Cosmetogynecolgy
Vaginal rejuvenation, the “Mommy Makeover”, “Designer Vaginas”, reduction labiaplasty and vaginal tightening are among the many terms used to describe operations focused on female genital enhancement. This is the fastest growing area of cosmetic surgery as women and surgeons become more aware that the nonmedical genital effects of childbirth, weight fluctuations, tissue laxity and anatomic idiosyncrasies can be addressed by a variety of procedures. The leaders and pioneers in this type of surgery are all members of the International Society of Cosmetogynecology.
Although cosmetic vaginal surgery is the general term, external or vulvar structures are also commonly treated. These include the labia majora and the labia minora including the clitoral hood or prepuce. The perineum which forms the muscular bridge of tissue between the anus and the vagina, and the lower third of the posterior vaginal wall are the areas typically operated in vaginal tightening procedures. The anterior vaginal wall plays a lesser role in vaginal tightening, but a far greater role in the surgical treatment of urinary incontinence. Hymenoplasty, sometimes referred to as “revirgination” is typically performed when a request is made for cultural reasons.
Prior to embarking upon cosmetic vaginal surgery, a thorough gynecologic evaluation will be performed to screen for pre-existing gynecologic, urogynecologic or urologic conditions which might alter the timing of the procedure or influence the surgical plan. Therapeutic and cosmetic surgeries can be performed under the same anesthesia in some instances. Other issues to be acknowledged as well, is the potential effects of future vaginal childbirth on the cosmetic procedure and that a cesarean delivery by patient request may not always be available.
Vaginal Tightening
Commonly known as vaginal rejuvenation, procedures for tightening the vaginal dimensions originate from a class of gynecologic operations referred to as vaginoplasties or colporrhapies initially developed for the treatment of prolapse of the bladder (cystocele) and of the posterior vaginal wall (rectocele). Mild to moderate degrees of vaginal laxity can be corrected quite adequately by targeting the lower third of the posterior vaginal wall and the perineal body for this type of surgery.
Experience with the management of complex pelvic surgical conditions is mandatory for surgeons embarking upon vaginal tightening procedures because of the frequency with which anatomic distortion from childbirth-related scarring is encountered in this region and also because of the close proximity to the bladder and rectum. Also, gauging the degree of tightening can be tricky in inexperienced hands and those considering offering these surgeries to their patients are well advised to seek specific training in these operations from experts
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