Female Genital Rejuvenation
Female genital rejuvenation typically involves the vaginal vault (vaginoplasty) and the external labia majora and minora (labiaplasty).
Women who choose to undergo these rejuvenative procedures typically are the postpartum mothers and those in the older age group. For each, there are both surgical and non-surgical options.
I will discuss labiaplasty first as this is the more commonly requested for procedure, and I divide the procedures into 2 groups - those for the labia majora (outer) and those for the labia minora (inner). These tend to result from ageing and the accompanying hormonal changes and there is typically volume loss as well as tissue excess, producing a flat and deflated labia majora and a thin and floppy labia minora. There is also accompanying dark pigmentation in place of the more youthful pinkish appearance. Although this is usually a consequence of ageing, I do get a number of younger, pre-pregnancy ladies who also have these symptoms.
The non-surgical method of rejuvenating the labia would be through the use of hyaluronic acid (HA) fillers that are injected to the labia to replenish the lost volume. However, this is a temporary solution and must be repeated annually or so. The other downsides include bruising and possible embolism resulting in tissue death, if inadvertently injected into a vessel, although this is rare.
This procedure takes about an hour and is performed under light sedation.
Surgical methods of rejuvenating the labia include:
The use of fat grafting to the labia majora, where the patient’s own fat (from the tummy or thigh areas) are removed and purified before being injected into the labia. This produces a full appearance that should last a few years or more, depending on the age of the patient.
- Removal of the excess floppy labia minor (usually the dark pigmented part) and a rotation flap to create a short youthful appearance. The scar is hidden internally and cannot be seen after healing. The degree of removal can also be predetermined as not everyone wants complete removal. It should be noted that care should be placed on removal of the clitoral hood so as not to damage the sensory nerve to the clitoris; excess removal can also result in dryness and over-sensitivity.
Vaginal Rejuvenation Methods
Vaginal rejuvenation is usually performed for post-pregnancy mothers who may experience vaginal laxity as a result of multiple vaginal births, large birth weight babies, large episiotomy cuts with inadequate repair or other forms of natural vaginal birth trauma. They typically seek to reduce the size of their vaginal vault in order to achieve better sexual intercourse with their spouse, and this degree of reduction also syncs with the partner’s penile size.
Non-Surgical Vaginal Laxity Treatment
This can be achieved non-surgically over multiple sessions for a small degree of tightening, through the use of a vaginal tightening device that is inserted like a probe. The procedure involves a combination of lasers as well as radio frequency to achieve gradual mucosal tightening over time, much like a non-surgical facelift.
Surgically, a vaginoplasty will involve the removal of a strip of mucosa, as well as a plication of the underlying muscle. This produces a more sustained tightening of a greater degree than can be achieved non-surgically. Vaginoplasty can be repeated on both sides of the back of the vaginal vault to achieve even more tightening, if required. I typically perform this procedure under moderate sedation, rather than general anaesthesia, as it is a relatively pain free procedure. It takes about 1 to 1.5 hours and is a day surgery procedure.
Patient Recovery Periods
Recovery is fairly straightforward for my patients and involve the use of sanitary pads for about a week due to the blood stained discharge that will occur. There is no stitch removal and they simply have to apply antibiotic ointment twice a day for 1 week till wound healing. They have to abstain from sexual intercourse for 2 weeks and other physical exercise for 1 week. For vaginoplasty, they will require lubrication for the initial few episodes of sexual intercourse that will usually be quite tight until the scar tissue relaxes fully.
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