SURGICAL & NON SURGICAL TREATMENTS
NON SURGICAL QUICK THERMIVA SESSION AND PRP INJECTION FOR
- Urinary Leakage
- Post Delivery Mummy Makeover
- Menopause vaginal dryness and recurrent infection.
- vaginal Laxity – Female Sexual dyfunction
- Atrophic vaginitis in cancer patients
- Vulvodynia Pain
- Lichen Sclerosus Skin Disorder
SURGICAL PROCEDURES
- Vaginoplasty (Tighten Up)
- Perineoplasty (Tighten Up)
- Hymenoplasty (Tighten Up)
- Labiaplasty – do you also want Barbie look
- Prolapse Surgeries
- Sling Surgeries
Labiaplasty, which is sometimes called labioplasty, is a gynaecologic surgical procedure to reduce the size and sometimes the shape of either labia majora or labia minora. It is currently one of the most frequently performed aesthetic vaginal surgical procedure. The bilateral longitudinal mucocutaneous folds between the labia majora and vulvar vestibule are called nymphae or labia minora. The labia minora are extremely sensitive to touch during sexual stimulation because of the erectile connective tissue and rich nerve endings in the nymphae. The minora vary widely in length, thickness, symmetry, protuberance by the patient and the color and texture of the labial edge, or the labia minora should be removed, if requested. Patients are given an in office, local anesthetic, concious sedation, or traditional general anesthesia.
The concept of tightening the vaginal dimensions altered by the childbirth is not new. Vaginal rejuvenation or tightening is more than 1000 years old, and it was introduced by women.Here it is described as suturing of vaginal lacerations at childbirth, which forms the basis for all modern vaginoplasty techniques. Also there are five non surgical techniques for restoring virginity. The section opens as follows: “A constrictive for the vagina, so that women may be found to be as though they were virgins, is made in this manner. Renowned medieval historian who spent decades researching all extant versions of the Trotula ensemble and salernan culture before her definitive translation opined: “It may be that some of these constrictive were meant only to tighten the vagina to enhance the friction of vaginal intercourse, not necessarily to produce a fake blood flow of ‘defloration’; in other words, they may have been intended as aids to sexual pleasure within marriage”.
Vaginoplasty is a general term for any procedure that reshapes the vagina. These includes cosmetic and therapeutic operations of both the introitus and the canal. a few common examples are perineoplasty, vestibulectomy, cystocele repairs, rectocele repairs, colpocleisis and colpopeineoplasty. In cosmetic gynaecology the word vaginoplasty has been taken on a more specific connotation to refer the procedures that reduce the caliber of the vaginal introitus and the vaginal canal with the simultaneous complication of the levator ani muacles
Surgical reduction of the width of the perineum is called perineoplasty. Technically, it involves the excision of midline tissues spanning the eprineum and lower posterior vagina and the approximation of tissues immediately lateral to the excision zone. In therapeutic gynaecologic operation, perineoplasty is performed to enhance the support of the pelvic floor at the time of pelvic reconstructive surgery. In cosmetic gynaecology, perineoplasty is performed to create an external muscular cuff of reduced vaginal circumference to complement a deeper zone of caliber reduction, typically executed through conservative canal displays residual laxity, and the surgeon fails to recognize the diagnosis. In therapeutic gynaecology, perineoplasty is sometimes used in the process of wide local excision of localized neoplasms. Many plastic surgeons use the term external vaginoplasty when discusiing perineoplasty or even labial surgery.
Perineoplasty defines any change in the shape of perineum, including efforts to wider the perineum and create a wider vaginal introitus. In practice, however widening process dures are not referred to as perineoplasty. In these situations, we see more descriptive name such perineal expansion, perineal release, or vestibulectomy frequently referencing the underlying reason for the intervention.
Informed Consent
Informed consent is a critical component of a lawsuit and essential for patient happiness. Risk managers speak of informed consent, recognizing its importance, yet it is rarely the sole basis of a successful lawsuit. Cardiovascular studies suggested that patients under stand and retain approximately 35% of what is discussed in a consultation. However, these data are old, and by presenting information in a manner to accommodate patients’ main learning styles-visual, auditory, and kinesthetic-rates of retention can be much higher. Through a collaborative effort of the surgeon, coordinator, nurse, and others, a practice can benefit by presenting a story of expectations for auditory learners, diagrams and photographs for visual learners, and specific examples of possible interactions for kinesthetic learners. The more all three are included in the informed consent process, the better a surgeon’s understanding of the patient’s expectations and the ability to achieve them, and the better the patient’s understanding of acceptable risks and complications.
The informed consent process should be documented in an educational style and not in a legalese style. An appropriate amount of time should be allotted for questions and answers and to acknowledge that the patient understands what can, and especially what cannot be achieved and that no results can be guaranteed. This cannot be accomplished in one visit, at the end of which the patient signs the reflection documentation, which is informed consent reflecting what has been discussed in this process.” Some patients never understand the informed consent process, whereas others do so after the second practice interaction. For those who do not understand, wise surgeons will not schedule surgery, but rather continue providing “nonselling” information, helping the prospective patient balance her goals and understanding. The process must be explained in part by the surgeon who will perform the surgery. The practice nurse or coordinator can assist but cannot thoroughly discuss and answer surgical questions.
Realistic Expectation
Patients should be informed about the risks of noncompilance. Suregons may say, “I can no longer be responsible for your outcome if you do not follow recommended instructions”. All patients should sign a revision policy. The consent should clearly state the requirement to comply with preoperative and postoperative instructions and explain that non compliant patients will be responsible for the cost of any additional surgery. For instance, labiaplasty patients who smoke before or after surgery are at very high risk for wound complications. These patients should sign a revision policy starting that they will be required to pay for any revision surgery.
Surgeons who describe in advance a complication that occurs postoperatively are often thought to be very smart; however, the same information provided after the complication occurs is often seen as an excuse and is not well accepted. The best advice I can offer is to discuss the benefits of a procedure versus the inherent risks and complications that may occur, while ensuring the patient’s goals are realistic. This process should be carried out over the course of several patient visits,