Intimate surgery (vaginal rejuvenation) is a broad field characterized by both functional indications and aesthetic motivations. In addition to conventional gynecological or urological surgical procedures on the female or male genitals, there are a number of aesthetic procedures in the field of plastic surgery. With the change of attitude towards individual sexuality, careful de-tabooing leads to the steady development of the field of intimate surgery.
Indications (areas of application)
Especially women often suffer from the changes in the intimate area. Causes of unsightly genitals, which can lead to a strong burden on the patient’s psyche, are as follows:
- Congenital labia majora
- Weakness of connective tissue
- Pregnancies
- Aging with sagging of the tissues
- Pathological changes, e.g. after tumor surgery
The changes in intimate areas are accompanied by a constant impairment in everyday life: pain in activities such as cycling or wearing tight clothing or swimming gear is not possible. In addition to everyday life, sexual life is very often significantly affected. In addition to women, men are also affected, and this usually involves conflicts or stigmatization caused by small genitals that are perceived as inadequate (e.g., a penis that is too small), which can become a strong psychological burden.
Before surgery
Before surgery, an intensive medical history discussion should be conducted that includes the patient’s medical history and motivation for the procedure. The procedure, any side effects, and the consequences of the surgery should be discussed in detail.The patient should also be advised that men are much less critical of the genital region and actually find almost any vulva erotic. Note: The requirements of the explanation are stricter than usual, since courts demand a “relentless” explanation in the field of aesthetic surgery. Furthermore, you should not take acetylsalicylic acid (ASA), sleeping pills or alcohol for a period of seven to ten days prior to surgery. Both acetylsalicylic acid and other painkillers delay blood clotting and can lead to unwanted bleeding.Smokers should severely limit their nicotine consumption as early as four weeks before the procedure so as not to jeopardize wound healing.
The procedure
In the following, a brief summary of different surgical procedures from the field of intimate surgery is given in order to gain insight into the subject. Different operations are mentioned and characterized. Aesthetic procedures on the female genitalia:
- Labiaplasty (labiaplasty; labiaplasty) – Due to various reasons such as age-related or due to a weakness of the connective tissue, changes in the labia can occur. Naturally, the outer labia cover the inner labia, if the inner labia protrude over the outer labia or if the outer labia are flaccid, the risk of infections increases. In addition, pain is possible. This process can be countered with a labia reduction or labia augmentation.
- Labia reduction (labia reduction) – This operation can be performed under local anesthesia and is used to correct inner labia that are enlarged or protrude beyond the outer labia.
- Augmentation of the labia (labia augmentation) – Implantation of autologous fat is usually used to enlarge the labia minora, if they do not cover the labia minora.
- Liposuction on the mons pubis – A very pronounced mons pubis can be corrected by liposuction in this area.
- Correction of the clitoris – If the clitoral hood is enlarged, it can be reduced.
- Vaginal constriction (vaginal narrowing) – Due to various processes, but especially pregnancy, the vagina can be severely lax (stretched or overstretched). By Raffung/Readaption/Reconstruction of the subepithelial fascial structures (“vaginal tightening”) can improve sexual sensation.
- Hymen reconstruction – restoration of the hymen (hymen).
- Reconstructive, plastic surgery after injuries, tumors or other changes.
Aesthetic procedures on the male genitals:
- Circumcision – This term refers to circumcision of the foreskin, which is performed both for ritual reasons and for medical reasons (eg, phimosis – narrowing of the foreskin).
- Penis enlargement / penis lengthening – This is a controversial procedure that achieves a gain in length of about 2-3 cm.
Not listed here are operations for the purpose of gender reassignment in transsexual people.
After surgery
After surgery, swelling, redness and mild pain are expected, which will subside after a few days. Sexual intercourse and sports activities such as horseback riding or similar should be avoided.
Your benefits
Intimate surgery represents an option for correcting psychologically stressful changes in the genital organs. However, such a procedure should always be preceded by a critical examination of its necessity and benefits.
