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Zhang X, Li B, Mao J, Richolsik, Zhang R, Faiz S, Zhao M. A Bibliometric and Visualisation Analysis on the Research of Female Genital Plastic Surgery Based on the Web of Science Core Collection Database. Aesthetic Plast Surg 2024:10.1007/s00266-024-03983-6. [PMID: 38671242 DOI: 10.1007/s00266-024-03983-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND AND OBJECTIVES Due to the increasing demand for improving the morphology and function of the external genitalia amongst women, it is necessary to conduct statistical analysis of research data on female genital reconstruction. The current study aimed to use bibliometric analysis to analyse the research hotspots and trend frontiers of the female genital reconstructive research. METHODS Publications on the female genital reconstructive research were extracted from the Web of Science Core Collection database. VOSviewer 1.6.18 was used to establish visualisation maps and find top authors, institutions, countries, burst keywords, co-cited authors, journals, research hotspots, and trends. RESULTS A total of 2207 studies published by 364 different journals authored by 7479 researchers were contained in this study. In the co-authorship analysis, the bulk of the retrieved studies was conducted by the USA, followed by England, Italy, and Netherlands, whilst the most productive institution, journal, and author were U.S. Univ Calif San Francisco, Journal of Sexual Medicine, and Bouman Mark-Bram, respectively. In the co-cited analysis, the top most-cited author and journal were Hage JJ and Journal of Sexual Medicine, respectively. The map of keywords occurrence revealed the most active research aspects were focussed on "vaginoplasty", "feminised genitoplasty", "laser treatment of vaginal atrophy", "transsexualism", and "labiaplasty". The time overlay mapping showed that the study of female genital plastic surgery focusses on the energetic treatment of genitourinary syndromes caused by transsexualism and menopause, especially by using management and treatment of vulvovaginal atrophy for the research trends, and through the vaginoplasty, feminising genioplasty, and laser treatments in the direction of treatments related to physical and mental problems. INTERPRETATION AND CONCLUSIONS This novel inclusive bibliometric analysis can help research workers to quickly understand the potential and active researchers, landmark studies, and topics within their interests. We are willing to provide more beneficial data to contribute valuable research of female genital plastic surgery through this study. LEVEL OF EVIDENCE III The journal asks authors to assign a level of evidence to each article. For a complete description of Evidence-Based Medicine ratings, see the Table of Contents or the online Instructions for Authors at www.springer.com/00266 .
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Affiliation(s)
- Xianling Zhang
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - Bo Li
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - JiaXin Mao
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - Richolsik
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - Ruipeng Zhang
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - Shabnam Faiz
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - MuXin Zhao
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China.
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Zahedi S, Bhat D, Pedreira R, Canales FL, Furnas HJ. Algorithm for Trim and Wedge Labiaplasties. Aesthet Surg J 2023; 43:685-692. [PMID: 36794378 DOI: 10.1093/asj/sjad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
In the last decade labiaplasty procedures have been on the rise in the United States. The trim and the wedge are among the most commonly used techniques. The purpose of this paper is to provide a trim-wedge algorithm to guide the surgeon based on the qualities of the individual patient. The choice of technique should be based on the reasonable labiaplasty candidate's goals, her nicotine/cocaine usage, and the physical characteristics of her labia, including edge quality, texture, pigmentation, symmetry, morphology of protrusion, and labial length. By considering these individual patient factors, the trim-wedge algorithm may improve labiaplasty outcomes and increase patient satisfaction. Some surgeons perform only the wedge or only the trim, and no algorithm should alter that. After all, the best technique is always the one the surgeon performs comfortably and safely. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Sanam Zahedi
- Plastic surgery fellow, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California Davis, Sacramento, C, USA
| | - Deepa Bhat
- Plastic surgery fellow at a private plastic surgery practice in Santa Rosa, CA, USA
| | - Rachel Pedreira
- Plastic surgery resident, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, Palo Alto, CA, USA
| | | | - Heather J Furnas
- Clinical associate professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, Palo Alto, CA, USA
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Wiśniewska-Ś Lepaczuk K, Pieczykolan A, Grzesik-Ga Sior J, Wdowiak A. A Review of Aesthetic Gynecologic Procedures for Women. Plast Aesthet Nurs (Phila) 2022; 42:226-237. [PMID: 36469394 DOI: 10.1097/psn.0000000000000479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Aesthetic gynecologic surgery is gaining popularity among women and physicians. Aesthetic genital surgery for women encompasses both minimally invasive and open surgical procedures. Cosmetic genital procedures for women described in this article include perineoplasty, vaginoplasty, vaginal rejuvenation, labiaplasty, G-spot enlargement, Bartholin gland surgery, clitoral hoodoplasty, clitroplasty, hymenoplasty, and mons pubis plastic surgery. Based on a review of the literature for each procedure, the article discusses procedural methods and techniques, indications for implementation, potential consequences and side effects of the procedure, nursing implications, patients' motives for undergoing the procedure, and positions of scientific institutions relative to the procedure.
