The central wedge labiaplasty removes a “V” or a pie-slice piece of the most protuberant portion of the labium to make it smaller. The anterior and posterior edges of the labium are reapproximated to preserve the normal labial edge and anatomy with minimal scarring. The lateral or medial-lateral clitoral hood can be reduced at the same time. The complication rate is very low if done using meticulous technique, thus avoiding the problems with alternative labiaplasty methods. The patient satisfaction level is well over 90%.