An abnormal sized labia(lips of the vagina)can cause discomfort during hygiene, sport activities and sexual intercourse. Labioplasty, often spelled labiaplasty, allows for the reduction of internal or external labia, which are often augmented and asymetrical. Surgery of the external labia, which may be losing size or elasticity, can also be done.

What is labiaplasty?

The female external genitalia consists of the vaginal opening, urinary opening and a peak with many sensitive nervous endings called the clitoris. This whole area is covered on all sides with gentle folds of skin tissue. The inner lips (labia minora) come together in the area of clitoris. The female external genitalia is covered on all sides with larger skin folds with fat cushions, known as the outer lips (labia majora). The outer lips usually cover and protect the external genitalia. Sometimes the labia minora grows larger in size or length and thus protrudes between the labia majora.

Usually this overlap is not too big so it doesn‘t cause any discomfort either aesthetically or functionally. If the inner lips protrude too much they can cause discomfort in an aesthetic way and also in everyday life. Sometimes it is difficult to fit an abnormally enlarged labis into tight underwear or a swimsuit, sometimes it can cause discomfort during sport activities – for example bicycle riding. It can also cause problems with intimate hygiene and this “defect” can also represent a psychological obstacle during intercourse. Labiaplasty is effective with good results. Sometimes a plastic surgeon can meet the request for a modification or reduction of the outer lips, although these procedures are rarely performed.

Why labiaplasty Prague?

Prague has many attractive features for those considering labioplasty abroad. Its location in Central Europe is easy to access; its mild climate is conducive to healing and its experienced clinics and labiaplasty surgeons ensure you’ll receive the best possible care. Labioplasty Prague costs are often much more affordable than in the UK or with the NHS. For more information about getting to and around the Czech Republic, please visit our handy cosmetic surgery Prague info guide.

Preparation for labioplasty

Labioplasty patients must be adults. All potential labioplasty patients should have a thorough consultative examination with a labioplasty plastic surgeon. Here, the patient should not only receive an examination but also detailed instructions on how the labiaplasty will be performed and what the patient can expect. In most cases the patient will agree on her requirements for the size or shape of the operated area with the plastic surgeon. The date of the surgery should then be scheduled so that the patient will receive the labioplasty shortly after menstruation has ended. The labioplasty surgeon will also instruct the patient on proper intimate hygiene in the period following the surgery.

Labioplasty surgery

The labiaplasty is almost always performed under general anesthesia, on an operating table with the patient in a gynecological position. The surgeon precisely measures the direction of the surgical incisions before the surgery so that the final scars will not be visible and so they won’t cause discomfort to the patient. Great attention should be paid to the area of the clitoris so the gentle nerves that give special sensitivity to this area will not be damaged.

In addition to very gentle and careful work, it is necessary to stop any bleeding during labiaplasty. After the modification, a very tight but also gentle suturing of the surgical wound is necessary. To stitch the wound, various types of suturing material are used; sometimes absorbable, sometimes nonabsorbable (such sutures have to be removed after the wound is healed.) Which suturing material is used depends on the plastic surgeon and his/her experiences. Labiaplasty takes about one hour, depending on the extent of the surgery, and is not especially difficult on the patient. Soreness after the procedure is normally not a large problem; most patients only describe unpleasant, but not overly strong, burning in this area.

After labiaplasty

Patients usually go home the next day following their labioplasty. It is good to stay relaxed for about one week, avoid sitting for long periods of time, including long car drives, and to perform hygiene several times a day. We recommend showering and washing with an intimate hygiene soap or with a good and gentle antiseptic soap after each toilet use and to cover the area with a pad. Some patients heal better if the wound is left totally uncovered. The operated area can often swell, but usually the swelling disappears after several days. It is best to be regularly checked by your surgeon. The healing process takes a minimum of 10 but usually 14 days, sometimes even more. Smaller swelling can stay for a longer time and the operated area settles into its final shape approximately six weeks later. After this period, the patient can resume her sexual life again.

