Genital Aesthetic Surgery

Genital Aesthetic Surgery

Laser vaginal rejuvenation, sagging labia majora and minora, Penis thickening, Penis Extension, Prostheses for erection purposes

Anatomically, the genital area is an area consisting of the skin containing the reproductive organs and the hair follicle covering them, called the pubic mountain (mons pubis), at the top, and fatty tissue and connective-muscular tissues at the bottom.

In the female genital area, under the mons pubis, there is the part called vulva, where the structures belonging to the entrance to the birth canal (large and small lips, urinary tract entrance, vaginal entrance and clitoris) are located, and behind this, there is the perineum, which supports the internal organs from below. The vulva continues inside with the vaginal canal (vagen) and connects to the uterus.

Image note: Anatomy of the external genital system in women

In men, the penis, testicles responsible for sperm production, and the perineum are located under the mons pubis.

Image note: Male external genital system anatomy

Some genital plastic surgeries can be performed with regional anesthesia. Pain is not an expected finding in the postoperative period.

Although plastic surgeries in the genital area are more often preferred by women, my male patients especially request surgery to increase the thickness and length of the penis .

The main demands of my female patients are vaginal rejuvenation and tightening surgeries, hymenoplasty (hymen repair), removal of vulva sagging (labioplasty), and G-spot surgeries .

While most of these surgeries can be performed with regional anesthesia, vaginal rejuvenation and tightening surgeries, G-spot and penis thickening surgeries that require liposuction and fat injection should be performed under regional anesthesia with at least deep sedation support. We have patients who prefer some of these surgeries in an office setting. However, surgeries that require sedative medication should be performed in the operating room environment. Please consult your doctor for more detailed information.

“How long are laser vaginal rejuvenation surgeries effective?” The question is actually related to the entire effectiveness of the laser. There is no study showing that laser is superior to surgical techniques in terms of long-term effectiveness.

Sexually active life and therefore birth causes loosening and sagging in the vaginal muscles and the inner covering called vaginal mucosa. The degree of this varies between individuals. The most frequently asked question from women regarding genital aesthetics is about my experiences with laser vaginal tightening and rejuvenation. Although it seems to have the advantage of not leaving a permanent scar on the vaginal wall, there is no study showing that there is a significant difference in surgical results with vaginal laser applications. In my personal experience, in surgical treatment, damage is only caused to the back wall of the vagina, while in laser treatments, the cylindrical structure of the laser probe causes damage all around. As a result of its effect, more widespread damage occurs. Therefore, patients apply with complaints such as correction of loss of sensation, pain and burning due to dryness during sexual intercourse. On the other hand, it cannot be said that the long-term results are superior in terms of loosening of the vaginal wall. In surgical techniques, there is also the opportunity to intervene in the incision mark (in necessary patients) at the entrance of the vaginal wall, called episiotomy, which is made to widen the entrance during birth. Before. Due to the three-dimensional effectiveness I mentioned, laser healing may take a little longer. In surgical techniques, some mucosa cover is removed from the back wall of the vagina, called the rectum, adjacent to the hindgut, according to the need determined by the physician during the examination. Afterwards, covering stitches are placed to include the underlying muscles.

In all techniques, a second pregnancy and intense sexual activity will actually affect and accelerate the return.

Vaginal rejuvenation surgeries are generally performed under sedation and regional anesthesia. General anesthesia or waist numbing techniques (epidural anesthesia) can also be used in patients who request it. Recovery takes an average of two weeks, but I do not recommend sexual activity before a month. This period can even be clarified during control examinations.

In women, there are labia majora and labia minora (labium majus and labium minus) in the vulva region, and sagging in them may negatively affect daily sports activities (running, cycling, etc.).

Another genital aesthetic issue that my female patients frequently refer to is sagging in the area called vulva. Genital sagging is generally observed in the structures called labium minus. Although there are variations in the labia minora between races and families, sagging has no relation with pregnancy or sexual activity. This sagging, which can also occur after puberty, sometimes covers the cylindrical structure called the clitoris , which is one of the most important structures of sexual stimulation in women. In this case, these structures should be reduced in size in a way that does not cause excessive nakedness and does not disrupt sexual stimulation and activity. Excessive exposure of the clitoris may disturb patients. In such cases, additional surgeries may be required to partially cover it again (such as fat injection to the upper part, closure with adjacent tissues prepared in the form of leaves). [photo] Some of our patients apply with the complaint of large clitoris . Screening for hormonal disorders may be necessary in these patients. Reduction surgeries on the clitoris may negatively affect sexual function by causing loss of sensation in this organ in some patients. Our patients take this possibility into consideration and undergo these surgeries.

