Aesthetic vulvovaginal surgery has become the final frontier of cosmetic surgery. Accordingly, there has been an increased interest in plastic surgical procedures for the female genitalia. Labiaplasty is the most common among such procedures, and the number of practitioners and techniques has varied widely in the medical literature. This article will focus on the problems and pearls encountered by the author in treating enlargement of the labia minora and clitoral hood. The content will focus on the technical aspects of the labiaplasty surgery and ways to avoid common complications encountered during this procedure.