Labioplasty results

Labiaplasty almost always brings satisfactory results to the patient. Of course, much depends on the experiences of the labioplasty surgeon so that he/she is able to avoid possible complications. It also depends very much on the cooperation and discipline of the patient so that she can fulfill all the recommendations following the surgery. Some doctors – sexologists – don’t like these surgeries too much as they are afraid of a possible reduction of sexual sensation in women who have undergone labioplasty. When labiaplasty has been performed here, the opposite has been seen. Women who have had the surgery mention mostly improved sensations during sexual intercourse. Also by having the surgery, any psychological problems with their genitalia appearance is removed. This contributes to a more relaxed and improved sex life.

The surgery is suitable for women with large outer lips that cause problems. It can be rubbing and hurting during walking, sport activities; problems with wearing specific clothes; if the lips are visible through swimsuit or they can present an obstacle during sex. Sometimes woman feels bad when she attracts attention of the others (e.g. in sauna) or of partner. The anomaly is usually on both sides.

Although it is possible to make an appointment for this procedure by phone without any previous consultations, I do not recommend it. First step in decision making if the surgery is worth it for you is to make an appointment for check-up – consultation with the doctor that would be eventually in charge of the surgery. It is common that the client consults her problem with more doctors and makes her appointment with the one to which she feels the strongest confidence.

During the performance ambulantly under local anaesthesia, in a woman that is fit and doesn’t undergo any medical treatment, no pre-surgical examination is necessary.

The principle of the surgery consists in the excision of the excessive part of the labia. The treatment is usually performed under local anaesthesia and ambulantly. The performance under general anaesthesia is of course also possible. In this case an internal pre-surgical check-up is needed and the treatment is then more expensive. The extension of the excision is drawn on the skin (it is possible to agree on it), the labia is then locally anesthetized. This part of the surgery is painful but lasts only 20 seconds. The extra skin is removed, the bleeding is ceased and the suturing of mucosa is made either with absorbable sutures that are not taken out or with classical sutures.

Progress after surgery might be complicated with bleeding that is not strong and doesn’t need any medical treatment, it is solved the same way as with bleeding during menstruation. The labias are usually very swollen and moderately painful. Caused by the swelling the look of the vaginal opening is changed, the labia look completely different and this look has nothing in common with the final result. The swelling and pain will fade after approximately one week to ten days. After the surgery you can have problems while sitting.

Since the surgery is made in the area where it is difficult to keep sterility, progress after surgery is very often complicated with infections and breakdown of the wound edges. In this procedure the insignificant complications of wound healing with no extra treatment are very frequent. It is possible to avoid danger of more significant complications of wound healing such as wound breakdown with painful infection by optimum treatment. Even insignificant complications are manifested by pain in the area of vaginal opening.

After surgical treatment: It is simple and provided by the patient herself – increased hygiene, showering with the use of soap or shampoo. Minimum twice a day wash with disinfecting solution – you will receive it during the surgery. At the beginning put sterile gauze into the underwear, later on sanitary pads are sufficient.

The checkups after the surgery with normal progress and absorbable sutures are not necessary although it is better to come for a check up after a week and after 14 days. Check up after 3 months is also appropriate to evaluate the final result. It is necessary to mention danger of creation of rigid scars as a late complication in patients with inherent inclination to creation of keloid and hypertrophic scars. This risk is lower than 1% and the state can be treated with care for such scars.

Temporary trend – an effort for perfect body – forces women to pay attention also to parts of their bodies that are mainly fully hidden from the eyes of public. For last few years the plastic surgeons have come up with aesthetic modifications even in the most intimate places – external part of female genitalia.

What does female genital surgery consist in?

