Aesthetic and Reconstruction Surgery of Female Genitals
According to sexology research, significant number of females is unhappy with the appearance and function of their genitals. Inadequate aesthetic appearance, as well as a sexual pleasure, can be a consequence of inborn asymmetry, age or childbirth. Dysfunctional anatomy as a consequence of various gynaecological conditions (lowered internal genitals and the bladder, along with the consequential involuntary urinating, mioma, etc.), is an unmistakable reason for consultation about intended surgical operation. However, a woman (or a couple) who demands a conversation on bettering their sexual life is almost impossible to be heard in the waiting room of a gynaecological polyclinic.
Indications for a surgical operation, which includes also the reconstruction of the outer part of female genitals, are connected with changes of the anatomy of the skin, muscles and connective tissue of the genital system.
During the childbirth, while the child passes through the birth canal, muscles and connective tissue, as well as the tissue of the bottom part of pelvis and vagina, are separating and irreversibly protruding.
This weakening of muscular tonus is gradually being stronger and at the beginning of the third age period pelvic organs can 'lower', changing their usual position. Sometimes the 'vaginal relaxation' can be observed with women who have not given birth to a child. Here the cause can be in inborn weakness of the supporting tissue, constant high inter-abdominal pressure, because of the chronic cough or fatness.
Additional factors of risk include the following: nicotine (destroys connective tissue), sexual habits (anatomy of the partner) and the race (white women are more vulnerable in relation to Asian or Black women). In the period of post-menopause, the physical condition is becoming worse during the process of ageing and insufficient hormone support. General symptoms which women mention within the framework of the syndrome of weakening of the muscular tonus, depend on that which organs are affected by. The feeling of weight or plumpness is frequent. Minor or larger quantity of urine can leak involuntarily during laughing, coughing, walking, running, and even during sexual intercourse. Sometimes a higher pressure in the abdominal cavity can push down pelvic organs even to the front of the vaginal opening. In cases of starting the tonus weakening of the bottom part of the pelvis, when the symptoms are mild, and there is no anatomy changes, the so called Koegel exercises are effective (which a woman can easily learn with a help of an experienced physiatrist), or electro-stimulation of the vaginal and bottom pelvic muscular tissue.
Operations by which we solve more noticeable problems frequently include removing the womb and ovaries (depending on the age of the patient), as well as the reconstruction of the lower third of the vagina and perineum. In this way we once again reinforce the bottom section of the pelvis and the exit of vagina.
The above-mentioned surgeries are performed under inpatient treatment conditions and require standard pre-operational procedures and treatment (laboratory tests, chest and heart X-ray, ECG and urodynamic test of the urinary bladder and the outlet of urethra). Anaesthesia which is applied is that of a general type (‘endo-tracheal’), and the operation takes from about thirty minutes to a couple of hours.
The reasons for the operation of this level are, within the framework of a classical medical consideration, ‘clearly legitimate’.
However, what can be replied to those women who do not have such ‘a strict medical indication’, but are asking expert advice and help because of, until recently sacrilegious, wish for aesthetics and pleasure?
For a conversation on bettering the sexuality using scalpel or laser, a physician must take a lot of time out and have a lot of consideration.
A woman with unequal inner labia wants to equate their size. One of them can be so long that during the intercourse it enters the vagina causing pain. The procedure of the reduction of labia is called a labia-plastic surgery reduction.
Some women want to have a youthful look of their outer genitals. Namely, the feeling of a sexual touch, especially after the childbirth, significantly changes. Often there is a visible space between outer and inner labia and not pleasantly looking wide scar at the spot of a cut perineum after the childbirth. Then the former sexual excitement is absent during the intercourse, and the quality and frequency of climaxes have dramatically changed. With perineorrhaphy, the opening of vagina is made narrower and the lower ends of outer labia are being placed in alignment with the middle line of the body.
In some cases (age or some other factor), outer labia become thinner. Their former exuberance can be achieved by the rearrangement of fat tissue from the unwanted part of the body to the labia. By using the same method, fat flabs can be remove from the mons pubis region or thighs below outer labia and so are the resulting and aesthetically satisfying contours of the outer genitals. Minimal invasive micro-surgical styling is an art of changing the look of the body with which by aesthetic and surgical operations unwanted areas of fat tissue are being removed (as the sculptor shapes stone). The procedure is minimally invasive. After this treatment ‘only you will know that there was an operation’. After normal scarring over, no traces remain visible. Scars from cuts are practically invisible (not longer or thicker than this line here:-). With proper skill, complications in this procedure are less than one percent.
Modern ways of living and fashion, that promote intensive physical activity (exercise programmes, fitness, extreme sports), can easily harm hymen. It is not infrequent that a woman, because of demonstrating her innocence, requires hymen plastic, by which its look is being renewed.
All the above-mentioned procedures are of aesthetic nature, because of cosmetic reasons, and it can also be performed under local anaesthesia. The operations are performed exclusively at the request and choice of the woman.
By the choice of a woman, operations with the purpose of bettering sexual pleasure of women are also performed. In fact, the relaxed part of the female genitals that is active in the sensation of pleasure or pre-climax is reconstructed: the lower third part of the vagina is made narrower, inner and outer radius, and the perineum is lifted. It is also possible to reconstruct vaginal wrinkles. These aesthetic operations take relatively short time. Skilled operator performs them (with laser and scalpel, the results are of same quality) even at well-equipped facilities outside hospital premises.
Ethically, although there are controversies in the world, these procedures are not disputable. The wish and satisfaction of a woman who by herself makes a decision about her body, is a sufficient motif. The established aesthetic operations of the ‘visible’ parts of the body, (nose, face, breasts) additionally reinforce the decision. On the other hand, association of gynaecologists and obstetrics at the USA (American College of Obstetrics and Gynaecology) recommends the following:
"The physician must put forward questions about sexuality.
Is the intercourse acceptable for a woman (under certain circumstances)?
Are there any doubts in connection with sexuality? Are there any obstacles in achieving orgasm?"
Arguments ‘for in discussions on ethics of aesthetic operations of the female genitals include also an evaluation on the part of urologist, a profession that deals among other things with male genitals and sexuality. It, according to some opinions, in 50 percent of the cases, deals with virility, erection or the look of the genitals. At the same time, there are more than 20 medicaments that arouse male sexuality and about 200 types of implants or prosthetic devices by which the problem of impotence is resolved. So stressed campaign for helping women does not exist for now in the world.
According to American opinion polls, even among the lesbians there is a significant interest for aesthetic operations of genitals.
Aesthetic and reconstructive operations can give a great pleasure and happiness, and optimism that a woman radiates is a clear indicator of a significantly better quality of living.