Aesthetic female genital surgery involves surgery on normal female external genitalia; therefore, it falls into the same category as liposuction, breast augmentation, facial rejuvenation, cosmetic dental surgery, or any other aesthetic surgery procedure to the body. It is designed to improve the appearance subjectively, and potentially provide psychological and functional improvement in sexual stimulation and satisfaction.
Labioplasty refers to reduction of the labia minora (mostly) or majora, as well as to augmentation through injection of bulking agents or autologous fat transfer. Women seek Labioplasty for different reasons. Functional indications include: discomfort in clothing or during sports, dyspareunia due to invagination of the labia on penetration can be another functional reason but a growing number of women seek this kind of surgery purely for aesthetic reasons. The technique consists of a full thickness wedge excision centrally or at the posterior part of the labia minora which has the advantage of making the residual scar almost completely invisible. It preserves the natural outline, the pigmentation of the free edge and the neurovascularity. Some swelling immediately postoperatively is to be expected and the first postoperative visit is usually scheduled around 1 week. Sooner incase of swelling, pain, or hematoma. Normally, patients can return to work after only 3–4 days. Sexual intercourse, bicycling, and intensive sports should be stopped for 4–6 weeks, until complete healing of the wounds has occurred.
Reduction of Labia Majora
Enlarged Labia majora (Outer Lip) could be primary labia majora hypertrophy (Volume Excess) and secondary labia majora hypertrophy due to volume loss (skin excess). When there is a true volume excess, the enlarged labia majora can be reduced by liposuction. However, this might create sagging and skin excess. In case of skin excess due to volume loss, a reduction of the labia majora can be performed by excision of the excess tissue .Postoperative complications of a wedge excision are bleeding and transient hypersensitivity for 4 to 6 weeks.
The procedure is mostly done in the labia majora and consists of augmentation through autologous fat injections or lipofilling. Fat can be harvested from the abdomen or the inner thigh. When performing a lipofilling of the labia majora a rather minor hypertrophy of the smaller labia can be masked. In case of a substantial labia minora hypertrophy, a reduction Labioplasty can be performed with lipofilling of the labia majora.
Vaginal Tightening Procedure
During life, most women experience decreased vaginal sensation, most commonly with a feeling of a widened vagina. Vaginal laxity, as it is called, is a common complaint among parous women. Although women report that reduced sexual sensation is the most common specific symptom of vaginal laxity. The goal of these procedures is to reconstruct (or to narrow) the lower third of the vagina, which includes ‘‘the orgasmic platform, internal and external vaginal diameter (introitus) and the perineal body. The procedure enhances vaginal muscle tone strength and control, and decreases internal and external vaginal diameters. In vaginal tightening procedures, portions of mucosa are excised from the vaginal fornices (via scalpel, needle electrode, or laser) to surgically ‘‘tighten’’ the lower third of the vagina.
The hymen is the mucous membrane that partially closes the entrance to the vagina, named after the god of marriage in classical Greek mythology, Hymenaios. The hymenoplasty procedure consists of surgically tailoring the hymenal remnants so that they can be sutured together with absorbable interrupted sutures to narrow the vaginal orifice. The procedure can be repeated as many times as desired.
The clitoris is the embryonic equivalent of the male penis and is packed with 8000 nerve endings, twice the number of its male counterparts.
Clitoral Hood Reduction
Clitoral hood reduction is designed to produce more exposure of the clitoral body with improved sexual stimulation and to improve the appearance of the genital area. Women request revision of their clitoral hoods usually for two reasons. Occasionally, the clitoris is ‘‘buried’’ under an overabundant prepuce, or ‘‘trapped’’ under a tight, phimosed hood, leading to little direct stimulation, regardless of maneuvers attempted. Second, as with hypertrophied labia, many women find their generous perpetual folds unsightly and a source of embarrassment.
Following are the approximate estimated costs for the above mentioned procedures:
Hymenoplasty 50000 INR
Vaginoplasty 70000 INR
Clitoral hood reduction 30000 INR
Total female genital rejuvenation Surgery involving all of the above: 120000 INR