The female external genitalia consists of vaginal opening, urinary opening and a peak with many sensitive nervous endings – clitoris. This whole part is on sides covered with gentle skin folds of tissue – the inner lips (labia minora) that come together right in the area of clitoris. The female external genitalia is on sides covered with bigger skin folds with fat cushions – the outer lips (labia majora). The outer lips usually cover and close the external genitalia. Sometimes it happens that the labia minora grows into bigger size or length and thus they can protrude between the labia majora. Mostly this overlap is not too big so it doesn‘t cause any discomfort neither aesthetically nor functionally.

If the inner lips protrude too much they can cause discomfort in aesthetic way and also in everyday life. Sometimes it is difficult to fit this abnormally enlarged labis into tight underwear or swimsuit, not even mentioning underwear of “tanga“ type, sometimes it can cause discomfort by sport activities – for example bicycle riding. It can also cause some problems with intimate hygiene and this “defect” can represent also a psychic obstacle during the intercourse. The labiaplasty is then effective with good results. Sometimes the plastic surgeon can meet the request for modification or reduction of outer lips, although these procedures are performed relatively rarely. Sometimes there is even request for hymen reconstruction surgery that can also be performed.

Relatively frequent request for modification or reduction of vagina is although already part of gynecological procedures.

Preparation for the surgery

As a necessary condition for the procedure is an adult patient. Another necessity is thorough consultative examination with plastic surgeon when the patient gets not only the examination itself but also detailed instruction how the surgery will be performed and what is to be expected. In most cases the patient can agree on her requirements for size or shape of the operated area with the plastic surgeon. The date of the surgery should be then scheduled so that the patient will be operated shortly after the ended menstruation. The plastic surgeon has to instruct the patient also about the need of right intimate hygiene in the period after the surgery.

The surgery itself

The labiaplasty is performed almost always under general anaesthesia, on the operational table in gynecological position. The surgeon measures precisely the direction of surgical incisions before the surgery so that the final scars will not be visible and mainly that they will not make any discomfort to the patient. Great attention should be paid to the area of clitoris so the gentle nerves that give special sensitivity to this area will not be corrupted.

Beside very gentle and careful work it is very necessary to cease the bleeding during the surgery. After the modification very tight and also gentle suturing of surgical wound is necessary. To stitch the wound various types of suturing material are used, sometimes absorbable othertimes nonabsorbable (such sutures have to be removed after the wound is healed). Which suturing material is used depends always on the plastic surgeon and his/her experiences. The surgery takes according to the size of the procedure around one hour and is not especially difficult to the patient. Also soreness after the procedure is normally not big, the patients mention only unpleasant but not that strong burning in this area.

After surgical care

The patients after the labiaplasty usually go home next day after the surgery. It is good to stay calm in the next period for about one week, to avoid long sitting, including long car drive and to have the opportunity of perfect hygiene several times a day. We recommend showering and washing with a soup for intimate hygiene or with good and gentle antiseptic soup after each visit of the toilet and to cover the area with pad.

Although some patients heal better if the wound is left on countrary totally uncovered or “free“. The operated area get relatively often quite swelled, but usually the swelling disappears after several days. It is better if you are regularly checked by your surgeon. In any case you should know that the healing process takes minimum 10 but mostly 14 days, sometimes even more. Smaller swelling can stay even for longer time and the operated place gets its final shape approximately after 6 weeks, after this period the patient can start with her sexual life again.

Results

The labiaplasty brings almost always very satisfactory results to the patients. Of course it very much depends on the experiences of the plastic surgeon, so that he/she is able to avoid possible complications that are nevertheless not too common. It also depends very much on the cooperation and discipline of the patient so that she can fulfill all the recommendation in the period after the surgery.

Some doctors – sexologists – don’t like these surgeries too much, they are afraid of possible reduction of sexual sensation in operated women. The experience of last years, when labiaplasty has been performed here, the opposite has been seen. Women who undertook the surgery mention mostly improved sensation during sexual intercourse. Also that by the surgery their psychic problem of their genitalia appearance is removed contributes to global relaxed and improved experiences in their sexual life.