In the process of reducing the labia minora, a wedge-shaped tissue is generally removed from the middle part and the upper and lower parts are joined together. Although there are surgeries that leave scars in the area, the scar is generally well hidden in the area.

Hymen repair is an issue with social and ethical dimensions. In cases where the patient's life is negatively affected (such as damage to the hymen due to rape, injury, etc.), hymen repair may be necessary.

Although it is not included in the scope of genital plastic surgeries, repair of hymen injuries is one of the frequently performed surgeries in this context as it causes social problems. Some patients request hymen repair with sagging vulva.

Although it is a structure with less pain sensitivity than other areas of the genital area, it can be applied under regional anesthesia and sedation support upon request. Although many repair techniques have been described, the main goal is to create a curtain with regional tissues that does not completely cover the vaginal opening. The techniques used vary depending on when the next sexual intercourse will be performed, from procedures performed only by placing stitches to creating a curtain with regional tissues. In general, failure rates are high in repairs performed only with stitches. The use of regional tissues provides a more stable repair. However, after a curtain is created, the vaginal opening must be checked by the patient at regular intervals due to the possibility of the tissues shrinking (contraction) and this is especially important for menstrual bleeding to occur.

The surgery takes between 15-20 minutes in total and does not require hospitalization. It is recommended that patients avoid activities that keep their legs apart, such as cycling or horseback riding, in the early period. You can take a normal shower after the surgery. It is usually followed by daily change of sanitary napkins.

Very rarely, hymen repair surgeries may not be successful. Here, the timing of sexual intercourse after repair is an important factor.

G-spot surgery is a surgery whose effectiveness is still questioned and is claimed to increase sexual arousal. The aim is to highlight this relative point by injecting fat or filler material.

One of the most popular reasons for application lately is G-spot surgery. G spot (G-spot) is an area located on the front wall near the lower end of the vaginal canal and is rich in sensory nerves and is thought to be supportive in terms of sexual stimulation. In the 17th century, Dutch physician Regnier de Graaf defined an erogenous zone in the vagina, corresponding to the prostate in men, and this area was later identified by German gynecologist Dr. It was introduced by Ernst Græfenberg. Based on the name of the point defined by Græfenberg, it was named G spot by Addiego and his colleagues. Græfenberg defined this point as a sensitive area within the vagina along the length of the urinary tract called the urethra. First, German gynecologist Dr. It was defined by Grafenberg in 1950 and put forward in a publication stating that the spot grows and the stimulation increases with the stimulation in this region. The G-spot can be enlarged in volume with hyaluronic acid-based fillers or fat tissues taken from the body, thus increasing the contact with the male organ during sexual intercourse and thus providing more stimulation. Especially in slightly heavier patients who need to have fat removed for fat injection, this can be done in the hair-dense area called mons pubis. I take it from the area and inject it. It is not a practice that gives positive results in all patients. Please get detailed information from our doctor about the pre-operative details.

Lengthening of the male organ using mechanical systems may have negative consequences that must be corrected by surgery.

The most common reason for genital aesthetic applications in male patients is penis thickening and lengthening . While some of our patients have a relative smallness due to excess fat tissue in the genital area, some of them have a real narrow penis diameter. Penis length varies between races. Some patients have tried to increase their height with mechanical systems before the application period, and some of them have erection problems after these procedures. The reason for this is that, due to the effort to get quick results, blood cannot be collected due to venous leakage in the spongy bodies (corpora spongiosa) located inside the penis and responsible for erection. In addition to mechanical lengthening systems, it is claimed that penis length can be changed, albeit to a small extent, in Indian and Chinese massage applications. For detailed information on these topics, please follow the articles on my blog. The diameter of the penis is more important than its length, as it initiates erogenous stimulation by providing tension in the woman's vagina. For this purpose, industrial silicone injections made illegally in offices in Far Eastern countries result in disaster for patients. Recently, patients who have serious inflammatory problems are applying for polymer filler injections called Aquafill. The material we use most safely in penis enlargement surgeries is the person's own fat tissue. We generally remove fat tissue from the mons pubis area by liposuction. In this way, especially in overweight patients, the penis, which is buried in the mons region and appears to be relatively short, becomes a little more visible. After the removed fat tissue is purified from its fluid by closed systems, it is injected between the inner sheaths of the penis and thickened. I prefer to perform these surgeries under general anesthesia. I explain the post-operative care process to the patients in detail, which lasts between 45 minutes and 1 hour on average. It is possible to go home in the evening of the same day.

Penile prostheses placed for erection purposes do not contribute to the lengthening of the penis. Requests to place a prosthesis for penis enlargement may have serious consequences.

