Rejuvenation of Male & Female Genitalia

Rejuvenation of female genitalia [Cosmetic Gynecology]
Overview 1

Female genital cosmetic surgical and nonsurgical treatments are a small segment of the plastic surgery market, but it is growing, with tens of thousands of women estimated to undergo such procedures every year all over the world.

Before any discussion on the subject it is important to understand the parts which form female genitalia as seen from outside. The following diagram illustrates the essential parts.

A variety of surgical and nonsurgical procedures exist for rejuvenation and restoration of the female genitalia.

Surgical Non surgical
1. Monsplasty Lasers,RF,Hifu
2. Labia majora rejuvenation Fillers
3. Labia minora reduction O shot
4. Hymenoplasty G spot enhancement
5. Vaginoplasty  

Surgical procedures

In recent years, demand for various cosmetic gynecology procedures has increased exponentially.

  1. Monsplasty – The mons pubis can get become loose and ptotic with age. Monsplasty is usually done in association with tummy tuck but can be done as an independent procedure.

The extra skin and soft tissues are removed providing a gentle lift to the area.

Deflated mons pubis can be made to regain its lost youthfulness and fullness by fat injection extracted from some other part of the body.

  1. Labia majora – The labia majora can become deflated with age giving a very old and haggard appearance to the external genitalia. The labia majora can be made full by injection of autologous fat graft from some area like tummy, thighs etc. The fat is aspirated and allowed to stand till the fluid separates at the base. The fluid is removed by pressing the plunger and then the fat is transferred to small syringes and injected to labia at desired locations. Some of the fat may get absorbed and the final result will become clear only after a few months. The procedure can be repeated if necessary.
  2. Labia minora – Labia minora are leaf like structures inside the labia majora which can become hypertrophic and dark. This can create a cosmetic problem. Sometimes labia minora can become a source of irritation because of their large size.

The solution to this problem is surgical. Under local anesthesia, the labia minora can be reduced to their normal proportions by a variety of surgical procedures. The best procedures donot leave any scar on the visible surface and also serve to preserve the normal sensations of the area so that the sexual pleasure is not compromised.

  1. Hymenoplasty – This procedure is mistakenlyknown as revirginization. The hymen is a delicate membrane which covers the vaginal opening in the virginity. This may or may not be present or be rudimentary. The membrane may be lost due to an active lifestyle. Absence of intact hymen is no proof of loss of virginity. Yet many conservative people give importance to an intact hymen ad bleeding after first night as a proof of virginity. Against this social setting, many females who are sexually active before marriage request restoration of hymen before their marriage. The procedure is done surgically under local or general anesthesia. The remains of hymen are stitched together with fine sutures to restore it to its original status and narrow the vaginal opening. Healing takes place over three weeks.
  2. Vaginoplasty and colpoperineorrhaphy – The vaginal passage can become loose with time due to reasons of age, child births, regular sexual activity and lack of active lifestyle. This may be associated with cystocoele [urinary bladder is prolapsing into anterior vaginal wall], rectocoele [ prolapse of rectum into posterior vaginal wall]- these two conditions merit treatment in their own right. The lax vagina itself can become a source of distress in that it can subtract from the quality of marital life as intercourse pleasure is decreased due to poor grip on the male organ.

Kegel exercises can help the situation a bit but they are tedious and patients seldom continue with them over long term. Also, they donot tighten the puborectalis muscle which surrounds a part of vagina.

This distressing situation can be relieved by the procedure of vaginoplasty. Done under anesthesia, it involves the removal of extra mucosa from the lower half of vagina and tightening of the all important puborectalis sling. The perineum can also be tightened if required.

Sexual intercourse can resume after 2-3 months. The results are very gratifying and long lasting.

Non-surgical procedures-These procedures include-

  • O shot – Here Platelet rich Plasma [PRP] is extracted from patient’s blood and injected into select areas around the clitoris and anterior vaginal wall to improve sexual function.
  • G spot amplification is a procedure where fat or filler are injected in the area of G spot to enhance sexual experience and quality of orgasms.
  • Laser,RF and Hifu have been used for nonsurgical vaginal tightening. They are typically done on out- patient basis without any anesthesia. They are repeated at intervals of 3-4 weeks for 3- times. The deep heat given by these lasers and energy devices leads to the production of new collagen which leads to modest tightening effect.
  • CO2 laser is also used on external genitalia for rejuvenation. This procedure requires topical anesthesia and has a down time of 5-7 days
  • Q switched ND YAG laser is used to lighten dark external genitalia

A WORD OF CAUTION

The growth of female genital plastic surgerycomes despite a warning from the American College of Obstetricians and Gynecologists (ACOG)that strongly questioned the medical validity and safety of female genital cosmetic surgery. The criticisms are-

Some of these procedures may not have proven effectiveness, and there is potential for harm such as infections, scarring, pain and the loss of the very sensations some patients seek to enhance. The trend is the latest service aimed at women pursuing an impossible ideal of physical perfection, hyped by Internet pornography.