Injection implants enable you to augment the lips, to smooth the wrinkles away and to correct the contours of the face. You will be young and beautiful….

What is Beautical?

Beautical consists of dissolved polyacrylamide hydrogel, which is biologically degraded. This substance is used especially for reduction of turned-down corners of the mouth, renewal of the volume of sagging temples, improvement of the appearance of the lower eye lids, renewal of the volume of the cheek bones and of the cheeks, correction of deep nasolabial furrows and improvement of the contour of the jaws and chin. Enzymes in the body gradually degrade the gel over a period of two to four years and excrete it from the body by a natural pathway. The use of permanents fillers (Bio-Alcamid, Artecoll, Demalive) is comparable.

BEAUTICAL®

Use

Duration of the effect

Temporary (2 – 4 years).

Duration of the treatment

About 30 minutes.

What is Beautical®?

Beautical (formerly Outline) consists of dissolved polyacrylamide hydrogel, which is manufactured in the laboratories of the PyroCytech company in Bordeaux in France according to the highest qualitative specifications. The use of the Beautical substance is comparable with permanent fillers such as Bio-Alcamid and Aquamid, with the difference that Beautical is a temporary filler, which is degraded by the organism. This temporary filler, which can be applied very accurately to the skin, has excellent filling and smoothing properties. The supple gel augments inadequate volume and the result is a natural, young-looking volume of the skin and smoothing of wrinkles and furrows. The Beautical substance interacts actively with the skin. The soft positive charge of the Beautical substance attracts negatively charged collagen in the skin like a magnet and thus forms a dense network with the skin’s own collagen. The gel thus becomes part of the skin tissue and its presence is not palpable. As soon as the positive charge is neutralized by the negative charge, the “magnetic” attraction disappears spontaneously. Enzymes in the body gradually degrade the gel over a period of two to four years and excrete it from the body by a natural pathway. Because of this property, Beautical is an extremely safe product that opens the door to the future. Beautical is a temporary implant with relatively long-term effect. Most temporary implants are effective for about half a year to a year; in contrast, the results of treatment with Beautical are apparent for a period of two to four years. Beautical exists in two forms: Beautical 2 for correction of finer wrinkles and furrows and Beautical 5 for correction of deeper furrows and renewal of volume, e.g. in the cheeks.

The treatment

The doctor anaesthetizes the skin locally using an anaesthetizing cream or injection. Beautical is injected through a fine needle into the skin or immediately under the skin. The treatment lasts less than half an hour. Immediately after the treatment, the skin is red and swollen; this disappears within one day. Bruises sometimes appear. You can continue your normal daily activities immediately after the treatment.

Results

The result of treatment with the Beautical substance is immediately apparent. After stabilization of the gel in the skin, the volume of the injected substance decreases by about 30%. This eliminates the risk of excessive correction. After two weeks, Beautical forms a network with the skin and the final effect is visible. The skin is soft and supple to the touch and the gel remains at the place where it was applied. Sometimes, it is necessary to undergo several applications of achieve the optimum results. Further treatment can be undergone after four weeks. The use of the Beautical substance leads to a pleasant, natural appearance for a period of two (Beautical 2) to four years (Beautical 5).

BIO-ALCAMID®

Use

• Renewal of the volume of the face
• Renewal of the volume of the cheek bones
• Reduction of deep nasolabial furrows
• Reduction of turned-down corners of the mouth
• Correction of the contours of the face
• Enlargement of a small or receding chin

Duration of the effect

Permanent.

Duration of the treatment

About 15 – 30 minutes.

What is Bio-Alcamid®?

Bio-Alcamid® is an implant gel consisting of 97% water and 3% polyacrylimid. It has been used for cosmetic correction since 1995. Bio-Alcamid® can be injected subcutaneously very accurately. Following its application, Bio-Alcamid® can be manipulated to produce exactly the desired shape. The cushion of gel remains under the skin but can be removed at any time. The product is very useful for major enlargement of the volume at a single place.

