By Doctor Catherine Bergeret-Galley
Intimate female surgery is a wonderful association of surgical and non-surgical procedures that improve a woman’s physical appearance and make her feel better about herself. The aim is to create an attractive vulva and inner and outer labia – most often in young women – and treat any gaping in the vulvovaginal opening after multiple or traumatic births. Some women who lack sensitivity during sex may require vaginal tightening if their vaginal opening gapes. The rising demand for this kind of surgery is directly linked to the new techniques available and, more generally, to enhancing a woman’s quality of life.
Vaginoplasty, vaginal tightening and treating vulvar and vaginal gaping
This kind of surgery is, above all, for women who have gone through childbirth multiple times, but often a woman only needs to experience one difficult delivery for the next few months to become a nightmare: loss of feeling in the vagina, no longer feeling comfortable in their own skin, a distended or gaping vaginal opening. Women describe this psychological suffering in a variety of ways – gaping, skin tears, loss of sensitivity – and often feel uncomfortable taking their clothes off, even in private. All of these symptoms are very real and previously went unnoticed because women did not feel they could complain about them and, pragmatically-speaking, women tended to just accept these undesirable after-effects as a natural consequence of having children. However, childbirth definitely has an effect on a woman’s anatomy by, at the very fanleast, enlarging their vagina and often changing the appearance of the inner and outer labia, which are compressed when the baby passes through. A vaginoplasty, often performed with a perineoplasty to recreate the vulvar fork and repair any scars from an episiotomy or tear, can treat all of these anomalies and give the patient her confidence back. It is often preceded by a series of pelvic floor rehabilitation sessions with electrostimulation to boost the muscle contractions. A vaginoplasty most often involves tightening the walls of the vagina by bringing the muscles closer together and repairing them if they have been cut at the vaginal entrance (episiotomy) to prevent the risk of a perineal tear. A vaginoplasty can go hand in hand with vulvar and intra-vaginal lipofilling, to supply growth factors and stem cells to the muscles and mucous membrane, and also optimise the tightening effect by improving the tissues’ hydration, suppleness and tonus.
Beautifying and/or repairing the labia, a protruding or hidden clitoris, and a prominent mons pubis
The other aspect of intimate female surgery is the treatment of external genital abnormalities that can be spotted in some young girls or young women after puberty. We might come across unfused outer labia, which makes the vagina look permanently open even though the patient has never had children, too-large or too-thick labia minora, or inner lips that hang down and protrude from the outer lips. These abnormalities are sometimes visible through clothes, forming a bulge or a “camel toe” in swimwear and sometimes even preventing the person from doing certain sports such as horse riding or cycling. A protruding clitoris is also seen as unsightly, as women often think it looks like a micro-penis. At the other end of the scale, some women complain that their clitoris is too well hidden, which is easily corrected by way of a straightforward clitoral hood reduction. This offers immediate functional improvement and enhanced sensitivity. A too-prominent mons pubis can look unattractive and can easily be treated with localised liposuction, unless it is an after-effect of obesity, in which case the stretched skin may need removing. All of these abnormalities cause significant psychological embarrassment in young women.
The plastic surgeon’s role is vital. A consultation enables them to examine and assess the extent of the anatomical abnormalities, any possible functional complaints, and the patient’s psychological complaints. The plastic surgeon reassures the patient and explains whether or not their genitals are abnormal. Sometimes, there is nothing really wrong with them. A young woman’s perception of her genitals depends on what other types of anatomy she comes into contact with and also, unfortunately, on the recent propagation of pornographic images on the internet, which show young women’s genitals completely uncovered and free from any public hair, looking like a Barbie’s privates to make them more asexual and uniform. In this case, the surgeon’s job is even trickier because they must explain the difference between normal and abnormal genitalia. However, we must often carry out a minor labiaplasty or perform a bit of lipofilling in the outer lips to make these young women’s private area look more attractive, since it must be said that removing all of the pubic hair does highlight any minor defects, such as asymmetric inner lips. Sometimes the inner lips protrude from the outer lips. This is a kind of ptosis so we must refix them to the upper part of the vulvar cleft and reduce them slightly. The aim is to boost the patient’s confidence without carrying out any excessive procedures. Labiaplasty is for the labia minora. There are many types of labiaplasty and the choice depends on the issue to be treated and whether the aim is to reduce or reshape the lips so that the vulva is able to come together more easily. In a “normal” vagina, the inner lips would just peek out from the outer lips.
In conclusion, intimate female surgery is a delicate type of surgery that, when the indication is carefully assessed and the procedures are performed competently, can treat a number of genital abnormalities that develop after puberty or after childbirth, boosting women’s confidence in their day-to-day life and also, more importantly, in their sex life.
Doctor Catherine Bergeret-Galley
Aesthetic surgeon, specialised in female intimate surgery. Member of SOFCPRE, SOFCEP, ISAPS and ASAPS. She trained in Paris and United States with 2 years’ experience experience in maxillofacial surgery focusing on facial development and abnormalities, and reconstruction after cancer then 2 years of specific training in general reconstructive and aesthetic surgery. In private practice she still does reconstructive surgery but focuses more on aesthetic facial rejuvenation, surgical and non surgical, aesthetic breast surgery, body contouring after obesity, genital surgery, fat transfer ( lipofilling) and stem cell stimulation.