Although female sexuality and related issues are not easily discussed in our culture, its importance is undeniable. A different than normal appearance of the female external genital organs may affect the individual’s psychology and sexual life, and ultimately become an issue she cannot discuss with anyone. It may cause women to feel unappealing or insufficient and avoid sexuality.
Female external genital organs consist of labia majora (outer lips), labia minora (inner lips), clitoris, hymen and vagina. Issues related to deformities of these areas may be congenital or occur later in life due to pregnancy.
Congenital problems include abnormalities of external organs along with internal organs, non-development, hypertrophy or abnormal development. This condition can be diagnosed at birth or appear with menstruation issues during puberty. In cases where the uterus or vagina is not developed, gender abnormalities are researched with detailed hormonal analyses.
External genital organs that are normal at birth may develop less or more during puberty for structural reasons. This condition directly affects the individual going through puberty. Undesirable appearance affecting these normal women can be corrected with genital cosmetic surgeries.
Hormonal changes during pregnancy, childbirth, excessive weight changes or aging cause sagging and loss of elasticity in genital area skin.
The surgeries to be performed for treatment of genital deformities should be planned depending on the affected area.
This procedure, also called Labiaplasty (or Labioplasty, labial reduction), is generallt the most commonly performed vaginal plastic surgery. The inner lips may be larger than normal and have a saggy appearance. This condition may cause physical and hygienic issues.
Labiaplasty is usually is 30 – 40 minute operation and is performed in hospital environment. Hospital stay is not necessary. Can be performed under sedation (tranquilizers) combined with local anesthesia, or under general anesthesia. Excess mucosa is removed and stitched with dissolving sutures. Hygiene should be carefully monitored during 10 days following the operation. The sutures will fall off without intervention. For a few weeks following the surgery, pain may be experienced when sitting. The patient may return to normal sexual life 3 weeks later.
Loss of outer lip volume is observed generally in very thin patients, or due to aging. Consequently, the clitoris will not be covered by labia majora, resulting in an undesirable appearance. In this case, the fat harvested from another part of the patient’s body will be prepared and injected in the outer lips. This procedure can be done under local anesthesia and most often, does not require sutures. Post-operative period is comfortable, the patient may return to normal sexual life 1 week later.
The area called pubis is the bony, protruding area under the abdomen towards the outer lips. It can be seen entirely when standing up. While firm and tight in young ages, it can appear saggy or hollow due to aging, or become more protuberant with increase in fat mass. Most of the complaints are related to excess mass and fat accumulation. This regional fat deposition prevent the patients from wearing pants and may be noticeable even underneath a dress. A liposuction procedure to be performed on the pubic area will resolve the issue to a large extent. The procedure can be done under local anesthesia and sedation.
It may be necessary to lift the skin and remove excess skin if sagging is observed in the pubic area. This operation can also be done simultaneously with a tummy tuck if the patient needs it. The scars of this operation have the appearance of C-section scars. It can be done under local anesthesia combined with sedation and the patient can return to daily activities after the first day.
The vagina may be loosened after childbirth, episiotomy sutures or tears due to childbirth may not be healed properly. The treatment of these conditions affecting the aesthetic appearance and functions is surgery. With this operation, also called vaginoplasty, the vagina is tightened and the unpleasant appearance of vaginal opening corrected. The surgery is done in the operating room under general or local anesthesia combined with sedation. When it is the only surgery to be done, staying in the hospital will not be necessary. Many of my patients request this procedure accompanied by an abdominoplasty (tummy tuck) and breast enhancement procedures. It is possible to do these surgeries simultaneously; also more comfortable for the patient as it is done under general anesthesia. Although the recovery period is short, sexual intercourse should be avoided for 3 – 4 weeks.