The treatment

The doctor applies a local anaesthetic before introducing Bio-Alcamid® under the skin. After the treatment, the skin is reddish and swollen. For two weeks, the skin is hard to the touch and bruises may form. These effects then disappear. The body forms a thin capsule of connective tissue around the implant, which ensures that the gel remains exactly in the place where it was applied. Several treatments may be required to produce the optimum effect. The treatments are separated by a period of four weeks.

Results

The result of the treatment can be seen immediately. After two weeks, the Bio-Alcamid® cushions can no longer be felt and the skin is again elastic. The product provides permanent cosmetic correction; however, because the natural ageing process is continuous, another treatment may be required after about five years.

Injection implants enable you to augment the lips, to smooth the wrinkles away and to correct the contours of the face. You will be young and beautiful….

What is Radiesse?

Radiesse is formed by particles of calcium hydroxyapatit (CaHa) in the form of gel that is suitable for facial abnormalities correction. CaHa is a natural part of human tissues (teeth, nails). On one side, results are fully evident immediately. On the other side, the substance is completely excreted from the body by a natural pathway over a period of one to two years. The filler is especially used for renewal of the volume of the cheek bones, reduction of deep nasolabial folds, correction of turned-down corners of the mouth, improvement of the contour of the jaws and nose shape, as well as for enlargement of the small or recessive chin.

RADIESSE

Use

• Renewal of face volume
• Renewal of cheekbone volume
• Reduction of deep nasolabial folds
• Reduction of turned-down corners of mouth
• Correction of jaw outline
• Correction of nose shape
• Enlargement of small or receding chin

Duration of the effect

Temporary (1-2 years).

Duration of the treatment

Approximately 30 minutes.

What is Radiesse?

Radiesse is a injection implant that is very suitable for correcting facial imperfections. It includes calcium hydroxyl apatite particles (CaHa) in gel formula for easier application. CaHa is a natural component of human tissue (teeth and nails) and has been used in medicine for over 25 years. A great advantage of the product is it’s immediately visible and long-lasting effect. Duration of the effect depends on the client’s age, skin type, lifestyle and muscle activity in the application area. For instance in the nasal area the effect may be visible for up to several years. However, over time the substance naturally fully leaves the body.

The treatment

The treated area may be anaesthezised before treatment, either by using a anaesthetizing cream or injection. Radiesse is then applied directly underneath the skin and a physician gently rubs it into desired shape. Immediately after treatment the treated area may be red, swollen and slightly painful, bruises may rarely appear. However, this is all only temporary. In some cases the desired effect is achieved already after the first treatment, in other cases repeated treatments are required. The treatment may be repeated any time.

Results

The effect is immediately visible. As soon as after two weeks the product cannot be felt in skin. The gel stays where it has been applied, since CaHa particles are stabilised in skin by newly formed collagen. The effect is visible for one to two years, in some cases even longer.

Both men and women occasionally wish to have their genitals altered through surgical means. In women it is usually vaginal surgery, surgery of labia minora or majora or hymen reconstruction surgery. Men usually wish to have the size and volume of their penis changed, or perhaps circumcision.

Female Genital Surgery

Vaginoplasty

Generally speaking vaginoplasty is the modification of the female vagina. The most frequent procedure is the narrowing of the vaginal opening. This specific narrowing of the vagina can lead to it becoming more firm.

The goal of this surgical procedure is to provide the patient with a better sex life.

This surgery is usually performed in middle-aged women who have given birth. The vagina and vaginal opening has loosened because of the birthing process and increasing age.

The procedure is performed under general anesthesia and usually lasts 45 minutes. It is performed using the following technique: In the area of the vaginal opening, on its back side, an excision of tissue in various sizes (according to the wish of the patient, anatomical findings, etc.) is made. Then the wound is sutured. It is better to make the extent of the excision bigger and therefore narrow the opening more because it is common that the vaginal opening will widen slightly again.