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Affiliation(s)
- Katarzyna Wiśniewska-Ś Lepaczuk
- Katarzyna Wiśniewska-Ślepaczuk, BND, MMid, is a PhD student, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Agnieszka Pieczykolan, MMid, is a PhD student, Department of Midwifery Development, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Joanna Grzesik-Ga˛sior, MMid, is a PhD student, Department of Midwifery, Carpathian State College in Krosno, Krosno, Poland
- Artur Wdowiak, MD, PhD, DSc, is a gynecologist, obstetrician, and andrologist, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Pieczykolan
- Katarzyna Wiśniewska-Ślepaczuk, BND, MMid, is a PhD student, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Agnieszka Pieczykolan, MMid, is a PhD student, Department of Midwifery Development, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Joanna Grzesik-Ga˛sior, MMid, is a PhD student, Department of Midwifery, Carpathian State College in Krosno, Krosno, Poland
- Artur Wdowiak, MD, PhD, DSc, is a gynecologist, obstetrician, and andrologist, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Joanna Grzesik-Ga Sior
- Katarzyna Wiśniewska-Ślepaczuk, BND, MMid, is a PhD student, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Agnieszka Pieczykolan, MMid, is a PhD student, Department of Midwifery Development, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Joanna Grzesik-Ga˛sior, MMid, is a PhD student, Department of Midwifery, Carpathian State College in Krosno, Krosno, Poland
- Artur Wdowiak, MD, PhD, DSc, is a gynecologist, obstetrician, and andrologist, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Artur Wdowiak
- Katarzyna Wiśniewska-Ślepaczuk, BND, MMid, is a PhD student, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Agnieszka Pieczykolan, MMid, is a PhD student, Department of Midwifery Development, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Joanna Grzesik-Ga˛sior, MMid, is a PhD student, Department of Midwifery, Carpathian State College in Krosno, Krosno, Poland
- Artur Wdowiak, MD, PhD, DSc, is a gynecologist, obstetrician, and andrologist, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Developed by the Joint Writing Group of the International Urogynecological Association and the American Urogynecologic Society. Joint Report on Terminology for Cosmetic Gynecology. Int Urogynecol J 2022; 33:1367-86. [PMID: 35604421 DOI: 10.1007/s00192-021-05010-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 10/18/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The current terminology used to describe cosmetic gynecologic procedures includes many nondescriptive, trademarked, or informal names, which contributes to substantial ambiguity about their aims and specific techniques. The development of clear, uniform descriptive terminology for cosmetic gynecology is needed for patients, researchers, and practitioners across multiple specialties. METHODS This document was developed from a collaboration of selected members from the International Urogynecological Association (IUGA) and the American Urogynecologic Society (AUGS). Wide-ranging literature reviews were performed to identify the breadth of currently used terms and tools for measuring efficacy and safety. After extensive internal review the adoption of each definition was ratified by group consensus. RESULTS A terminology report for elective cosmetic gynecology procedures, anatomical classification, outcome metrics, and reporting of complications has been developed. This document seeks to provide clear descriptive guidance for patients, researchers, and practitioners across multiple specialties. This document will be subject to internal review by IUGA and AUGS to incorporate and adopt evidence-based changes in the field. CONCLUSIONS A consensus-based document establishing clear terminology for cosmetic gynecology procedures has been created. Use of these terms should be encouraged to provide clarity to patients seeking these procedures and to facilitate future research to establish the safety and efficacy of these procedures.
