Female Genital Aesthetics
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Development of surgical techniques make genital aesthetic surgeries that mostly cause embarrassment in women possible both to have a good appearance and increase self-confidence, also in functional terms to improve sexual health and life quality.
Proportion, size, or color change in anatomic structures in that area remains the main reason of the surgeries of that area and also affects the sexual life of people and couples. Therefore, genital area should be considered as a whole in women and the intervention planned be evaluated within that whole.
It might be the most performed operation among female genital aesthetic surgeries. Having bigger labium minus that normal either from birth or due to excessive weight gain or loss, or pregnancy makes women want to go through this operation due to the difficulty in selection and use of underwear or bikinis / swimsuits, or embarrassment in sexual life, or if it I folded backwards, pain and hygienic reasons (fungal infections in the folding area due to humidity).
Being married or single is not a consideration to have the operation since it has nothing to do with the hymen, neither with urinary tract or getting pregnant.
To achieve an aesthetically successful result from the operation, it is important to understand what the exact complaint of the patient is and to decide which technique will be used to correct it. Since the vagina of each woman is unique, each operation should be performed using an individual technique.
The operation can be performed in 45 minutes under local anesthesia and the patients are discharged the same day. Sutures used in the operation are dissolvable and therefore do not need to be removed.
There can be swelling or edema in the genital area for a few days after the operation. Sutures disappear in 1-2 weeks after the operation and a dressing with antibiotic pomade and batticone will be sufficient within this period.
Scars usually heal well in genital area operations and leave no marks. Patients can go back to their sexual life 4 weeks later.
The most undesired post-operation result is to take out too much tissue to prevent the labium minus to cover the vagina entry. Therefore it is important to decide with the patient on which part of the labium minus the excessive tissue exactly is and what the best technique would be to correct it. It should be noted that the appearance of the vagina is different in each and every woman.
This is the second most performed group of female genital operations following the labium minus aesthetic operation.
Having a wider vagina than normal can be structural or due to loss of integrity or tonus of vaginal muscles because of the birth traumas associated with an excessive number of normal deliveries.
It has a negative effect especially on the sexual life of couples and the sound of the air coming from the vagina during sexual intercourse causes embarrassment in women. Additionally, the loss of tonus in that area as developed with menopause and vaginal dryness can have a quite negative impact on life of women.
Vagina broadening can be accompanied by urinary incontinence due to herniation of the rectum towards the vagina or collapse of the bladder towards the vagina.
First of all, to decide the intervention to be performed, all complaints of the patient must be carefully understood and examined. In case of any rectum herniation or sagging bladder, these must be identified before the operation and it must be decided if they will be intervened in. In other words, vaginoplasty is not only the narrowing of a tube but the repair of deteriorated muscle structures, and the repair of defects if any. Therefore it would be correct to define this operation as vagina reconstruction instead of vagina narrowing.
The operation is generally takes 1 hour under spinal or general anesthesia. The tampon inserted into the vagina following the operation is usually removed the post-operation night or the next morning. The patient will stay a night at the hospital. It is possible to get back to daily activities in a controlled way following a 3-5 day recovery period. It will be enough for patients who have sutures on the outer part following the operation to make dressing with batticone following the daily toilet.
The patient can go back to their sexual life 6-8 weeks later. They should pay attention to the recommendations of their physician regarding going back to their sexual life, and inform their partner of the physician’s recommendations regarding their first intercourse following the operation.
Especially in cases of muscle repair, it is important to avoid heavy physical activities or lift heavy materials or be constipated following the operation.
Labium majus in the female outer genital system (the hairy area on the outer part of labium minus) is inclined to go saggy due to aging or loss of volume or excessive skin by heritage.
If the problem in labium majus is a deflated look due to the loss of volume, lipofilling (fat graft) can be performed which is the injection of fat into labium majus. This is the injection of fat cells obtained from any part of the body by liposuction – fat vacuuming from the body – into the labium majus that has lost its volume.
The operation can be performed in about 45 minutes under local sedation anesthesia. the patients are discharged the same day. Swelling and edema can be seen in the labium for 3-7 days following the operation. No mark is left in the operation area.
As in other fat injections, it is not possible for the fat transferred to fully remain in their new place. In other words, part of the fat injected into the labium majus will dissolve, therefore the operation can be repeated and patients must be aware of that. The operation can be repeated once every 6 months.
In case of excessive skin on labium majus, this can only be corrected by skin removal. This operation will also take about 45 minutes under local sedation anesthesia and a vertical scar can occur between the labium majus and the groin curvation and a horizontal one on the labium majus following the operation. The wound maintenance will be completed upon dressing on the said scars with antibiotic pomade and batticone for 1-2 weeks. It will take months for these scars to diminish and this is not a method to leave no scars. Therefore, patients to be operated by this method must be carefully chosen and fully informed of the final results of the operation.
The cut on the vagina entry (episiotomy) to ensure a comfortable delivery from the vaginal canal in normal deliveries can sometimes leave a bad mark due to poor recovery or repair and lead to pain during sexual intercourse.
That bad scar tissue is removed by an operation that usually takes 30 minutes under local sedation anesthesia and that area is repaired by minimum reactive sutures. Patients can be discharged the same day. Sutures generally heal by dressing with antibiotic pomade and batticone for 1-2 weeks.
The reverse triangle-shaped hairy part forming the upper part of the vagina is called mons pubis and this area can have a very puffy look due to the underlying fat tissue in some women.
The operation that usually lasts 30 minutes under local anesthesia is actually liposuction and patients can return home the same day. Please note that there will be swelling and edema on the operation area for 7-10 days. The outcome of the operation will be seen 1 month later.
The excessive or puffy skin on the clitoris can lead to both poor appearance and orgasm problems.
Following this operation that lasts about 30 minutes under local anesthesia, patients can usually return home the same evening.
The operation does not only improve the aesthetical appearance but also facilitates orgasm in the right cases.
In societies where the hymenoplasty is demanded especially due to religious reasons, it should be known that the hymen can disintegrate not only by sexual intercourse but also due to traumatic accidents. It should also be known that there will be no bleeding in about 60% of the women in their first sexual intercourse. It is even known that some hymens break during delivery. Therefore it should be noted that no hymenoplasty can guarantee 100% bleeding in sexual intercourse. The hymen placed 1-1.5 cm inside of the vaginal entry can vary greatly in structural terms.
Hymenoplasty is performed in 2 ways.
Temporary technique: This is the method usually performed 5-7 days before the wedding night, and a few temporary sutures put on the hymen are expected to break and cause spot bleeding during sexual intercourse. Most of these methods is not the original hymen repair and sutures might reveal during the intercourse. I do not perform this method.
Permanent hymenoplasty by flep: This method is permanent hymen repair and the operation should be performed minimum 1 menstrual period before the wedding date.
Operation date usually scheduled at the end of the menstrual period lasts about 45 minutes under local anesthesia. Following the technique performed on the principle of stitching the hymen in fleps, a small hole will be left to discharge menstrual bleeding. Patients are discharged the same night.
Patients should avoid stretching to open their legs and wearing tight underwear during the first week. Since the sutures will be completely healed 1 month after the repair, usually no scar will be left, and the repair will remain even years after, i.e. this operation is not temporary but permanent. This means you can have the operation not a few days before the wedding but even years before.