If the incision is expanded even to the back of the vaginal wall and in different lengths, we can contract the whole vagina in this way. This surgery is also performed under general anesthesia, it takes about 1.5 hours.

The surgery does not only involve the mucosa, but it enters into the muscular layer of the vaginal wall. First, the vaginal mucosa is excided in the needed (chosen) extent; next, the muscular layer of the vagina is firmed and shortened. The last phase of the surgery is to suture the vaginal mucosa. The same procedure is valid regarding the extent of the excision as is mentioned in the correction of the vaginal opening. During this surgery, the prudence and experience of the surgeon is critical because of the vagina’s proximity to the terminal part of colon. This is necessary to prevent the creation of a so-called rectovaginal pouch.

Both methods of surgeries use absorbable suturing material. Following the surgery, it is recommended to avoid sexual intercourse for up to six weeks. More information about vaginoplasty abroad can be found here.

Labiaplasty

Labia minora

This term refers to the surgical modification of the inner and outer lips of a woman’s vagina.

The labia minora in women often protrudes between the labia majora and may reach an unbelievable size. The goal of this surgery is to reduce the protruding inner lips, and in severe cases, sometimes even almost completely remove them. Because of their function we do not recommend their total removal.

The surgery is not especially difficult; it can be performed under local anesthesia, analgosedation, or if needed, under general anesthesia. We use absorbable material for the sutures and don’t recommend sexual intercourse for about one month.

Labia majora

There are several solutions:

It is possible to perform all the above surgeries under local anesthesia, although it is better under analgosedation or general anesthesia. More information about labiaplasty abroad can be found here.

Hypertrophic (excessively large) labia majora

This most often occurs in young women. There are also several solutions:

Hymenoplasty – Hymen reconstruction surgery

Much could be written about the reasons women decide to undergo this surgery.

There are several methods, although it is impossible to fully reconstruct the real hymen. The only goal of this surgery is bleeding during sexual intercourse so the man believes he was the first man for his partner.

Usually, a thin, short and small flap of mucosa is separated from the vaginal wall (approximately 1/3 of vaginal width.) It is then sewed very gently to the opposite vaginal wall. In this way, the vagina is not blocked too much to interfere with menstruation; but at the same time, the woman will bleed during sexual intercourse.

The surgery is not difficult for an experienced surgeon. It is better to perform the surgery under general anesthesia. More information about hymenoplasty abroad can be found here.

Male Genital Surgery

Foreskin

Circumcision

– Total (complete) removal of the penis’ foreskin; the foreskin is removed to the extent that the glans penis is uncovered. The sutured surgical wound is under the glans penis. More information about circumcision abroad can be found here.

Common reasons for this surgery include:

So-called Burian Plastic Surgery

– An incomplete foreskin removal that is combined with the enlargement of the opening of the foreskin flap for the glans penis.

This type of procedure is usually done for medical reasons:

It is possible to perform both types of surgeries under general anesthesia with several hours or a one day stay in hospital. It can also be performed under local anesthesia as an out-patient procedure, when the patient goes home after surgery. The sutures are not removed as they are from an absorbable material. Sexual abstinence is necessary for approximately 3 to 4 weeks.

Many men have questions relating to the possibility of a penis enlargement or extension. It is necessary to keep in mind that this surgical procedure has its difficulties; and the risk for complications is great. If complications do occur, they can lead to irredeemable penis damage, not only anatomically but also functionally (penis deformation, erection defects, etc.)

Penis Enlargement

Extension

– And perhaps even enlargement of the penis in volume. It involves several procedures; usually a combination is best.