Undeterred, tens of thousands of women are choosing to undergo such procedures every year all over the world. The least they can be done is to get the procedure done only after fully understanding the implications off the procedure and getting it done at a center with full facilities and an experienced  plastic surgeon well versed with the procedure.

Overview 2

Rejuvenation of Male Genitalia

The penis is a considered a symbol of male masculinity and fertility and is therefore has been a subject of a lot interest and attention. Many dubious, ingenious and sometimes crazy and out rightly dangerous methods have been tried over centuries to lengthen the penis or phallus. However, one needs to understand the science behind it to separate the wheat from chaff.

Is the penis size really small?

Most guys think they are smaller than average, they probably are not. They just think they’re below average. This is considered a variant of body dysmorphia.Looking from above gives a bad perspective and adds to the worry.

A scoring system has been devised to quantify the anxiety the patient has in his mind about his penile size and sexual inadequacy. Scores calculated can guide us if the patient needs counselling or treatment. The same method can be used to measure the success of surgery.

The typical erect penis is usually 5 to 6 inches long with a circumference of 3 to 5 inches. There’s more variation in the size of flaccid penises. Some guys are genuinely smaller than that. In rare cases, genetic and hormone problems can cause a condition called micropenis — an erect penis of under 3 inches.  Calculations can also be based on the flaccid length and diameter. Based on these findings the penile size can be calculated.

Options for treatment are- non- surgical and surgical

Non- surgical options are pills, creams, stretching exercises, vacuum devices. Almost none of it works.

Weight loss can take the fat away from around the area of penis and increase the visual length of penis.

Surgical option is Penis Enlargement Surgery

Phalloplasty is the name given to procedures which lead to a real or apparent increase in length or girth of penis or both.

 There are two basic penis enlargement surgeries.

  1. Lengthening of penis
  2. Widening of penis

Combination procedures involve both of these methods. Supplementary techniques work on structures around the penis to increase penile show.

It is important to give the patient realistic expectations. Gain in length and diameter are usually in the range of one to two inches only in most cases.

Lengthening the penis

A] The most common procedure is to cut the suspensory ligament that connects the penis to the pelvic bone. The approach is usually just above the penis and a part of the ligament is cut to free the penis. Itallows a little more of the shaft — about an inch — to become visible outside the body. It’s not really lengthening the penis so much as revealing more of what’s usually hidden. To prevent the ligament from reattaching, a guy would need weights or stretching devices daily for about six months.

B] Liposuction of the fat pad around the penis can work if traditional weight loss remedies fail. Lifestyle modifications are necessary to have permanent results.

C] In some cases, the scrotum attaches high up on the shaft of the penis.  Correction of this problem by releasing the web can reveal more of the shaft, making the penis look longer. This is a very simple low risk operation with definite benefits.

Widening the penis. For men who think their penis is too thin, more controversial procedures can thicken it using

a] fillers– implanted autologous fat, silicone, fillers. Silicone, paraffin and PMMA can be associated with troublesome granulomas which may be hard to remove, Fat is a safe option.

b] dermal grafts or dermafat grafts can also be used. Commercial dermal grafts are also available.

Side effects of lengthening surgeries are numerous and include hematomas, infections, damage to nerves leading to reduced sensitivity, scarring and difficult erection. Scarring can leave you with a penis that’s shorter than what you started with. Widening the penis can lead to a lumpy, bumpy, bruised and uneven penis.

Counseling-Psychology plays an important role, too. Some average-sized guys become obsessed with the idea that they’re too small. There’s even a psychiatric diagnosis: penile dysmorphic disorder.  Such patients will not be satisfied with surgery; they need psychiatric counseling. According to one study, many men who get penis enlargement surgery have this condition. They’re also the least satisfied with the results.

In any case sexologists claim that female gratification is not always a function of penile size but depends on being a good and creative lover. Abnormal sized male organ may lead to coital difficulties and pain or discomfort.