November 25, 2020 - Dr. Markarian

Feeling self conscious about their vagina – orexperiencing a lack of function and pain in their genitals – is something manywomen face. And through lack of knowledge or shame, it’s often an issue they mayavoid addressing. But it’s one that surgery is often well placed to solve. In fact, in a survey of patients who opted for vaginal rejuvenation surgery, 93% gave this type of procedure a “Worth It” rating.What is vaginal rejuvenation?Who makes a suitable candidate for vaginal rejuvenation?What specific issues are addressed and what type of surgical procedures are involved?Vaginal loosenessUrinary leakageThe Labia Minora are too longExcess skin around the clitoral hoodLabia Majora are too large Mons are too prominent or saggy Is surgery the only option?Are the results from surgery permanent?How risky is it?How much does vaginal rejuvenation cost? What’s involved in recovery?ConclusionWhat is vaginal rejuvenation?Many women suffer discomfort or pain from theshape, condition and size of their vagina and hope that vaginal rejuvenation willgive them a better quality of life. Chronic pelvic pain is a very real and often hidden problem. There are others who are dissatisfied with thelook of their genitals – they may deem them too fleshy, bulky or just not theright shape – and are focussed on their aesthetic improvement.Vaginal rejuvenation, also known as femalegenital plastic surgery and designer vagina surgery, is a broad term thatcovers several different types of procedure. Strictly speaking, the clinical world uses theterm to describe procedures that address issues affecting the vaginal canal– but many other operations like labiaplasty, which may be for more cosmeticreasons, are often associated with it too. According to research,10% to 20% of women in the United States suffer from dyspareunia (painfulintercourse) and up to 28% are affected by vulvodynia (pain affecting the vulvaregion).Another study found that nearly half thewomen surveyed are worried that their vagina is abnormal in some way and around18% said they had considered altering the appearance of their vagina throughlabiaplasty or other methods. The situation isn’t helped by the fact thatlots of people – and that includes women – aren’t as familiar as they could bewith the intricacies of the female anatomy. Verywellhealth.com says the word “vagina” refers to the “elastic, yetmuscular canal” that connects internally to the cervix. And as cosmopolitan.com reports, the vulva is the general term for theexternal parts of the female sexual anatomy. There are two sets of labia, thelabia majora (the outer set) and minora, (the inner set).The area above the pubic bone is called themons and in the middle is the clitoral hood that covers the clitoris.Underneath this lies the opening to the urethra, and below that, the vaginalopening.Not surprisingly, with so many working partsinvolved, there isn’t a one size fits all solution for women who are anxiousabout, or are suffering pain in or around their private parts. But science hasprovided solutions that will soothe many. Who makes a suitable candidate for vaginalrejuvenation?Issues with the female sexual anatomy fallbroadly into two categories – function and appearance – and some women arebothered by both. Good candidates for vaginoplasty are those who,for one reason or another, have found that their vaginal muscles have losttone. This may be as a result of getting older, and the associated reduction inoestrogen causing laxity and a thinning of the skin, or from giving birth.For others, it may be because they are nolonger feeling the same sensations during sex as they once did or want toimprove the shape of the fleshy parts of the vulva – either for cosmeticreasons or because they cause discomfort when sitting or exercising. And some women find that their genitals arejust too bulky and want to reduce areas that may be protruding too much throughtheir clothes. What specific issues are addressed and what typeof surgical procedures are involved? Vaginal loosenessA loss of elasticity in thevaginal canal can be improved with a vaginoplasty. According to plasticsurgery.org, a vaginoplasty brings the separated musclestogether and the extra mucosa skin from the back side of the vagina is removed.This usually results in a tighter vaginal canal with stronger muscle tone.A perineoplasty can also help with a loss of elasticity at the opening of the vagina. A tear, or cut, in that area, can create a wider vaginal opening. As aedit.com describes, a perineoplasty is a procedure that reshapes and tightens the area between the vaginal opening and anus. Incisions are made in a V-shaped pattern within the vaginal mucosa (membrane) and any excess skin or scar tissue is excised. The reduction in excess skin can also improve the appearance of the perineum. Urinary leakage According to research,urinary incontinence affects twice as many women as men because events likepregnancy, childbirth and menopause affect the pelvic area. The Mayo Clinicsays there are many treatments to try before surgery, but that slingprocedures, bladder neck suspension and prolapse surgery can treat problemsthat cause incontinence.The Labia Minora are too long Every woman’s size and shapeis different and this goes for genitals too. Some women find that their labiachange shape after birth, they may have been born with labia that hang lowerthan they’d like or they might have become larger with age. As well as theaesthetic element, UCHealthreports that some women feel discomfort with intercourse, bicycling or whenthey wear tight clothing or bathing suits. A labiaplasty reduces thelength of the labia minora and was performed over 11,000 times by Association of American Plastic Surgeons in 2019. Realself explains there are two main techniques – thetrim method (one continuous incision) and the wedge method (where a V-shapedwedge of tissue is removed). One patientsays, “I just didn’t like how much longer my inner labia were, and I feltlike I was always having to tuck them in when putting on a bathing suit”. Afterher op, she felt differently, “Iloved, loved, loved how it turned out and went into my next relationship, withthe man who is now my husband, feeling really good in my own skin and able tobe completely open sexually”.Excess skin around the clitoral hoodA labiaplasty is often performed alongside a clitoral hood reduction that’s designed to reduce skin around the clitoris. Following a labiaplasty, the top area of the vulva may appear too prominent, so a reduction in the clitoral hood aims to provide symmetry.Labia