 Size enhancement

The most advantageous method is to use one’s own tissue – usually a fat tissue:

It is always necessary for doctors to know precisely what the patient has in mind; regarding both the result and the reasons for the desired surgery. Knowing this, we can hopefully meet the patient’s expectations; or inform them of the true possibilities. This is true for all cosmetic procedures.

This is a message particularly for women who are going to have liposuction in a typically problematic part of their body; and who also are starting to notice signs of ageing appearing in their face, or, they are interested in repairing some congenital disproportions in facial fat tissue. This message is also for those who suffer from the results of a poorly performed liposuction and have unnatural depressions in the treated areas as a result of “over-suction.”

First an explanation of some terms

Lipofilling – the removed fat tissue is applied to the target area as a filler. It brings about the same effect as with the use of other fillers like for example, Colagen, Restylane and others. However, the use of fat as a filler is inherent to the body and has no complications. The disadvantage, as with some other fillers, is that the fat will be absorbed and lipofilling must be repeated.

Lipografting – fat transplantation is a more demanding procedure compared to lipofilling. The fat tissue removal method, the preparation of tissue for grafting and the performance of the transplant is different. It is true that swelling and sometimes bruising last longer after the lipografting operation, however the effect is permanent or, at least, long-term (several years).

Facial lipofilling or lipografting is recommended

1) In cases of natural signs of facial ageing.

With growing age the partial atrophy of subcutaneous fat tissue occurs, accompanied by depression resulting from gravitation. It results in depressed temporal areas, circles under the eyes, depressions in the cheek-bone area and in cheeks, depressed nasolabial folds and typical depressions on both sides of chin.

The aforementioned signs are usually indications for cosmetic surgeries including lower eyelid surgery, medial lifting and a facelift. These surgeries, however, have better results when more significant signs of ageing occur, particularly loose skin and deep wrinkles in the area of the neck, chin or mouth. Beginning changes, mainly in the area of the lower eyelids, cheeks and nasolabial folds and particularly those in younger people (35 – 45 years of age) may be solved effectively and with no scars using lipografting (respectively temporarily with lipofilling). In some cases lipografting may substitute for a lower eyelid surgery (blepharoplasty), formerly often performed and not very wisely chosen, in place of a transition of lower eyelids in the cheek-bone area.

At this age women often undertake liposuction and it may be an advantage to combine both procedures.

2) Congenital dispositions

Some of the abovementioned signs do not have to be the result of ageing and often occur in young people with a congenital disposition. Usually, it includes upper eyelids visibly sunk under the upper edge of the eye socket, circles under the eyes, sunken cheeks or sharp nasolabial folds. In these cases lipografting is the best solution. Lipografting can also effectively enlarge thin lips.

3) Unnatural depression on any part of the body caused by an “over-suction” during liposuction or as a result of an injury or operation.

A limited lack of fat tissue may also occur congenitally.

It may be concluded that lipofilling and lipografting can be performed independently but it is an advantage to combine these procedures with planned tumescent liposuction. The area treated by liposuction can be used for the extraction of fat. Tumescent liposuction is completed in the usual way while the extracted fat is prepared for transplant. Lipografting can also be combined with some facial cosmetic surgeries. The innovative rejuvenation facial operations not only remove and tighten tissues, but also are a suitable and gentle filling.

To visit a plastic surgeon in order to change intimate parts of your body is not a snap decision. If you’ve gotten to that point you’ve probably done your research and are prepared for the surgery. Some women have genital surgery for esthetic reasons and others for medical reasons. Modern clinics offer many modifications of external female genitalia. Most of the procedures carry minimum risk and only require several days of hospitalization.

The first step should be a consultation with a possible plastic surgeon. An exam will be performed by a gynecologist who specializes in female genital surgeries. The goal of the consultation is to “coordinate” the patient’s esthetic requirements with the surgical possibilities of the procedure. The final effect of the procedure should be a satisfactory one with minimum medical risks. The date for the procedure is set right after the end of menstruation. This is to ensure optimum hygienic conditions of the genitals during the healing process. (Women taking hormonal birth control can postpone their menstruation by not stopping the pill to have it so they are freer to select the date of the procedure.)

