Female Genital Rejuvenation

It seems as if one of the latest trends in plastic surgery is the cosmetic enhancement of the female genital area. In fact Vaginoplasty and Labiaplasty have always been performed, as it has always been demanded, yet it was historically not talked about. Patients were embarrassed to talk about female genital surgery with others, and surgeons were not apt to promote these procedures in their practice. That has all changed now. Women are increasingly seeking aesthetic enhancement of their vulva and genital areas, much as men have done for years.

The female genital procedures can be divided into five areas where surgeries are performed;
Labia majora and Mons pubis, labiaplasty/ labioplasty (labia minora reduction), vaginoplasty, clitoral de-hooding, and hymen reconstruction.

Labia majora
are the two outermost bands of female genital tissue directly next to the thighs. The Mons pubis is the collection of fatty tissues directly over the pubic bone above the vulva. The functions of the Mons and the Labia majora are to enclose and protect the genital organs The Labia majora, as with other areas of the body, with age, weight loss or child bearing, there is a reduction in the amount of fatty tissues in these areas leading to a more wrinkled and deflated appearance. Although laser resurfacing of the labial majora has been advocated by some, my preference for rejuvenation of this area is for fat injection into the labial majora and Mons pubis in order to replenish the lost fat and to ”plump“ up the skin wrinkles. Simply removing the wrinkles still leaves the patient with a flat and abnormal looking labial majora. Like fat injection in other body parts, some of the fat may resorb after the first surgery and a repeat fat injection may need to be performed. The Mons pubis may on the other hand be too large and fatty. In such cases liposuction of the fat from the Mons can be performed to reduce its size. These procedures are performed in the office under local anesthesia as an outpatient procedure. The surgeries take 1-2 hrs. You can resume work in 1 to 2 days.

Labiaplasty
The term labiaplasty (or labioplasty) refers to the reduction in size of the Labia minora. The Labia minora are the bands of tissue on either side of the vagina that are directly inside the Labia majora. These two flaps of skin extend down from the clitoris. Hormonal changes in the body brought on by pregnancy, puberty, menopause and age, enlarge and darken the color of these tissues. Many women find these changes particularly disturbing as they are the most obvious to them and their sexual partners. In some cases the labia minora can become so large that they will interfere with sexual intercourse.
Labiaplasty is the most common of the genital rejuvenation procedures performed. Labiaplasty involves cutting away the excess tissue and closing the wound. The aim of the labiaplasty surgery is to reduce the labia minora and not to totally remove them. Labiaplasty performed in the office using a local anesthetic and takes 1 hour. The patient must refrain from sex for several weeks until the wounds are healed, but is otherwise walking directly after the surgery and has minimal discomfort.

Vaginoplasty
Vaginoplasty refers to the reduction in the size or tightening of the vagina that has become enlarged or lax following childbirth. The vagina is composed of three layers. An outermost fibrous layer that attaches it to the surrounding tissues, a muscle layer that contracts, and a redundant mucosal layer. In the vaginoplasty procedure, the aim is to reduce the volume of the vagina in the first 1-2 inches while maintaining its shape. The mucosa is removed in several locations around the vagina with care being taken not to injure or affect the urethral opening through which urine flows out. The muscle layers is then folded over itself, and the wounds closed. Vaginoplasty tightens the entrance to the vagina. In some cases another suture is placed around the vaginal opening to tighten it further. Vaginoplasty is performed under local anesthesia in the office and takes 1 hour. The patient must refrain from sex for several weeks until the wounds are healed, but is otherwise walking directly after the surgery and has minimal discomfort

Clitoral de-hooding
The clitoris is the tissue at the top of the labia minora which is involved in conveying sensations associated with sexual pleasure. There is a fold of tissue, or “hood”, which covers part of this cylinder shaped organ. In some cases, to allow for increased sexual arousal, patients request removal of the hood. This is a small but delicate procedure. It is performed under local anesthesia in the office and takes 1 hour. The cost includes the operating room fee and all of your follow up visits. The patient must refrain from sex for several weeks until the wounds are healed, but is otherwise walking directly after the surgery and has minimal discomfort.

Hymen Reconstruction
Hymenoplasty; The hymen is a thin fold of mucosa covering the opening of the vagina. This is typically associated with sexual virginity in females, and throughout history the finding of blood on the sheets of the newlyweds was a testament to the hymen no longer being intact. In many cultures the intactness of the hymen is of profound importance in cases of marriage and its lack not associated with a happy outcome. There are women that are born without a hymen and others where the fold is so thick that it must be surgically excised (imperforate hymen). The reconstruction of the hymen involves forming a fold of mucosa to cover the vaginal opening. This procedure is performed under local anesthesia in the office and takes 1 hour. The patient must refrain from sex for several weeks until the wounds are healed, but is otherwise walking directly after the surgery and has minimal discomfort.