Labiaplasty is a cosmetic procedure for natal women to reduce redundant floppy labia minora and at times a drooping clitoral hood, and in transgender patients to produce or refine labia already created.
Most American women seem to prefer labia minora that are not excessively large because of protuberance and chaffing problems. Labia minora normally have a mucosal pink inner side and an outer pigmented or epidermal side. They are generally confluent with the sides of the clitoral hood. When approaching a natal female it is important to identify exactly their goals. Equally important is to pre-mark before injection of local anesthesia as anesthetic injections always swell and distort tissue. So called arc plasties done at the area of greater width may leave a scar in the mid section where the radii of the incision are made and approximated. I prefer a smooth trim along the border from end to end with modification as needed. For transgendered in the Orient, labia are made from penile skin and to my judgement seem a little floppy. We like to use penile skin to create a vaginal vault as the nerve endings remain intact. This versus a scrotal graft which has no continuity of nerve fibers.
Tension on the posterior commissure usually creates a refined labia minora appearance.