It is not necessary to schedule gential surgeries in the fall and winter seasons like for cosmetic and vascular surgeries that are performed on uncovered parts of the body.

The procedure is performed under sterile conditions in the surgical room, under general anesthesia, with the necessary pre-surgical, laboratory and specialized medical (internal) examinations.

After surgery care and the healing process is usually uncomplicated if medical recommendations and hygienic measures are strictly followed. The healing process usually takes five to ten days, depending on the extent of the procedure. Post-surgery pain usually lasts one to two days. Plan on staying in hospital for one to two nights. Medical check-ups and compresses, (eventually iced compresses) are an essential part of the hospitalization, just like controlling pain after the surgery. The patient will receive effective analgesics in the form of inner-muscle injections, pills or suppository applied in the rectum. The patient will change to out-patient check-ups during their home care based on the surgeon’s recommendation.

The above mentioned procedures, pre-surgical consultation, laboratory and internal examination and hospitalization are not covered by health insurance.

Labiaplasty

Labiaplasty is a cosmetic surgery, mainly the reduction and eventual “reshaping” of the labia minora. An undesirable change in the shape of the labia can be influenced by changes after the birth of a child, an accident, congenital asymmetry or congenital enlargement of this part of the external genitals. The reasons for the surgery might be esthetic or medical. The enlarged lips can cause problems for example during walking, sports, sexual intercourse, etc. Women and young girls of any age can undergo this procedure. The surgical process consists of the removal of extra tissue through a sharp incision. The edges of the incision are consequently cosmetically modified through a suture with absorbable stitches. The absorbance of the stitches takes up to three weeks; the stitches are not removed.

Hymenoplasty

The hymen is a mucous membrane that partially covers the vaginal opening in women that haven’t had sexual intercourse yet. Hymen restoration can be performed through the surgical modification of the mucosa of the vaginal opening. The incision is done with a scalpel around the circumference of the vaginal opening. The reconstruction of the so-called hymen circle is consequently performed with a suture. An absorbable suturing material is again used with minimal irritating (causing irritation) characters on the sensitive mucosa and skin in this area.

Perineoplasty

This procedure means plastic surgery of vaginal opening and (according to the need and situation) also of the adjacent part of the vagina and perineum. It is mainly performed in women who have an acquired deformation of their external genitalia. The reason might be a vaginal delivery of a large baby or a badly healed perineum cut. Besides esthetic reasons, patients often have problems with pain during sexual intercourse and in extreme cases do not have sex because of the pain. Another group of women that have this surgery are older women with a reduced elasticity of submucous tissue. The vaginal opening is more exposed because of age, hormonal reasons and a congenital disposition. It can lead to a less satisfactory sexual experience for both partners, frequent inflammation of the vaginal or urethra and an uncomfortable feeling when walking or sitting. The surgeon chooses the optimal process based on the deformation of the vaginal opening and the character of the problems. The extra tissue, parts of the vaginal mucosa or the skin folds of vaginal opening and the skin of the perineum are sharply removed and the edges are carefully reformed and sutured with absorbable stitches.

Combined procedures

The above mentioned procedures can be combined according to the wishes and needs of the patient and based on recommendations from the surgeon.

Other procedures

Other female genital procedures include the removal of birthmarks, “classic” warts and so on from the area of the genitals or the removal of or the application of piercing. According to the extent and placement of the skin formation it is possible to choose to have a simpler local anesthesia. It is applied through anesthetics in the form of intra-dermal injection or gel on the skin at least 15 to 30 minutes before the disinfection of the treated area. The above mentioned procedures can be performed out-patiently with check-ups after the surgery at the clinic. Unusual skin formations are checked before the procedure by a dermatologist. The removed tissues are subsequently submitted for histological analysis.

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