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Intimate surgery

nymphoplasty

Intimate surgery of the vulva and perineum

 

Reduction of the labia minora-Nymphoplastic reduction surgery

 

Labia minora hypertrophy

 

Patients express an esthetic discomfort and a physical one which is accentuated by the change in women’s clothes and underwear (tight jeans, leggings, g-string.. ). Women also tend to compare themselves with erotic film actresses and their juvenile-looking vulvas. This hypertrophy is an isolated malformation on overly developed inner lips, causing a disgraceful aspect and a functional discomfort in day-to-day activities, as well as in sports and sexual activity. Usually women complain in their teenage years, at the start of their physical (sports) or sexual activities. Some patients can be quite embarrassed, often since adolescence, and sometimes just be reassured by the surgeon as the issue could merely be a slight excess of skin. If a surgical act is deemed necessary, it will simply consist of removing the excess skin on both sides. This type of surgery requires a short hospitalization stay.  But, before surgery, a medical consultation is essential in order to evaluate if there is a real anatomical problem, and quite often, the patient will only need to be reassured on her own anatomic "standard" and to evaluate the real inconvenience.  

If the hypertrophy is objectively evaluated as being symptomatic, a nymphoplastic reduction will be an option.  The surgery will consist of reducing the size of the lips by dissecting the excessive tissue using the « V » technique.  This is an outpatient procedure, and requires specific postoperative care.

This technique leads to satisfying anatomic results.  In this area of the body scarring is variable from one patient to the other, and can be a slow process, so a medical consultation is required 10 days after surgery.  In any case the scarring will be completed.

 

Vulvar plastic surgery: correcting the vulvar apertognathia

 

Symptoms: feeling of being open, vaginal air sounds, strange sounds during sexual acts, liquid leaks, diminished vulvar-vaginal sensations and the partner’s recrimination.

The vulvar apertognathia is often the consequence of one or several deliveries and although many women suffer from it, only a few will dare speak out, as this condition remains a taboo.  The vulvar apertognathia is a lack of tonicity in the perineal muscles that causes a lapse in the vulvar "fork" and an increase of the vaginal capacity.  It is not an anatomical but a functional problem: some women complain about emitting gases during sexual acts (vaginal farts) and of a diminished sexual pleasure that is also felt by their partner. It can also cause vaginal liquid leaks after taking a bath.

  1. The treatment is first and foremost preventive, with post partum perineal re-education sessions that can be repeated.  The re-education consists of better controlling the muscular contractions, but in any case will not replace a weakened muscle.  This re-education can be done even if no anatomical defect is diagnosed, and in addition to surgery.
  2. A surgical operation can be indicated when considering reparative surgery. This surgical procedure consists of merging the muscles of the dehiscent vulvar banks, in order to reinforce the muscles and reduce the vaginal opening.  Three ambulatory surgeries are offered:

            -Perineoplasty

            -Vaginal lift

            -Vaginoplasty

 

All those surgical acts can be completed by narrowing the vagina through adding autologous fat, obtained from the patient by liposuction, injected back with hyaluronic acid: it can also be done by reducing the vaginal surface by Laser or lateral resection.

 

Today, these surgical methods are efficient; however, even if the objective results (anatomical) are good, they will not be signs for improved postoperative sexual acts. Therefore, a surgical act will only be suggested if important and significant symptoms exist, in order to ensure the best possible results.

 

Vaginal diaphragm surgery

 

In most cases, treating vaginal malformations remains a surgical procedure. If the patient has a transversal vaginal wall or vaginal diaphragm, the surgical treatment will be based on various techniques, each corresponding to the different clinical aspects (complete or incomplete vaginal wall, anatomical condition).  There are many ways of detecting the condition depending on the permeability of the walls: the age at which it is diagnosed is therefore variable, from the foetal stage to the parturient in labor.  Many surgical techniques exist and can be basically divided in two categories: resection or real vaginal plastic surgery. The main complication is common to both: recurrent vaginal stenosis.  Since this malformation is rare, there is no precise consensus on the overall treatment. Yet, it is always necessary to do a complete preoperative medical evaluation to determine the type of vaginal wall, and to define the associated anomalies (endometriosis, malformations).

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Vaginal rejuvenation in London : Intimate surgery