When and how Vaginoplasty
There has been a long debate inside the scientific community about when It’s indicated to perform female genital surgery.
It has been started years ago in the U.S.A. and South America but in the last years It has become widespread also in Europe. Deformities of the external genitalia from birth defects, cancer surgery, female “circumcision”, intersex and trauma are candidates of reconstruction with real improvement and satisfaction. A team network made by the plastic surgeon, gynaecologist, urologist and psychologist is usually firmly recommended.
It’s a reconstructive plastic surgery and cosmetic procedure to tighten vaginal muscles that after childbirth have lost the previous characteristics. Many women find that while the experience of childbirth may be the most rewarding of their lives, sometimes the after effects for both their sexual partner and themselves is not as satisfying as before. Also called “vagina rejuvanation” It improves the muscular tone and sexual feelings. It’s usually performed in 30-40 minutes under sedation or general anesthesia with recovery from activities of daily living in a few days and from sexual actitives in 4-6 weeks. Rare complications are bleeding, infections and anomalous scarring.
Recently a lipostructure using autologous fat tissue has been introduced. This procedure combines liposuction, fat tissue processing and fat tissue transplantation under the mucosal layer. The technique of autologous fat-graft injection to the vagina is applied also for “vagina rejuvenation”. The careful harvesting and processing (usually centrifuge) of the predetermined volume with mature adipocyte tissue is topical. Autologous fat is then injected using blunt cannulas in small aliquots to the submucosal layer. This technique allows the transplanted fat tissue to remain viable in the vagina, but due to the 50% of resorption a secondary procedure may be required.
The labia minora can be asymmetric or overdeveloped leading to an impairment in wearing tight pants or during sports activities. The effective solution to the problem is represented by an operation: the labiaplasty.
The reductive labiaplasty is a remodelling by a direct edge resection technique or by a flap technique which produces a refined surgical scar that is less tethered and diminishes the physical tensions exterted upon the surgical-incisionwound, reduceing the likelihood of a notched scar. The surgical procedure is performed under local or general anesthesia in 30-40 minutes with a complete recovery from activities of daily living in a few days and sexual activities in 4-6 weeks. Rare complications are bleeding, infections and anomalous scarring.
CLITORAL HOOD REDUCTION
Excess skin on the sides of the clitoris causes a prominent clitoris and may interfere in sexual intercourse. By excising the extra folds of skin of the clitoris or lateral to the clitoris the procedure will give a more aesthetic appearance preserving the small sensory nerves. It’s performed in 20-40 minutes under sedation or general anesthesia with a complete recovery from activities of daily living in a few days and sexual activities in 2-3 weeks.
It’s a reconstruction of the hymen by a precise incision of the hymen remnants of the hymeneal ring bringing them into close approximation to allow delicate sutures to hold the tissues in place and recreate the hymen to a “pre-sexual” state, either for culture or religion.
RECONSTRUCTION OF THE PROMINENT PUBIS
Removal of fat from the pubis is a typical indication for genital rejuvenation. Any weigth loss, aging or marked obesity cause a prominent or loose pubis. A liposuction or mini-abdominoplasty or complete abdominoplasty represent the most effective solutions.
It’s the physical or psychological condition that affects a woman’s ability to engage any form of vaginal penetration, including sexual intercourse. Many psychological or anatomic reasons induce a muscular spasm. The Botulinum Toxin, injected inside the vaginal mucosa, relaxes the small muscles resulting in a reduction of symptoms. A contemporary psychological support is recommended
OTHER CONDITIONS WHEN PLASTIC SURGERY MAY BE HELPFUL
Plastic reconstruction may be helpful in patients with functional or post-surgical impairment
A few examples:
-vulvar or vaginal reconstruction after oncologic excision;
-vaginoplasty after childbirth to reduce the size of the opening
-lipostructure to correct mucosal atrophic conditions