Majora are too large Some women feel that theouter labia are too prominent – thanks to fat deposits or sagging – causingdiscomfort or self-consciousness. A labia majoraplasty makes them smaller byremoving excess tissue from each labia to improve the appearance of the vulvalarea. Mons are too prominent or saggy A monsplasty reduces the tissue of the mons pubis – thearea that protects the pubic bone. Due to aging, childbirth or weight changesthe mons can begin to change shape which influences how clothes look as well asmaking an impact on intercourse and urination. A surgical incision is made totighten the muscles and create a reduced silhouette. Is surgery the only option?While surgery has proven very effective formany patients who want to improve their genitals, it isn’t always necessary togo under the knife. Many patients have opted to try vagina tighteningusing non-invasive techniques like lasers and radio frequency waves. It’ssaid these stimulate collagen production and improve vaginal lubrication. Hyaluronic acid fillers, that are often used for facial rejuvenation,can also be used to enhance the shape of the labia majora, providing morevolume and a younger- looking aesthetic. An alternative injectable is platelet-rich plasma, or PRP, (a component of the patient’s ownblood) which it’s thought promotes healing and cell growth in damaged tissues.Some claim it helps with urinary leakage and pain during intercourse amongother effects.The advantage of non-invasive treatments isthat downtime is usually minimal (if there’s any at all) and patients can oftenget straight on with life as normal. However, they aren’t suitable for everyone andthe results aren’t permanent. The extent of work that a patient requiresdetermines whether an operation is a more suitable option and this is bestassessed by a board-certified surgeon. There may also be some risks attached(see below). Are the results from surgery permanent?The results from vaginal surgery are permanentbut as a woman matures, just as with other parts of her body, her genitals maychange. They could become plumper or perhaps more saggy. Some patients may wantto revisit their results with their surgeon down the line. How risky is it?Some non-invasive therapies rank very highly for “Worth It” ratings on realself.com (although arguably the samples aren’t extensive). However, in 2018, the FDA said that it had not established the safety and effectiveness of energy-based medical devices to perform vaginal “rejuvenation” and/or cosmetic vaginal procedures. So, patients are encouraged to carry out thorough research and consult an experienced and certified gynecologist before booking treatments. In terms of surgery,many of the procedures can be done under local anaesthesia, although manypatients opt for general. As a result, many of the risks are the same as thoseassociated with most surgical procedures ie infection, bleeding and pain. It’s worth bearing in mind that one piece of researchreports that the few studies that have been done on vaginal tighteningprocedures have found that they result in improved sexual function with lowcomplication rates. How much does vaginal rejuvenation cost? The cost of vaginal surgery varies widelydepending on the number of procedures being done as well as the surgeon’sexperience and specialisms, their locality and extra costs includinganaesthesia and medication. Patients can expect to pay anything in theregion of $4,000 to $8,000 but only a series of consultations withboard-certified surgeons who specialise in this field will provide a range ofprices for the procedures required by a particular patient. For example, after a surgery that includedlabiaplasty majora reduction and a vaginoplasty, one patient reportsthat, “The entire procedure, with a year of aftercare, came to $10,000. Iconsider it to have been a gift to myself. I look great in bathing suits now,with the inner labia removed and just feel so much more comfortable in all myclothing.”What’s involved in recovery?Recovery from vaginal rejuvenation typicallytakes one to two weeks – with the area being sore for a few days. A patient’ssurgeon can advise whether a cold pack wouldbe useful to reduce swelling and how soon a patient can return to work,exercise and sex. Conclusion There are many reasons why a woman may electfor a procedure on her genitalia – and it isn’t always true it’s because ofpressure from outside parties. She may be self conscious about how the arealooks or impacted every day by discomfort or chronic pain to varying degrees. The good news is that there are a wide varietyof procedures that may help – many of which can be performed in combinationwith the aim of producing a result that’s refined, symmetrical and mostimportantly – pain free. But as always – a patient should do theirresearch thoroughly. Consult a board- certified surgeon to discuss surgical goals, any medical conditions and previous surgeries. And research photos and ask questions – how much special training and experience does this surgeon actually have in this particular field? And what are the risks associated with the specific surgery being considered? Moreover, don’t be shy. This is an incredibly important part of your body and it’s essential you understand everything you need to know about the surgery you’re thinking about. Then once you’re satisfied with your decision, it’s about looking forward to your new life, post op. contact the officeDisclaimer Please note: All materials on the Site, such as text, treatments, outcomes, photographs and images and any other material provided on the Site are for information purposes only and are not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding treatments. Never disregard professional medical advice or delay in seeking it because of something you have read on this Site.Though the content of this blog has been carefully prepared, the author of this content is not a medical doctor and the content has not been reviewed by a Board-Certified Plastic Surgeon. Unless specifically stated, patients referred to in this blog have not received Vaginal Rejuvenation or associated procedures by Dr Mark Markarian. This blog does not endorse the work of any doctors or surgeons mentioned. Stories relating to patients’ personal experiences of the Vaginal Rejuvenation procedures should be treated as anecdotal only.Any application of the material provided is at the reader’s discretion and his, her or their responsibility

MD, MSPH, FACS

HARVARD-TRAINED BOARD
CERTIFIED PLASTIC SURGEON

Day: November 25, 2020

Vaginal Rejuvenation: 8 Frequently Asked Questions