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Abstract
BACKGROUND Labia minora reduction has become part of the treatment spectrum offered by most plastic surgeons. The author has performed many corrective procedures involving the outer female genital region, most of which involved reducing the labia minora of approximately 4300 women. Over the years, the number of corrective procedures to rectify poorly performed initial operations increased significantly at the author's practice. The most common iatrogenic deformity is the overresection of the labia minora below the clitoris, leaving behind excess tissue in the area around and above the clitoral hood (small penis deformity). METHODS Two basic procedures may be used to reconstruct the labia minora below the clitoris: reconstructing the labia minora by redundant labial tissue above the clitoris to form bilateral preputial flaps being rotated downward into the defect and reconstructing the labia minora by vaginal skin advancement. Other reconstructions depend on the deformity itself. The postoperative outcome was assessed in an anonymous questionnaire answered by 544 patients. RESULTS The outcome showed a significant improvement in functional and psychological impairment as a result of the deformities caused by the initial operation. Even if the reconstruction of the labia minora did not produce the desired initial result, overall satisfaction with the corrective surgery was very satisfactory. CONCLUSION The increase of iatrogenic deformities after the initial labia reductions is alarming. The causes of this growth are manifold: underestimation of the procedure, misjudgment and a lack of detailed knowledge. This has a heavy psychological and physical impact on patients. Reconstruction of excessively shortened labia minora is often not easy and not always satisfactory. Training and the establishment of surgical standards should be used to avoid errors and achieve the best result. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Jiang X, Chen S, Qu S, Ma N, Wang W, Li Y, Yang Z. A New Modified Labiaplasty Combined with Wedge De-Epithelialization on the Medial Side and Edge Resection. Aesthetic Plast Surg 2021; 45:1869-1876. [PMID: 33683383 DOI: 10.1007/s00266-021-02137-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Labiaplasty (labia minora reduction) has been increasingly requested in recent years. The surgical procedures previously reported in the literature may have some complications that affect patient satisfaction. METHODS Patients who underwent a new bilateral labiaplasty procedure that combined wedge de-epithelialization on the medial side with edge resection on the lateral side were retrospectively reviewed. Satisfaction rates were assessed, and questionnaires, namely the Female Sexual Function Index (FSFI) and Genital Appearance Satisfaction (GAS) scale, were distributed and analyzed. The data from the study group were compared with data from cases who underwent traditional labiaplasty with wedge resection (control group). RESULTS From October 2015 to February 2020, fifty-one women underwent modified labiaplasty, while 26 women underwent traditional labiaplasty. A total of 94.1% (48/51) of patients in the modified group were satisfied with the genital appearance. Compared with the 96.2% (25/26) satisfaction rate in the control group, the difference was not statistically significant. A total of 43/55 valid questionnaires were returned, including 29 in the modified labiaplasty group and 14 in the control group. There was a significant improvement in the postoperative GAS scale compared to the preoperative scale in both groups (P<0.05). The new modified method had a significant FSFI improvement after the operation compared with preoperative scores (P<0.05), while the FSFI improvement was not significant in the control group (P>0.05). There was no significant difference in the FSFI score improvement, postoperative GAS score or postoperative FSFI between the two groups (P>0.05). CONCLUSION This new modified labiaplasty is a satisfying and safe method with low risks, and it may result in better sexual sensitivity for the patients LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xudong Jiang
- Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 33 Badachu road, Shijingshan District, Beijing, 100144, China
| | - Sen Chen
- Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 33 Badachu road, Shijingshan District, Beijing, 100144, China
| | - Siwei Qu
- Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 33 Badachu road, Shijingshan District, Beijing, 100144, China
| | - Ning Ma
- Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 33 Badachu road, Shijingshan District, Beijing, 100144, China
| | - Weixin Wang
- Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 33 Badachu road, Shijingshan District, Beijing, 100144, China
| | - Yangqun Li
- Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 33 Badachu road, Shijingshan District, Beijing, 100144, China
| | - Zhe Yang
- Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 33 Badachu road, Shijingshan District, Beijing, 100144, China.
