Cosmetic Surgery Bangalore

Anatomy of female genitalia

What are the aging changes?

In preadolescents the pubic mons and labia majora are closely attached to the underlying periosteum by strong fascia. The vestibular clitoris and prepuce are smooth and small, surrounded by pink labia minora hidden by the labia majora.The labia minora are loosely located to either side of the vagina and border the introitus.They extend anteriorly to drape over the clitoris as a hood and diffuse posteriorly to the perineal body. At puberty the labia minora begin to protrude between the majora and take on a darker pigmentation, clitoral prepuce becomes more wrinkled and covers clitoris.
Pregnancy and weight gain give rise to increased fat accumulation and relaxation of the fascia, which results in perineal ptosis.The labia hypertrophy, laxity create wrinkled appearance, increase in size, pigmentation, sebaceous glands. It may generate problems with hygiene, pain on intercourse, inflammation, infection with exercise, difficulty in sitting. The drooping of labia makes it difficult to sit, wear tight pants. As the age further increases, external genitalia begin to atrophy, with loss of subcutaneous fat, ptosis, dryness and mucosal atrophy.

Who will seek this type of surgery?

Most of the people are middle aged, after pregnancy, weight gain, and people trying to regain shape and fitness after child birth. People try to reduce the fat by running, weight training,aerobics,riding bicycles all of these actions will increase stress on perineum, same set of people wear small bikinis,tighter pants, which will irritate perineal tissues. Most of the cases are straight forward, requires simple correction.

What are the common surgeries done for the aging genitalia?

What will be done here?
The fat deposit may be confined to only suprapubic and vulva or may be part of regional like abdomen/thighs or generalized obesity.
By making 4mm cut[less than half centimeters] at the lower abdomen crease or cesarean section scar, the fat will be aspirated. The procedure is confined to vulva/precaution taken not to expose clitoris or increase the clitoral sensitivity by liposuction of the surrounding tissues. About 100 ml of the fat will be aspirated.


What technique will be used?

We will use tumescent technique and latest equipments.

How painful is the procedure?

Mild pain will be there for about a week.
What are the other complications of this procedure?
Serous oozing for about 48 hours rarely longer time, swelling –usually for 2-3 weeks, sometime for longer period .The other complications are similar to other area liposuction.

What other surgery can be done?

This procedure can be clubbed with liposuction of the abdomen/abdominoplasty, thigh tucking, labia reduction, on plastic surgery procedures like hysterectomy etc.

How many days of hospital stay and rest required?

No need for the admission if done alone.
About 48 hours of rest required due to swelling.
Pressure garment required or not?
Pressure garment reduces the swelling fast, the chance of seroma is less, and countouring will be good. But few people will not wear it in view of location of liposuction.

What is about the privacy? Can lady doctors be provided?

Strict privacy and confidentiality will be maintained, the assistant surgeon, anaesthetist, OT technician, OT nurse will be ladies [on request]

Why vagina loose tightness?

It may be due to multiple vaginal deliveries, weight gain and perineal ptosis-all these factors result in levator muscle diastasis, laxity of perineal body, attenuation of the superficial perineal tissues.

What will be done here?

Here the vaginal tone will be increased by coaptation of the levator muscle dehiscence and excision of the excess skin and mucosa.
This includes elliptical excision of the excess posterior vaginal mucosa, imbricaion of the medial levator muscles, re creation of the perineal body and excision of the skin tags.


How major is the procedure?

Vaginal tightening is a minor procedure, done under spinal or general anesthesia.
No admission will be required.

What are the complications of this procedure?

No major complications reported after this procedure, however the minor complications are wound infection, pain for few months on intercourse, scar.
How many days of rest required? Whether dressing will be there?
48 hours of rest will be required. No dressing will be required. May need to wear sanitary pad depending on the wetness.

What are the other surgeries can be done?

This surgery can be clubbed with pubic liposuction, labia reduction, hymenoplasty or other gynecological procedures.

What are normal labia minora?

There is wide range of normal anatomy of labia minora.
Most of the patients do not want their labia minora to protrude past the labia majora, thus length of about 1 cms is considered ideal.
Friedrich classification is more than 5 cms when measured horizontally from the midline when placed on mild lateral traction.

Why labia minora will enlarge?

The labia enlargement and asymmetry are congenital. However it may be due to chronic inflammation, pulling or traction on the labia, exogenous androgenic hormones.

What will be the side effects of enlargement?

The enlargement can cause difficulties with hygiene, self catheterization, sexual intercourse and infection. It can cause irritation/pain while wearing tight cloths.

What will be done?
1. The old method is amputation of the enlarged labia and over sewing of the edge. The drawback of this procedure is loss of normal labial edge with its unique contour and color, with a suture line running along its length.
2. In new method, a wedge of protuberant labial tissue is removed; the edges are reapproximated preserving normal edge and color.

How major is the procedure?

Labia reduction is a minor procedure, can be done under spinal or general anesthesia.

How many days of rest/admission will be required?

No need for the admission, about 48 hours of rest will be enough.
What are the complications of this procedure?
No major complications reported the minor complications are bleeding, swelling, wound infection, and wound dehiscence.

What dressing required?

The person may need sanitary pad dressing for about 48 hours.
What other procedures can be clubbed?
This procedure can be clubbed with liposuction, vaginal tightening, and other gynecological procedures.

Click here to know more on other Plastic Surgeries done by Dr.Naveen Rao