Cosmetic gynecology is a very recent term coined for various procedures that can be used to enhance the appearance of the female genitalia. However, many of the procedures are very established gynecology treatment which are not just cosmetic but also important to enhance the function of the female genitalia which is sexual function, urinary function and including anal function. With the addition of newer treatments including those using lasers, fillers and even fat injection, the public is confused by the various terms used.
Vaginal delivery is the most important factor that changes the condition of the vaginal and affects the vaginal function which includes the sexual and non-sexual function. The hormonal changes that occurs during pregnancy prepares the vaginal for stretching to allow the baby to be born. The passage of the large baby stretches the vaginal muscle and does damage not only the muscle but also the nerve supply. The vaginal muscle does recover but it is never the same again as before vaginal delivery or to lesser extent pregnancy. It is well known that there will be a higher incidence of leakage of urine in later life, decrease vaginal tone and even some problem with the anal function. In severe cases, some women may have prolapse of the uterus which is a condition where the support of the womb (uterus) is severely damaged and the womb drops out of the vagina.
Aging process itself will also change the appearance of the skin around the vagina. Menopause women will have vaginal dryness because of the lack of female hormone (oestrogen).
The various procedures describe below also includes procedures that not only enhances the appearance but also helps in restoring the sexual and non-sexual function of the vagina.
The hymen is a thin membrane with a small hole in the center covering the opening of the vagina. The hymen is torn during the first sexual intercourse. Hymen repair is a common request especially in conservative society when the women do not wish her past pre-marital sex to be known. While not all of us subscribe to this idea that a bride must be a virgin, many of these women needs this surgery because of the background they come from. The hymen can be repaired and restored.
The labia refers to the two flap of tissue on either side of the opening of the vagina. Some women are born with very large labia. Other than looking a bit odd in severe cases, it can also interfere with sexual intercourse and cause pain. Some women as they grow older, the labia also enlarges. The labia can be trimmed and repaired to a smaller size.
This is a very common and established gynecology procedure to tighten the vaginal muscle especially after childbirth. It is also commonly call posterior repair. The loose muscle of the vagina can be brought together and tightened resulting in better sexual satisfaction for the couple. This can be done under local anaesthesia in a center setting.
Urinary incontinence surgery
This is not really a cosmetic gynecology surgery but mainly for treatment for urine incontinence ( leakage of urine when coughing). A procedure call anterior repair can be done to tighten the vaginal part near the bladder opening. More complicated operations are also available for more severe cases but those operations will have to be carried out in the operating theater.
This is a major condition where the whole womb has drop out of the vagina. This will involve a major operation to restore the position of the vagina and will have to be carried out in the operating theater. The operation will also involve tightening of the vagina.
Laser vaginal rejuvenation
This original term was trademarked by a doctor in US – Dr. Matlock. However, it has come to mean a lot of other things over the years. Dr. Matlock is a very savvy doctor at marketing. He used the term to refer to the use of laser to cut instead of using a knife for the operation. Basically, the treatment is similar to a posterior repair for tightening the vaginal opening.
More recently, lasers have been used to restore the vaginal lining (mucosa) thereby reducing vaginal dryness and enhancing sexual function. Many doctors nowadays will use the term laser vaginal rejuvenation for this this non-surgical treatment. The laser can be either a CO2 laser or an Erbium-yag laser for rejuvenation of the vaginal wall. It is very effective not only for normal pre-menopausal women but also post-menopausal women. It will also result in some tightening of the vaginal and even helps in women with some urination problem.
The laser can be used to complement simpler treatments such as hormone replacement therapy, vaginal cream and vaginal lubricants.
Laser vaginal whitening
The skin around the vagina will usually darken after pregnancy. The skin in that area like any part of the body will also age. Some women may request for laser vaginal whitening. This will help to restore the appearance of the skin. This is purely a cosmetic procedure. Other simpler procedures like whitening cream can also be tried first for milder cases.
G spot enhancement
This is a procedure introduced by Dr Matlock more than 10 years ago. The G spot is a sensitive spot at the opening of the vagina with extra nerve endings. Injection of fillers at the spots helps increasing sensation to the women during sexual intercourse.
O spot injection
This is one of the most recent treatment introduced for enhancing sexual function. This involves using PRP (platelet rich plasma) to rejuvenate this sensitive area in the vaginal and also the vaginal lining. The area in the vagina just behind the cervix is the O spot and may help in orgasm. Studies have shown a success rate of 80 % in enhancing the orgasm in women.
PRP has also been similarly used for improving the sensation for men. This is call the P injection.
The term cosmetic gynecology is a fairly new term and many are not familiar or confused by the term. It includes a lot of traditional procedures and also some new procedures used to enhance mainly the sexual function and also the appearance of the female genitalia. With the liberalization of women and also increase exposure to the media, an increasing number of women are requesting for these procedures. Gynecologist with special interest in aesthetic may be more suited to offer this service
Dr. Terence Teoh
MBBS (Singapore), FRCOG (UK)
AM (Malaysia), FAM (Singapore)
Diploma in Aesthetic Medicine (AAAM)