title: A Cadaveric Study of the Arterial Blood Supply of the Labia Minora.
abstract: BACKGROUND
  Labiaplasty has become a rather common operation. The main complication of the different surgical techniques is the dehiscence of the suture line. The dehiscence rate varies among the different techniques, and this may imply that the vascular anatomy is not respected in some cases. The detailed arterial anatomy of labia minora is not well described, so the aim of the authors was to describe this anatomy with a cadaveric study.
  
  
  METHODS
  Eleven fresh cadavers were dissected, and arterial study was made with injected computed tomography scans and rotational angiography. At the end, a cast of the arterial network was made and chemically exposed to verify the radiological findings.
  
  
  RESULTS
  The findings of this study allowed identification of a dominant central artery that was named "C" artery, two posterior arteries named "P1" and "P2," and one small anterior artery, "A." Furthermore, a connection between the anterior system of the external pudendal artery and the posterior system of the internal pudendal artery was confirmed.
  
  
  CONCLUSIONS
  The arterial network of the labia minora was identified with this study. This may help surgeons orientate the wedge excision when they perform labiaplasties. More precisely, when this wedge is placed at the most anterior part of the labia minora, the least perfused area is removed, and a posterior flap is created that will preserve a robust blood perfusion.
authors.affiliation: Nice, France From the St. Roch University Hospital of Nice; and the Anatomy Laboratory of Nice's Medical School.
authors.forename: Charalambos A
authors.initials: CA
authors.lastname: Georgiou
authors.forename: Marc
authors.initials: M
authors.lastname: Benatar
authors.forename: Pierre
authors.initials: P
authors.lastname: Dumas
authors.forename: Bérengère
authors.initials: B
authors.lastname: Chignon-Sicard
authors.forename: Thierry
authors.initials: T
authors.lastname: Balaguer
authors.forename: Bernard
authors.initials: B
authors.lastname: Padovani
authors.forename: Patrick
authors.initials: P
authors.lastname: Baqué
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries; D003357:Cosmetic Techniques; D005260:Female; D056973:Four-Dimensional Computed Tomography; D006801:Humans; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000517:prevention & control; D014844:Vulva / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*
references.citation: Honoré LH, O’Hara KE. Benign enlargement of the labia minora: Report of two cases. Eur J Obstet Gynecol Reprod Biol. 1978;8:61–64
references.citation: Felicio Yde A. Labial surgery. Aesthet Surg J. 2007;27:322–328
references.citation: Mirzabeigi MN, Moore JH Jr, Mericli AF, et al. Current trends in vaginal labioplasty: A survey of plastic surgeons. Ann Plast Surg. 2012;68:125–134
references.citation: Davis CF. Cosmetic gynecology and the elusive quest for the “perfect” vagina. Obstet Gynecol. 2012;120:955
references.citation: Braun V. Female genital cosmetic surgery: A critical review of current knowledge and contemporary debates. J Womens Health (Larchmt). 2010;19:1393–1407
references.citation: Goodman MP. Female genital cosmetic and plastic surgery: A review. J Sex Med. 2011;8:1813–1825
references.citation: Colson MH. [Female cosmetic genital surgery: Point-counterpoint]. Gynecol Obstet Fertil. 2012;40:445–448
references.citation: Ellsworth WA, Rizvi M, Lypka M, et al. Techniques for labia minora reduction: An algorithmic approach. Aesthetic Plast Surg. 2010;34:105–110
references.citation: Benadiba L. [Labiaplasty: Plastic or cosmetic surgery? Indications, techniques, results and complications]. Ann Chir Plast Esthet. 2010;55:147–152
references.citation: Alter GJ. Aesthetic labia minora and clitoral hood reduction using extended central wedge resection. Plast Reconstr Surg. 2008;122:1780–1789
references.citation: Hodgkinson DJ, Hait G. Aesthetic vaginal labioplasty. Plast Reconstr Surg. 1984;74:414–416
references.citation: Alter GJ. A new technique for aesthetic labia minora reduction. Ann Plast Surg. 1998;40:287–290
references.citation: Maas SM, Hage JJ. Functional and aesthetic labia minora reduction. Plast Reconstr Surg. 2000;105:1453–1456
references.citation: Rouzier R, Louis-Sylvestre C, Paniel BJ, Haddad B. Hypertrophy of labia minora: Experience with 163 reductions. Am J Obstet Gynecol. 2000;182:35–40
references.citation: Pardo J, Solà V, Ricci P, Guilloff E. Laser labioplasty of labia minora. Int J Gynaecol Obstet. 2006;93:38–43
references.citation: Heusse JL, Cousin-Verhoest S, Aillet S, Watier E. [Refinements in the labia minor reduction procedures]. Ann Chir Plast Esthet. 2009;54:126–134
references.citation: Ginger VA, Cold CJ, Yang CC. Structure and innervation of the labia minora: More than minor skin folds. Female Pelvic Med Reconstr Surg. 2011;17:180–183
references.citation: Hwang WY, Chang TS, Sun P, Chung TH. Vaginal reconstruction using labia minora flaps in congenital total absence. Ann Plast Surg. 1985;15:534–537
references.citation: Mojallal A, Wong C, Shipkov C, et al. Redefining the vascular anatomy and clinical applications of the sartorius muscle and myocutaneous flap. Plast Reconstr Surg. 2011;127:1946–1957
references.citation: Bailey SH, Saint-Cyr M, Wong C, et al. The single dominant medial row perforator DIEP flap in breast reconstruction: Three-dimensional perforasome and clinical results. Plast Reconstr Surg. 2010;126:739–751
references.citation: Crouch NS, Deans R, Michala L, Liao LM, Creighton SM. Clinical characteristics of well women seeking labial reduction surgery: A prospective study. Br J Obstet Gynaecol. 2011;118:1507–1510