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Toplu G, Altinel D. Genital Beautification and Rejuvenation with Combined Use of Surgical and Non-surgical Methods. Aesthetic Plast Surg 2021; 45:758-768. [PMID: 32997240 DOI: 10.1007/s00266-020-01980-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/14/2020] [Indexed: 11/25/2022]
Abstract
AIM In female genital rejuvenation and beautification, interest and demand for combined surgical and non-surgical methods are increasing. This study presents the results of our labia minora reduction technique and a vulvovaginal rejuvenation and beautification concept, where a combination of fat injection into the mons pubis and labia majora, if necessary, combined with fractional carbon dioxide (CO2) laser is used. PATIENTS AND METHODS Genital rejuvenation and beautification were performed on 37 patients between January 2014 and January 2019. Postoperative follow-up for 1 year to obtain data on the satisfaction of surgical and non-surgical procedures was performed. RESULTS Of the 37 female patients included in the study, 33 (94.5%) were satisfied or very satisfied with their postoperative appearance. Thirty (80%) patients were satisfied or very satisfied with functional results. CONCLUSION The described genital beautification and rejuvenation technique combines different aesthetic female genital surgery techniques and non-surgical noninvasive procedures. These procedures, like other plastic surgeries and procedures, are designed for the subjective improvement of the patients' appearance and feelings. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Gaye Toplu
- Department of Plastic, Reconstructive and Aesthetic Surgery, Univeristy of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey.
| | - Dincer Altinel
- Department of Plastic, Reconstructive and Aesthetic Surgery, Univeristy of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
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Qiang S, Li F, Zhou Y, Cao Y, Liu M, Yuan Y, Zhang Z, Li Q. A New Concept for Central Wedge Resection in Labiaplasty. Gynecol Obstet Invest 2021; 86:257-263. [PMID: 33691320 DOI: 10.1159/000513402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/26/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study was to develop a new concept for central wedge resection to improve surgical results. Currently, the most common postoperative complications of the regular central wedge (RV) resection technique are wound dehiscence and scar contracture. METHODS A case-control study was applied to randomly divide 119 patients with labia minora hypertrophy deformities into 2 groups: new central wedge (NV) (n = 57) and RV (n = 62). All patients underwent the corresponding corrective surgery to repair the deformity. During the NV procedure, we changed the direction of the scalpel to form 2 inclined sections and sutured these sections together to achieve nonparallel closure lines. The patients in the 2 groups were followed up at 1 and 6 months postoperatively. We described the details of this method and evaluated the treatment outcomes of the 2 groups. RESULTS Patient age, labia minora width, and procedure time were not significantly different between the 2 groups (p > 0.05). However, the visual analog scale (VAS) scores in the 2 groups were significantly different (p < 0.05). Two patients in the NV group were somewhat dissatisfied because of lymphoedema and asymmetry; 6 patients in the RV group expressed dissatisfaction with scarring, healing complications, and asymmetry. A minor corrective operation was performed for asymmetry, and the dehiscence healed spontaneously. The patient with edema is still being followed up. CONCLUSION The surgical method we introduced was indicated to be a simple and effective procedure that avoided wound dehiscence and scar contracture, which are common with the regular approach.