Although the length of the penis varies between races, values ​​of 5-6cm and above are considered normal, while at the point of erection (hardening), values ​​above 11-12cm are considered normal. The main problems with the size of the penis are shortness and curvature of the axis (penile deviation). To get more detailed information about axis curvatures, follow the upcoming articles on our blog page. In addition, in terms of sexual intercourse, an erect penis below these values ​​may be sufficient for a weak-bodied couple.

Some of the patients insistently request extension by placing a prosthesis inside the penis. However, these prostheses do not have a penis-extending effect; they only keep the penis erect and are used for impotence problems. In patients where lengthening will be performed, the suspensory ligament that suspends the penis in the body is cut during the surgery, and the skin is advanced, and an extension of around 2.5 cm can be achieved. Cutting the suspensory ligament does not have a prolonging effect on erection. In my technique, instead of completely cutting this ligament, I use a ligament-lengthening sliding procedure similar to tendon lengthening surgeries. This prevents the "pendulum penis" deformity that may occur during erection due to complete severing of the ligament. The advancement applied to the skin provides a relative increase in length, and this increase does not exceed 2.5 centimeters.

Fat injections into the penis also positively affect the problem of premature ejaculation when the tip of the penis is included.

Fat injection into the penis is a method that can generally be applied by regional anesthesia under sedation. While more than half of the injected fat is melted by the body in 8-10 months, some of the fat tissue turns into connective tissue and some remains as fat. Thickening procedures with fat injection, which includes the tip part called the glans penis , can delay the process in case of premature ejaculation problem by providing a mechanical narrowing at the tip of the urinary tract. However, results may not be obtained for every patient. In practical application, synthetic materials that have a longer effect than oil have also been injected into the tip of the penis for this purpose. However, I generally think that fat injection is a more innocent procedure due to their potential to be treated as a foreign object by the body. The amount of fat taken for this purpose is not too much.

Penis lengthening and thickening surgeries may have undesirable consequences such as loss of erection and sensation, deterioration of penis blood circulation, skin necrosis (gangrene), and infection in unsafe hands.

The most common problem in genital area plastic surgery is that the desired change cannot be achieved completely. That's why I discuss all the possible consequences of these surgeries with my patients in detail. I do not operate on patients who have expectations other than the maximum length increase of 2.5cm and some diameter increase in the penis. Apart from this, infection will be inevitable, especially when the surgery is performed under conditions that are not suitable for disinfection/sterilization. In some inexperienced hands, the corpuscles (spongy bodies), which are the basic building blocks of the penis, may be damaged and heavy bleeding may occur in this case. In addition, the nerves that enable erection of the penis may be damaged during surgery and must be repaired by surgeons who know microsurgery techniques. Skin loss is also a result of entering the wrong layer during fat injection or filler injection. Again, if the fat injection is not done proportionally to each area, it may appear as swelling on the patient's hand and there may be a difference in thickness on both sides of the penis.

Folding techniques called plication in penis curvatures can be reversible. Therefore, correcting the deficiencies in the sheaths surrounding the penis on the side where the curvature occurs will provide better results.

Penile deviation (sideways curvature of the penis) is a frequently seen finding in society. It may not require intervention as long as it does not affect sexual intercourse. Patients who request curvature removal should be examined and questioned whether they have various connective tissue diseases. For example, in cases where curvatures occur spontaneously, the most common cause is a connective tissue disease known as Peyronee's disease , where the curvature is caused by various thickening and shortening in the connective tissue on the relevant side, which bends the penis to that side. Repair in these patients requires removal of the offending band and repair with membrane patches. Although it is possible to break this curvature without surgery with the connective tissue dissolving enzyme called collagenase , it is reversible in a significant portion of patients and skin loss may occur. Peyronie's patients may also have another variant, Dupuytren's disease, on their hands. Although partial healing can sometimes be achieved by placing plication stitches on the longer side for the treatment of curvatures, a significant part of them opens and may cause painful erection in some patients. Whether you are a candidate for these surgeries or not will ideally be revealed during a physician's examination.

There are cryotherapy, laser and surgery options in the treatment of warts. Non-surgical solutions may not be beneficial for all patients.

A wart is a lesion transmitted through sexual intercourse and caused by Human papillomavirus (HPV). Patients apply for reasons such as disrupting the aesthetics in the genital area or making sexual intercourse difficult by blocking the entrance to the penis or vulva. In some neglected patients, skin cancer also develops from the base of the wart, and this cancer is the reason for admission. It is one of the important causes of cervical cancer in women. Since it is less likely to scar in small lesions, cryotherapy or laser burning can be tried, but it requires repeated sessions. In large lesions, it is important to remove the lesion surgically and send it to pathology. We recommend that the patient's sexual partner also be examined for a possible lesion. Since it is not possible to completely eliminate the virus, recurrences or other new foci may appear after surgery. It is recommended that female patients receive HPV vaccination against cervical cancer.