Dr. Reed, My clitoris seems to be somewhat larger than normal. I can send you some photos, and if you agree, can this be easily reduced without loss of sensitivity.
I have received your photos and concur. Our approach is to reduce the clitoris from the underside avoiding the nerves. (so called ventral clitoroplasty reduction). For girth we can take out a wedge of tissue and for an overly long clitoris we have reduced length. The reasons for clitoral enlargement include normal variation, perhaps androgen effects during gestation, steroid usage which I have seen in professional female athletes. This is a well understood procedure and has been reported with successful outcome in the literature. Below is a pre-op photo of one of our patients who required also a hood reduction and labiaplasty.
|The attachment of the clitoris to the pubic arch should not be disrupted|
|Dorsal neurovascular bundles should be preserved. There may be significant lateral branches along the corporal tissue|
|The neurovascular bundles branch distally in a fan fashion toward the glands clitoris|
|Reduction of the clitoral erectile tissue is better achieved with a ventral incision along the urethral plate|
|The urethra and vagina should not be separated|
|Dissection of the bladder from the uterus below the bladder neck should be avoided|
|Using labial and clitoral skin to cover the new introitus is more physiological than rotational skin flaps from the buttocks and perineum (with credit to Dr. Lisandro Piaggio)|