The term Aesthetic Vaginal Surgery is also known by other names such as Vaginal Rejuvenation, Laser Vaginal Rejuvenation, Labiaplasty, Vaginoplasty, Designer Laser Vaginoplasty, Perineoplasty, and Hymenoplasty.
Aesthetic Vaginal Surgery is a broad term that includes the individual procedures.
Surgery to improve the appearance and function of a woman’s vaginal tissues is important for both personal esteem and physiologic function. Childbirth is often traumatic resulting in lacerations and healing process that is not personally satisfying. The use of forceps or vacuum assisted delivery and the increasing
weight of babies today result in more prolepses of pelvic organs, more incontinence, and more looseness of vaginal tissues or unappealing appearance of labial tissue. Many who have finished their childbearing years are now concerned about their personal appearance and are looking for ways to deal with this problem. Some feel that they have lost a great deal of sexual sensation due to “loosenes” of the vagina.
Gynecologists, urogynecologists, and a few plastic surgeons do most of these types of surgeries. Gynecologists are trained specifically in repair of fallen bladders and rectums, fallen uterus or vagina, and repairing tears in the vaginal region as part of their everyday work. Urogynecologists usually are highly sub specialized and focus primarily on the worst incontinence and pelvic organ prolapses encountered. Plastic surgeons are generally trained in cosmetic surgery on men and women and very few are trained in vaginal surgery. Some plastic surgeons are highly trained in totally reconstructing new vaginas in transsexuals, transvestites, and pelvic cancer patients. With experience and training all specialties mentioned above can perform aesthetic vaginal surgery.
The laser is an important surgical tool that has many advantages. Certain lasers are very precise and are used as scalpels. Some lasers are ablative (destructive) and used more to destroy abnormal tissue or to resurface the skin. Many dermatologist and plastic surgeons use this type of laser. However, there is no magic in the use of lasers. In fact, other modalities such as radiofrequency cautery units can give more precise cuts and less tissue destruction by a factor of ten or more. Other surgeons will avoid electrical units altogether and use highly precise scissors or scalpel units. Another way to look at lasers is to realize that it is a tool in the doctor’s bag but that it is not ultimately any better than a cold knife. However, it is undeniable that using the term “laser” adds glamour and a sense of prestige to a procedure.
Almost all of the cosmetic surgeries are outpatient. Labiaplasty and vaginoplasty cases are typically finished within an hour. If a repair of the bladder, rectum or bowel is needed then a 23 hour overnight stay may be needed. If a hysterectomy is needed than it is typical to stay one to two days. Placement of a sling to help with incontinence does not prolong the hospital stay. Many patients feel the pain involved is similar to the discomfort AFTER a baby has been born. They are somewhat sore but not in agony. Pain control is excellent in the large majority of cases.
Labiaplasty is the cosmetic reshaping of the inner folds of tissue, called the labia minora, or smaller inner lips of the vagina. Various instruments are used such as pinpoint cautery, Yag lasers, fine scissors, or a knife. The edges are then sewn together with delicate absorbable sutures. A vaginoplasty (commonly referred to as vaginal rejuvenation) is when a diamond shaped section of tissue is excised from the inside of the vagina and brought down to the outside of the vagina. Often times a small triangular area is also excised from the perineum (the area right below the vaginal opening). This is called a perineoplasty or perineorrhaphy. The size of the tissues removed rarely are larger than a domino block. If needed, sutures that bundle loose muscles together are used to narrow the vaginal opening. At the very end of the procedure, a CO2 laser may be used to smooth out any skin irregularities and further tighten the vaginal opening. The laser provides for growth of new, softer, smoother, and tighter skin just as it would when used on a face.
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