Many women complain about the size of their labia. There are various procedures that can be performed to reduce the size of the labia. This includes using excision patterns that can employ trimming the edges of the labia, performing a wedge excision, a z-plasty excision, or using de-epithelization techniques. These techniques can be performed as an outpatient and performed under local anesthesia with or without sedation. The various techniques have pros and cons. Most of the time I prefer to use a wedge excision using a z-plasty technique to maintain the appearance of the labial border, but at the same time reducing the size of the labia.