A Private Look at Female Genital Surgery

To visit a plastic surgeon in order to change intimate parts of your body is not a snap decision. If you’ve gotten to that point you’ve probably done your research and are prepared for the surgery. Some women have genital surgery for esthetic reasons and others for medical reasons. Modern clinics offer many modifications of external female genitalia. Most of the procedures carry minimum risk and only require several days of hospitalization.

The first step should be a consultation with a possible plastic surgeon. An exam will be performed by a gynecologist who specializes in female genital surgeries. The goal of the consultation is to « coordinate” the patient’s esthetic requirements with the surgical possibilities of the procedure. The final effect of the procedure should be a satisfactory one with minimum medical risks. The date for the procedure is set right after the end of menstruation. This is to ensure optimum hygienic conditions of the genitals during the healing process. (Women taking hormonal birth control can postpone their menstruation by not stopping the pill to have it so they are freer to select the date of the procedure.)

It is not necessary to schedule gential surgeries in the fall and winter seasons like for cosmetic and vascular surgeries that are performed on uncovered parts of the body.

The procedure is performed under sterile conditions in the surgical room, under general anesthesia, with the necessary pre-surgical, laboratory and specialized medical (internal) examinations.

After surgery care and the healing process is usually uncomplicated if medical recommendations and hygienic measures are strictly followed. The healing process usually takes five to ten days, depending on the extent of the procedure. Post-surgery pain usually lasts one to two days. Plan on staying in hospital for one to two nights. Medical check-ups and compresses, (eventually iced compresses) are an essential part of the hospitalization, just like controlling pain after the surgery. The patient will receive effective analgesics in the form of inner-muscle injections, pills or suppository applied in the rectum. The patient will change to out-patient check-ups during their home care based on the surgeon’s recommendation.

The above mentioned procedures, pre-surgical consultation, laboratory and internal examination and hospitalization are not covered by health insurance.

Labiaplasty

Labiaplasty is a cosmetic surgery, mainly the reduction and eventual “reshaping” of the labia minora. An undesirable change in the shape of the labia can be influenced by changes after the birth of a child, an accident, congenital asymmetry or congenital enlargement of this part of the external genitals. The reasons for the surgery might be esthetic or medical. The enlarged lips can cause problems for example during walking, sports, sexual intercourse, etc. Women and young girls of any age can undergo this procedure. The surgical process consists of the removal of extra tissue through a sharp incision. The edges of the incision are consequently cosmetically modified through a suture with absorbable stitches. The absorbance of the stitches takes up to three weeks; the stitches are not removed.

Hymenoplasty

The hymen is a mucous membrane that partially covers the vaginal opening in women that haven’t had sexual intercourse yet. Hymen restoration can be performed through the surgical modification of the mucosa of the vaginal opening. The incision is done with a scalpel around the circumference of the vaginal opening. The reconstruction of the so-called hymen circle is consequently performed with a suture. An absorbable suturing material is again used with minimal irritating (causing irritation) characters on the sensitive mucosa and skin in this area.

Perineoplasty

This procedure means plastic surgery of vaginal opening and (according to the need and situation) also of the adjacent part of the vagina and perineum. It is mainly performed in women who have an acquired deformation of their external genitalia. The reason might be a vaginal delivery of a large baby or a badly healed perineum cut. Besides esthetic reasons, patients often have problems with pain during sexual intercourse and in extreme cases do not have sex because of the pain. Another group of women that have this surgery are older women with a reduced elasticity of submucous tissue. The vaginal opening is more exposed because of age, hormonal reasons and a congenital disposition. It can lead to a less satisfactory sexual experience for both partners, frequent inflammation of the vaginal or urethra and an uncomfortable feeling when walking or sitting. The surgeon chooses the optimal process based on the deformation of the vaginal opening and the character of the problems. The extra tissue, parts of the vaginal mucosa or the skin folds of vaginal opening and the skin of the perineum are sharply removed and the edges are carefully reformed and sutured with absorbable stitches.

Combined procedures

The above mentioned procedures can be combined according to the wishes and needs of the patient and based on recommendations from the surgeon.

Other procedures

Other female genital procedures include the removal of birthmarks, “classic” warts and so on from the area of the genitals or the removal of or the application of piercing. According to the extent and placement of the skin formation it is possible to choose to have a simpler local anesthesia. It is applied through anesthetics in the form of intra-dermal injection or gel on the skin at least 15 to 30 minutes before the disinfection of the treated area. The above mentioned procedures can be performed out-patiently with check-ups after the surgery at the clinic. Unusual skin formations are checked before the procedure by a dermatologist. The removed tissues are subsequently submitted for histological analysis.