Female cosmetic genital surgery is rapidly gaining popularity. Patient demand is increasing, and female cosmetic genital surgery is becoming a subspecialty of plastic surgery. Two predominant techniques exist in labia minora reduction: edge trim and wedge resection. Dr. Hamori prefers the wedge resection for most clinical situations. This video vignette clearly describes aesthetic analysis, marking, and technical execution for an extended wedge procedure. Patient safety and the management of patient expectations are emphasized.