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Aesthetic procedures for female genitalia

Dr. HamoriDemand for cosmetic genital surgery is growing exponentially, and doctors from several specialties are responding by offering genital rejuvenation services, says plastic surgeon Christine A. Hamori, M.D., founder and medical director of the Christine Hamori Cosmetic Surgery and Skin Spa, in Duxbury, Mass.

Plastic surgeons are trained to perform these complex aesthetic procedures during surgical residency training. During the past few years, a growing number of gynecologists have started to perform aesthetic procedures of the female genitalia. Dermatologists also have begun to perform noninvasive skin tightening procedures of the vulva, says Dr. Hamori, who presented “Surgical and nonsurgical genital rejuvenation” at the American Society for Aesthetic Plastic Surgery’s The Aesthetic Meeting 2017 in San Diego, Calif.

“Since more and more patients are interested in vulvar procedures, it is important that surgeons be properly trained with appropriate aesthetic techniques,” Dr. Hamori says.

Labiaplasty, for reduction of the labia minora, is by far the most popular aesthetic genital surgery for women, she says.

“Noninvasive treatments are available to improve lubrication, urinary stress incontinence and vagina changes due to menopause,” Dr. Hamori says.

But not all have panned out in studies.

“Vaginal tightening devices are on the market but few studies, so far, show significant improvement in vaginal tone,” she says. “Vaginoplasty or surgical tightening of the vagina is necessary if significant vaginal laxity is present after vaginal birth. It is similar to attempting to tighten the abdominal muscles after pregnancy via a noninvasive laser or [radiofrequency] device, when what is really needed is plication of the rectus muscles in the midline via an abdominoplasty.”

Dr. Hamori says cosmetic surgeons should do their research before purchasing devices for genital rejuvenation. She offers these tips for wiser purchasing:

Ask for copies of articles from peer-reviewed journals showing efficacy in treating menopausal symptoms (stress incontinence, vaginal atrophy and vaginal dryness), and/or vaginal tightening.

Ask about consumables, number of treatments necessary and warrantees.

Don’t jump on the bandwagon because everyone else is buying vaginal noninvasive devices, because the same thing will happen that happened to noninvasive facial tightening. It works for very specific problems in some patients, some of the time. Best to wait until there is clear data demonstrating efficacy.

Disclosure: Dr. Hamori reports no relevant disclosures.

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