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Affiliation(s)
- Shuai Qiang
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengyong Li
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Zhou
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yujiao Cao
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meichen Liu
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Yuan
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhen Zhang
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiang Li
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,
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Filho OP, Ely JB, Lee KH, Paulo EM. Labiaplasty with Stable Labia Minora Retraction-Butterfly-like Approach. Plast Reconstr Surg Glob Open 2020; 8:e2664. [PMID: 32440394 DOI: 10.1097/GOX.0000000000002664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 01/08/2020] [Indexed: 11/25/2022]
Abstract
Labiaplasty, referring to a surgical labia minora reduction, is the most commonly requested genital rejuvenation by women. The purpose of this article is to show an innovative maneuver in the technique for this increasingly demanded procedure. In this strategy, labia minora are attached temporarily to the internal thigh with stitches resembling an open butterfly wing. This maneuver stabilizes the redundant labia minora soft tissue, easing the evaluation of asymmetry and aiding precision in the treatment. The study investigated 12 patients, 10 presenting bilateral hypertrophic labia minora and 2 patients with only unilateral abnormal anatomy, n = 22. The mean age was 25 years. The postoperative follow-up was uneventful. All patients presented labia minora with anatomic configuration. In 1 patient, we registered immediate bleeding that needed revision. The butterfly-like maneuver with the labia minora temporarily attached to the inner thigh can ease labiaplasty with central and inferior wedge resection. It helps diagnose asymmetry and adds precision to resect the correct amount of the hypertrophic tissue.
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González-Isaza P, Lotti T, França K, Sanchez-Borrego R, Tórtola JE, Lotti J, Wollina U, Tchernev G, Zerbinati N. Carbon Dioxide with a New Pulse Profile and Shape: A Perfect Tool to Perform Labiaplasty for Functional and Cosmetic Purpose. Open Access Maced J Med Sci 2018; 6:25-27. [PMID: 29483973 PMCID: PMC5816306 DOI: 10.3889/oamjms.2018.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 11/17/2017] [Accepted: 10/29/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: To describe the benefits and safety of using Carbon Dioxide Laser in multi-pulse modalities when performing labiaplasty and anatomical variants approach for functional and cosmetic indications. DESIGN: This is a prospective, descriptive case series study. SETTING: Private Practice Quirofano Calculaser Megacentro Pinares Pereira Colombia. POPULATION: One Hundred and twelve women seeking labia minora labiaplasty for functional and cosmetic reasons were enrolled in the study protocol from June 2013 to June 2016. Labia minora labioplasty and anatomical variants approach were performed with Carbon Dioxide laser Multi-pulse modalities DEKA M.EL.A Florence Italy MAIN OUTCOME MEASURES: Good Cosmetic results, functional and sexuality improvement RESULTS: Dramatic changes in the VAS and VSQ were detected after the surgical procedure. All the participants reported a high degree of satisfaction, felt more confident with their partners during sexual encounters, and the procedure was well tolerated. CONCLUSION: Laser Carbon Dioxide Laser with a new pulse profile and shape seems to be a safe and precise surgical tool to perform this type of procedures, optimal biophysical and bio stimulative laser-tissue interactions allow delicate vulvar tissues to shorten downtime.
