Surgical Management of Unilateral Labia Minora Hypertrophy: A Retrospective Clinical Study of Individualized
Wei Ding1, Man Fang1,2, Xing Chen3
1Department of Plastic Surgery and Cosmetic Laser Center, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, 61 JieFangXi Road, Changsha, 410008, Hunan Province, China.
Background:
Unilateral labia minora hypertrophy (ULMH) presents unique surgical challenges, primarily in achieving strict bilateral symmetry and preserving neurovascular integrity while using the contralateral normal side as a reference. Traditional techniques often fail to address the specific morphologic nuances required for individualized unilateral reconstruction.
Objectives:
This study aimed to evaluate the clinical efficacy, aesthetic outcomes, and safety of a refined surgical approach-the mucosal advancement flap combined with a de-epithelialized mucosal flap specifically tailored for ULMH.
Methods:
A retrospective review was conducted on 46 consecutive patients with ULMH treated between January 2020 and December 2025. The surgical design utilized "opposilateral reference calibration," where the dimensions and contour of the unaffected labium served as a dynamic template. Precise tissue reduction was achieved by combining superior/inferior mucosal advancement with central de-epithelialization to protect the main neurovascular bundles. Outcomes were assessed via labial width measurements, complication rates, and patient satisfaction using a 5-point Likert scale.
Results:
The mean labial width decreased significantly from 29.72±5.18 mm preoperatively to 7.78±1.75 mm at the 3-month follow-up (P<0.0001). Primary wound healing was achieved in 45 cases (97.8%), with only one case of delayed healing and no instances of hematoma, infection, or permanent sensory loss. The overall satisfaction rate was 100%, with patients reporting significant improvements in aesthetic symmetry, functional comfort, and psychosexual confidence.
Conclusions:
The individualized mucosal advancement and de-epithelialization technique is a safe and highly effective strategy for ULMH. By prioritizing anatomical mirroring and neurovascular preservation, this approach ensures superior bilateral symmetry and natural aesthetic contours.\ LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .