Genital Aesthetics

 In studies conducted in the United States, genital aesthetic operations have taken first place in recent years. While the demand for facelift and breast aesthetics has decreased by 18%, the demand for vaginal aesthetic operations has increased by 30%. Among women, the correction of the labiaplasty (labiaplasty) and the narrowing and adjustment of the vagina are the new trends.

With the developments in the last 20 years, modern operation techniques and materials, effective and permanent operations are now possible. We don't just look at it from an aesthetic point of view. I take care not to use the word aesthetic in front of patients. First of all, if you correct the distorted anatomy, which develops due to births and personal connective tissue structure and increases with advancing age, you will already achieve the result desired by the patient. Sometimes, there may be congenital structural disturbances in the outer region. It creates problems both in appearance and in daily life. We repair these situations with corrective operations.

Why do women demand plastic surgery for their genitals?

Among the organic-caused sexual problems, disorders due to congenital or subsequent structural disorders in the genitals of women have an important place. Except for obvious cases such as "I have a swelling down in my hand, I feel like I'm sitting on a balloon, something comes out when I push on the toilet", some patients come to us and say that their vaginas are large and they cannot enjoy intercourse. Sometimes this can be their own feelings, sometimes their spouse's complaint. The question is, is this real? Or is it the other side's excuse? It's a situation we come across often. For this reason, there are patients who say that their spouses have distanced themselves from them and they have become seriously depressed as a result of this. The vagina is a sensitive organ and its tissue does not have the ability to regenerate. Any unnecessary or improper action can lead to irreversible and even worse results. In principle, I do not look at the patient's wishes, but whether it is necessary or not. Our action must make a difference.

I don't operate if it won’t make a difference.

Enlarged or asymmetrical outer lips can cause some problems. There may be sensitivity due to rubbing on underwear or trouble in intercourse, urination, sports, and cycling. In these cases, we can take action from a medical point of view. But increasingly, we have patients who request it for cosmetic-aesthetic reasons. An important group among them sees this as necessary from a professional point of view. For example, those who work as dancers, actresses and models. This procedure can be applied to both inner lips and outer lips. There are different operating techniques. However, considering the Labium (inner-outer lips), Clitoris and the tissue covering the Clitoris as a whole, and correcting the entire region will give the best results. Expectations and what can be done should be discussed in detail with the patient before the operation, and patients should not have unrealistic expectations.

Many women find their genitals unsightly and their vaginas wide after giving birth. Some patients say that water constantly leaks into their vaginas during showering and swimming, and they experience chronic infections and irritation problems due to this. Before the operation, a detailed examination should be done to determine the area in which the procedure will be performed, and it should be shared with the patient. No incision should be made on the skin at the entrance to the vagina. Because this area is very sensitive to pain and the incisions and stitches in that area will not help narrowing.

Do these damages occur in every woman who gives birth? Does the type of birth matter?

After the pregnancy process and a birth, nothing is the same as before. This applies to all systems. The severity of this damage varies according to the person and the process experienced at birth. Of course, we encounter damage more often in vaginal delivery, which is a natural result. However, genital area damage can occur even after a cesarean section. Roughly one in three women who give birth experience structural and functional problems with the Pelvic Floor. It should be taken as a memory of your children.

Recovery period and complications

Although rare, infection, bleeding, wound healing problems, disturbing scar tissue and post-correction asymmetries may occur in labiaplasty. After the first 7-10 days, sensitivity, pain and discharge decrease. The patient is sent home on the same day and can start working the next day. The patient who stays in for a maximum of two nights in vaginal tightening can return to her normal life after a week. However, in both cases, sauna, swimming, intercourse, some sports, running, and cycling are not recommended for the first 4-6 weeks.

Procedure time

Depending on the procedure and technique, it takes 30-60 minutes for the outer lips, and 75-120 minutes for vaginal tightening.

Patient satisfaction and results after vaginal aesthetic operations

The degree of satisfaction depends on the patient's expectations and the skill of the surgeon. Patients who do not want to encounter undesirable results should find an experienced and proven physician, although it is sometimes more expensive. The results of the operation on the outer lips are mostly satisfactory. However, operations such as vaginal aesthetics and narrowing require a good determination of the damage and a complete repair. Problems are exacerbated by "simple" surgical techniques, where tissues are cut out and sutured as they are considered redundant, as is often the case. If a vagina tightening operation is to be performed to increase the pleasure of the patient from intercourse; As David Matlock, an American, important person in Genital Aesthetic Operations stated in a study, it should be known that only half of the patients can be successful in this regard. In women, sexual aversion is multifactorial.

Are there any sexual problems that can be treated surgically other than for aesthetic purposes?

Raising sexual problems is still taboo. In this sense, pain during intercourse is the most common reason for application. However, there are many reasons for this. In addition to this region and many systemic diseases, there are drugs that are used in the treatment of some chronic diseases but also reduce sexual desire. First of all, a detailed examination is required. From my point of view, urinary incontinence (even during intercourse) pushes the person away from their partner more and more. A vicious cycle occurs with hygienic problems, treatment-resistant infections, feeling unwell, etc. The same is true for genital organ prolapse. Although they are in the sexually active period, approximately 60% of these patients do not have a sexual life. Again, patients who cannot control their bowel movements, especially as a result of birth trauma, experience similar problems. Enlargement in the vagina as a result of ligament-muscle injuries at birth makes it difficult to enjoy intercourse, and chronic back pain due to prolapse can alienate the woman from everything. In addition, it forms an important group in patients with a shortened, scarred vagina due to vaginal operations and removal of the uterus.

Summary

The word of Hippocrates is important to us. “First do no harm”. As I mentioned at the beginning, in patients who apply only for aesthetic concerns, the benefit/harm balance of the procedure for the patient should be well calculated. This type of operation may not be required for every childbirth. Sometimes exercises that strengthen the muscles in this area can be beneficial. There are even stimulation devices that are sold for this job and used by placing them in the vagina. Of course, significant connective tissue damage can only be corrected by surgical treatment. In our country, the demands for vaginal aesthetics are increasing rapidly. You can get the ideal guidance from Gynecologists and Obstetricians in order to reach a specialist who is particularly involved in this subject and can offer you the best results. We make a detailed evaluation of the patient who applied with the request of "vagina aesthetics" and talk about its necessity. Goeschen / Çalışkan method offers an ideal solution in this sense. Contrary to routine applications, we do not remove any tissue as redundant during the procedure, we reuse it by performing special operations. Thus, we maintain the elasticity and flexibility of the vagina. After such operations, hardening of the tissues, shortening of the vagina, and pain in intercourse are rarely encountered. Another feature of the technique is the extremely insignificant scarring. In fact, after a few years, the operation scar cannot be noticed in most patients.