Objective To analyze the effect of extended central wedge excision on incision healing and genital appearance satisfaction in patients with labia minora combined with clitoral hood hypertrophy. Methods A total of 40 patients with labia minora combined with clitoral hood hypertrophy admitted to Chengdu Wuhou Mi'ai Angel Medical Beauty Hospital from January 2024 to January 2025 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 20 patients in each group. The control group was treated with modified arc excision, and the observation group was treated with extended central wedge excision. The incision healing, genital appearance satisfaction and complication rate were compared between the two groups. Results The primary healing rate of the observation group was higher than that of the control group, and the secondary healing rate was lower than that of the control group (P<0.05). The GAS score of the two groups at 3 months after surgery was lower than that before surgery (P<0.05), but there was no significant difference in GAS scores between the two groups at 3 months after surgery (P >0.05). The GAS score of the two groups at 6 months after surgery was lower than that before surgery and 3 months after surgery, and that of the observation group was lower than that of the control group (P <0.05). The incidence of complications in the observation group (10.00%) was lower than that in the control group (30.00%) (P<0.05). Conclusion Extended central wedge excision in patients with labia minora combined with clitoral hood hypertrophy can effectively improve incision healing, help to improve genital appearance satisfaction, and the risk of complications is low, which is worthy of clinical application.