Candidates for these operations are: patients with hypertrophy of labia (lips excess) and patients reporting pain or discomfort for penetration, difficulty using tight or normal clothing and issues in performing certain types of exercises, such as cycling.
Vaginal issues can produce some degree of depression and self-consciousness, avoiding undressing in front of your partner with the lights on.
In the first consultation we assess the overall health of the patient and the external appearance of the genitals: excess labia minora or clitoris exposure that may be partly or completely hidden by the labia minora, as well as enlarged labia or with low fat tissue. We evaluate the vaginal canal recognizing if there is weakness of the anterior wall that produces involuntary urination (urine leakage), mainly while realizing physical effort. Finally we check for weakness of the back wall that is in contact with the terminal portion of the colon, consequence of muscle tears and ligament tissue of the pelvic floor.
We indicate laboratory tests, preoperative cardiovascular assessment, and removal of certain medications, such as aspirin 15 days before, and others like vitamin E and omega that tend to favor increased bleeding. We also specify not to have sex the night before surgery and 4-6 weeks thereafter. If the process is a labiaplasty, vaginoplasty, vulboplasty or external rejuvenation, as it is also called, it could be performed under local anesthesia, local with sedation or regional with sedation as appropriate. If the process is an internal vaginoplasty or colpoperineorrafy as it is also called, we should use assisted regional anesthesia with sedation, or general anesthesia.
In vulboplasty (external vaginal rejuvenation) reduction of the labia minora is made by removal of excess of these, including the cap covering the clitoris, exposing it partially or totally according to the desire of each particular patient. For labia deficit, we proceed in the same operating time to increase the labia through lipoinjection, i.e. autologous fat transfer in the area.
In internal vaginoplasty we strengthen the vaginal canal reinforcing the core muscles and adjusting the internal walls of the vagina. Absorbable sutures are used (not required to withdraw) which remain in union with the wet mucose where the scar will become imperceptible in a few weeks.
In the case of a vulboplasty (external) the patient can return to their daily lives in about 7-10 days. The onset of sexual intercourse is from 4-6 weeks postoperatively in a smooth manner.