Gary Alter in 1998 and became the most published alternative to trim during the 2000s. A V-shaped wedge of tissue is cut out of the middle of the labia — full thickness, from outer surface to inner surface — and the two remaining edges are brought together and sutured.

Design features and limitations:

• Avoids removing the full length of the labial edge
• Places a transverse closure within the body of the labia
• Involves a full-thickness wedge incision
• Carries risks including bleeding, infection, scarring, asymmetry, altered sensation, wound separation and notching

Whether a wedge approach is appropriate depends on the individual anatomy, concerns and clinical assessment.

The DOVE Surgery Technique

DOVE stands for Double Offset V-Plasty with Extended De-epithelialisation. The technique uses superficial dissection within the outer tissue layers rather than the full-thickness excision described above.

What the DOVE Surgery Technique does:

1. The outer skin layer is removed (de-epithelialised) over a defined area, rather than a strip of full-thickness tissue being cut away
2. Dissection is planned within the superficial tissue layers
3. The underlying tissue is folded and sutured into its new shape
4. The closure is placed within the body of the labia rather than along the visible edge

These design features do not establish that blood supply, nerves, sensation, pigmentation or appearance will remain unchanged. The DOVE Surgery Technique carries the general risks of labiaplasty and risks specific to the individual procedure plan.

Practical implications:

Because the DOVE Surgery Technique uses superficial dissection rather than full-thickness cutting, local anaesthetic with sedation may be considered for some patients. Local and general anaesthesia have different risks, monitoring and recovery requirements, and the appropriate option depends on the individual plan. The Australian and New Zealand College of Anaesthetists (ANZCA) publishes patient information about local, regional and general anaesthesia.

Which Technique Is Right For You?

There is no single technique that is appropriate for every patient. Technique selection should be based on:

• The individual patient's anatomy
• The clinical goal of the procedure
• The doctor's training, scope and experience with the proposed technique
• Whether full-thickness reduction is clinically required or whether superficial reshaping is sufficient

The appropriate technique can only be discussed after individual assessment. The doctor should explain the proposed tissue changes, alternatives, limitations and material risks. No technique assures a particular result.

Risks Common to All Three Techniques

Regardless of technique, all labiaplasty procedures carry risks, including:

• Bleeding
• Infection
• Scarring (visible or thickened)
• Asymmetry
• Wound dehiscence (the wound separating during healing)
• Altered sensation, which may be temporary or permanent
• The possibility of requiring revision surgery

These risks vary in likelihood and severity between techniques and between individual patients. They are discussed in detail at the consultation. Individual results may vary. Labiaplasty is not suitable for everyone.

Booking a Consultation

To discuss whether labiaplasty may be appropriate for your individual anatomy, book an initial consultation. A GP referral is required for the first consultation and may be brought or supplied at the appointment; it is not required before booking. At least two consultations are required, including at least one in person with the doctor who would perform the surgery. After the two consultations and informed consent, a minimum seven-day cooling-off period applies before surgery can be booked or a deposit paid, as set out in the Medical Board of Australia's cosmetic surgery guidance.

Book via the Book Online page or call 02 9188 1949.

Related Reading

• What Is the DOVE Surgery Technique?
• DOVE Surgery Technique — full procedure page
• Trim vs Wedge Labiaplasty
• Who invented the DOVE Surgery Technique?