case_images: PMC11328592_01
case_images: (A) Pre operative vulva's aspect with flap markings. (B) Associated schema : absence of right labia minora.
case_images: ICRP_A_2387032_F0001_C.jpg
case_images: PMC11328592_01_ICRP_A_2387032_F0001_C.jpg
case_images: F0001
case_images: In the first operation, we performed the labia minora sharing flap and exploring of eventual remnants of the previously debrided clitoris (Figures 1(A,B) and 2(C,D)).
case_images: (E) Posterior leaflet. (F) Associated schema: posterior leaflet sutured to inner margin of right defect.
case_images: ICRP_A_2387032_F0003_C.jpg
case_images: PMC11328592_01_ICRP_A_2387032_F0003_C.jpg
case_images: F0003
case_images: The posterior layer was then sutured to the inner margin of the right defect with separate stitches of Vicryl 4/0 followed by an intradermal suture of Monocryl 4/0 (Figure 3(E,F)).
case_images: (G) Anterior leaflet. Silicone rod placed behind labia bridge before applying a padded dressing, to allow easier discharge of secretions. Separate stitches with 2/0 silk placed cranially and caudally to the clitoris. (H) Associated schema: anterior leaflet sutured to outer margin of right defect.
case_images: ICRP_A_2387032_F0004_C.jpg
case_images: PMC11328592_01_ICRP_A_2387032_F0004_C.jpg
case_images: F0004
case_images: Two separate stitches with 2/0 silk were placed cranially and caudally to the clitoris, and a silicone rod was placed behind the labia bridge before applying a padded dressing, to allow easier discharge of secretions (Figure 4(G,H)).
case_images: (I) Second Part of the reconstruction with the division of the new labia minora. Pre operative vulva's aspect. (J) Definitive incision from new lateral border to have two labia minora of similar size. (K) Associated schema: definitive incision.
case_images: ICRP_A_2387032_F0005_C.jpg
case_images: PMC11328592_01_ICRP_A_2387032_F0005_C.jpg
case_images: F0005
case_images: With the patient in lithotomy position, we planned the definitive incision, about 12 mm from the new lateral border to have two labia minora of similar size (between 12 and 14 mm in width) (Figure 5(I-K)).
case_images: (L,M) The patient received intravenous ICG, and we could evaluate flap perfusion intraoperatively. Such imaging allows for precise vascularization monitoring and could be particularly useful when adopting splitting pedicle techniques, early detecting any potential vascular flap impairment.
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case_images: PMC11328592_01_ICRP_A_2387032_F0006_B.jpg
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case_images: The two separated labia showed to be perfectly vascularized clinically and after indocyanine green fluoroscopy (Figure 6(L,M)).
case_images: (N) Final result one year post op after labia majora fat grafting. (O) Associated schema: two separated labia minora.
case_images: ICRP_A_2387032_F0007_C.jpg
case_images: PMC11328592_01_ICRP_A_2387032_F0007_C.jpg
case_images: F0007