Aesthetic Reconstruction of the Interlabial Sulcus: from Anatomical Rediscovery to Surgical Approach
In brief
Interlabial sulcus reconstruction raised satisfaction without more complications
In a retrospective study of 274 patients with an absent interlabial sulcus, satisfaction was higher among the 109 who had reconstruction than among those who had conventional surgery. The technique added about 20 minutes to surgery without a detected increase in complications, but the nonrandomized design leaves its comparative benefit uncertain.
- Journal
- Plastic and reconstructive surgery (Q1)
- Published
- 29 October 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Guojing Chang, Donghao Jia, Lan Ge, Yuanbo Kang, Xinran Zhang, Dian Wang, et al.
- PMID
- 42967489
- DOI
- 10.1097/PRS.0000000000013581
Why clinicians should know about it
- Picked for Anatomy (paper of the day, 4 November 2026): Perineal anatomy findings directly inform vulvar surgical reconstruction
Abstract
BACKGROUND: To explore the anatomy of the interlabial sulcus and introduce a simple surgical technique for its reconstruction, and evaluate its efficacy and safety. METHODS: Anatomical (macroscopic and microscopic) analysis was performed on 18 hemi-perineum specimens. A total of 723 patients undergoing labiaplasty between January 2016 and December 2024 was retrospectively reviewed. Among 315 patients who had composite labia minora and lateral clitoral hood reduction, 274 were identified with an absent interlabial sulcus and were the focus of this study. Of these, 109 patients (198 sides) underwent the four-step sulcal reconstruction (Group 1), while 165 patients (299 sides) received conventional surgery without reconstruction (Group 2). Operative duration and complications were recorded. Satisfaction questionnaires via the Female Genital Self-Image Scale (FGSIS) were completed during follow-up either in the outpatient clinic or online. RESULTS: Macroscopic examination reveals a clear demarcation between the labia majora and labia minora. Microscopic analysis showed that collagen and smooth muscle fibers at the interlabial sulcus exhibited a disordered, interwoven pattern. The sulcal reconstruction prolonged operative time by approximately 20 minutes (p < 0.05), but did not increase complications (p=0.52). Patients in the reconstruction group reported higher satisfaction compared to those without reconstruction (p < 0.05). CONCLUSIONS: Anatomical study indicates a distinct tissue boundary at the interlabial sulcus, accompanied by a localized alteration in fiber architecture. The four-step reconstruction technique proved safe and effective, with satisfactory outcomes. Given its advantages of simple steps and natural aesthetic outcomes, this approach holds promising potential for application in vulvar aesthetic surgery.Level of Evidence: IV.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.