(1) Some scholars have measured the labia minora of Chinese women and reported that the length is (30.05±6.75)mm on the left side and (29.67±6.79)mm on the right side, and the width is (9.91±2.95)mm on the left side and (10.20±2.95)mm on the right side, according to which we can understand the normal range and use it as a reference for the size of labia minora after repair. The size of the labia minora after repair can be used as a reference indicator. We believe that it is better to use the basal width instead of the length and the height instead of the width to describe it clinically, because the labia minora is a lip-like protrusion attached on one side and free on the other three sides, which is usually wrinkled, so it is easier to use the basal width and height, and the length of the free edge to describe it. (2) Observe the position, shape, and accumulation of labia minora in their natural state. Easily stretch the wrinkled labia minora, observe and record the general shape of the hypertrophied labia minora, and determine the degree of tissue hyperplasia and hypertrophy of the labia minora. To facilitate the design, the anterior point of the labia minora base (i.e. the transition point between the labia minora and the clitoral ligament) and the posterior point of the labia minora base (i.e. the transition point between the labia minora and the posterior union of the labia) are roughly determined, connecting the above two points as the labia minora base line, and the distance between the two points is the labia minora base width. (3) If the actual measurement of the labia minora base width is 40mm and the expected height of the labia minora after plastic surgery is 15mm as an example, briefly describe the design process. The length of the free edge of the labia minora after plastic surgery is about 60 mm, and this value is divided by 2, which is 30 mm. The two points are marked at 30 mm from the anterior and posterior points of the labia minora base along the free edge of the labia minora respectively, and these two points are the suture docking points where the free edges of the labia minora meet after reduction. Take 1/3 of the expected height of the labia minora of 15mm, i.e. 5mm, and make two rectangular flaps on one side of the labia minora starting from the above two points. These two rectangular flaps need to form an inlay when suturing, so the direction of the two flaps is opposite. The two lines can be straight lines or curved lines with certain curvature in order to make the length of the two lines close to each other. The curved surfaces of the two curves are in the same direction, which is conducive to suturing together. The same method is used for the design of the incision on the other side of the labia minora, with the difference that the formation direction of the two rectangular flaps is opposite to that of the other side, in order to avoid overlapping of the incision sutures on the inner and outer sides of the labia minora. At this point, the tissue far from the above incision line was determined to be the labia minora planned to be removed. 2. Clinical data: From March 2005 to September 2007, 11 patients underwent labia minora reduction using this procedure. The patients were aged 20 to 37 years, all with bilateral hypertrophy, and four of them were cyclists. Patients were placed in a bladder truncated position, disinfected and laid out as usual, and first anesthetized with sacral anesthesia or with local infiltration. A suture was first used to close one stitch above and below the free margin, and the thread was left for traction. According to the original incision marker, a lateral rectangular flap was first incised, and the distal point of the incision of the rectangular flap was temporarily approached and sutured, and the amount of excess tissue between the original incision design lines was observed, and the direction and curvature of the two lines were appropriately corrected and incised along the lines. The same method was used to do the excision of the other side. The trauma was thoroughly hemostatic, and obvious bleeding points were hemostatic with ligatures. With 0/6 absorbable sutures, the rectangular flap is closed first with several stitches of mattress suture on the free edge of the labia minora. Contralateral labia minora reduction was performed in the same way. After the operation, the patient was asked to rest in bed for several days and wash the area with 0.5% iodine volt after each urination, and the stitches were removed after ten days. 3. Results: All cases went smoothly after surgery, and the incision healed well. After 11 months to 3 years of postoperative follow-up (outpatient follow-up in 7 cases and telephone follow-up in 4 cases), it was found that the patients were satisfied with the shape and size of the labia minora after surgery, the free edge of the labia minora had a natural curvature, and there was no obvious color difference between the two sides of the incision. Most of the cyclists resumed normal training one month after surgery, and the original symptoms disappeared. 4. Discussion: (1) The awareness of female vulva morphology and sensory aesthetics is rapidly increasing among young women in recent years, and some labia minora hypertrophy without clinical symptoms also seek for plastic surgery. Female cyclists with labia minora hypertrophy caused by long-term abrasion and local irritation account for a certain proportion of the cases in this group, and the incidence is known to be quite common among teammates upon inquiry. For the plastic treatment of labia minora hypertrophy, there are various designs to choose from, such as linear excision and suture, marginal “W” excision and plastic surgery, “wedge” excision and central de-epithelialization and suture, and some scholars have made a comprehensive review of the above surgical procedures. In 2004, Giraldo et al. proposed a new procedure: central wedge excision with Z” reshaping, which, as we learned during the subsequent application, has the advantage of non-linear incision than the previous wedge excision, and is less likely to produce linear scars. It is less likely to produce linear scars and contractures, and the revised labia minora is more natural and simple to design. (2) In the actual application of Giraldo’s procedure, we also found some disadvantages: for example, according to the Z-shaped design, the trimmed labia minora often retains too much height, and it is easy to present a semi-garden shape, which is far from the natural lip-like appearance; the Z-shaped design with full-thickness layer incision is simpler to suture, but the incisions on the inner and outer sides of the labia minora are completely overlapped, which is easy to have local adhesions and lead to labia minora When Giraldo et al. introduced the surgical incision design, they only proposed a reference template without specifying the design basis, giving a practice based on experience, which is not easy for beginners to understand and master. For this reason, we have made some improvements: (1) a design value and steps that can be used more generally are clearly proposed, according to which operability is strong; (2) instead of the standard 90º Z-shaped incision, the incision is a combination of a small talar flap with a long oblique incision; (3) the incisions on the inner and outer sides are designed separately, with similar morphology in opposite directions, and the final incision sutures on the inner and outer sides do not overlap. (3) The key points of the improved surgical design and operation: ① The length of the free edge of the labia minora after revision is about 60 mm, based on the standard of 35 mm~40 mm in width and 15 mm~20 mm in height, with the above mentioned values as reference, which can be appropriately adjusted in combination with the patient’s specific situation; ② In principle, the designed side length of the rectangular flap should not be less than 5 mm, otherwise the shape of the rectangular flap will be lost under the pulling force after suturing. The shape of the rectangular flap is lost. In the design and incision of two rectangular flaps in one plane, they can be appropriately shifted in one direction so that the suture incisions on both sides of the face that meet the free edge are not easily overlapped. (3) When suturing the free edge of the labia minora, several stitches of mattress suture are made, which can avoid postoperative incision-like deformity of the free edge. (4) Advantages of the improved procedure: ① Clear fixed points, regular design, easy to grasp, wide indications, and applicable to different degrees of labia minora hypertrophy. ② The suture incision lines on the inner and outer sides of the labia minora do not overlap, which is conducive to incision healing and less likely to produce deformation caused by contraction of the incision scar; ③ The integrity of the free edge tissue near the base of the labia minora is preserved, the nerve endings of the most sensitive part are not damaged, and the sensory function of the reduced labia minora is more normal; ④ The free edge of the labia minora after plastic surgery still has color difference, but it is closer, has a natural appearance, and is less likely to have ⑤ No matter how serious the degree of hypertrophy is, the preserved labia minora tissues or rectangular flaps have sufficient blood supply and no ischemic changes will occur.