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Affiliation(s)
- Pablo González-Isaza
- Hospital Universitario San Jorge - Head Chief of Urogynecology, Pereira, Colombia
| | - Torello Lotti
- University of Rome "G. Marconi" - Centro Studi per la Ricerca Multidisciplinare e Rigenerativa (CSRMR), Rome, Italy University G. Marconi of Rome, Dermatology and Venereology, Rome 00192, Italy
| | - Katlein França
- University of Miami School of Medicine, 1400 NW 10th Avenue, Miami, Florida 33136-1015, United States
| | | | | | - Jacopo Lotti
- University of Rome "G. Marconi" - Dept. of Nuclear, Subnuclear and Radiation Physics, Rome, Italy
| | - Uwe Wollina
- Städtisches Klinikum Dresden, Department of Dermatology and Allergology, 01067 Dresden, Germany
| | - Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior (MVR-Sofia), General Skobelev 79, 1606 Sofia, Bulgaria.,Onkoderma - Policlinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria
| | - Nicola Zerbinati
- Universita degli Studi dell'Insubria Dipartimento di Scienze Chirurgiche e Morfologiche, Varese, Italy
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Goodman MP, Placik OJ, Matlock DL, Simopoulos AF, Dalton TA, Veale D, Hardwick-Smith S. Evaluation of Body Image and Sexual Satisfaction in Women Undergoing Female Genital Plastic/Cosmetic Surgery. Aesthet Surg J 2016; 36:1048-57. [PMID: 27084062 DOI: 10.1093/asj/sjw061] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Little prospective data exists regarding the procedures constituting female genital plastic/cosmetic surgery (FGPS). OBJECTIVES To evaluate whether the procedures of labiaplasty and vaginoperineoplasty improve genital self image, and evaluate effects on sexual satisfaction. METHODS Prospective cohort case-controlled study of 120 subjects evaluated at baseline, 6, 12, and 24 months postoperative, paired with a demographically similar control group. Interventions include labiaplasty, clitoral hood reduction, and/or aesthetic vaginal tightening, defined as perineoplasty + "vaginoplasty" (aka "vaginal rejuvenation."). Outcome measures include body image, genital self-image, sexual satisfaction, and body esteem. RESULTS As a group, study patients tested at baseline showing body dissatisfaction, negative genital self-image, and poorer indices of sexual satisfaction. Preoperative body image of study patients were in a range considered to be mild to moderately dysmorphic, but matched controls at one and two years; genital self-image scores at entry were considerably lower than controls, but by 2-year follow-up had surpassed control value at entry. Similarly, sexual satisfaction values, significantly lower at entry, equaled at one, and surpassed control values, at 2 years. Postoperatively, at all points in time, these differences in body image and genital self-image disappeared, and sexual satisfaction markedly improved. Overall body esteem did not differ between study and control groups, with the exception of the genital esteem quotient, which improved after surgery. CONCLUSIONS Women requesting and completing FGPS, when tested by validated instruments, at entry report sexual dissatisfaction and negative genital self-image. When tested at several points in time after surgery up to two years, these findings were no longer present. When performed by an experienced surgeon, FGPS appears to provide sexual and genital self-image improvement. LEVEL OF EVIDENCE 2 Therapeutic.
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Affiliation(s)
- Michael P Goodman
- Dr Goodman is a cosmetic gynecologist in private practice in Davis, CA, Dr Placik is an Assistant Clinical Professor, Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, Dr Matlock is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Simopoulos is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Dalton is Director, Master of Advanced Study Program, Department of Criminology, Law and Society, University of California, Irvine, CA, Dr Veale is a Consultant Psychiatrist in Cognitive Behavioral Therapy at the South London and Maudsley NHS Trust and The Priory Hospital North London, London, United Kingdom, Dr Hardwick-Smith is a cosmetic gynecologist in private practice in Houston, TX
| | - Otto J Placik
- Dr Goodman is a cosmetic gynecologist in private practice in Davis, CA, Dr Placik is an Assistant Clinical Professor, Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, Dr Matlock is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Simopoulos is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Dalton is Director, Master of Advanced Study Program, Department of Criminology, Law and Society, University of California, Irvine, CA, Dr Veale is a Consultant Psychiatrist in Cognitive Behavioral Therapy at the South London and Maudsley NHS Trust and The Priory Hospital North London, London, United Kingdom, Dr Hardwick-Smith is a cosmetic gynecologist in private practice in Houston, TX
| | - David L Matlock
- Dr Goodman is a cosmetic gynecologist in private practice in Davis, CA, Dr Placik is an Assistant Clinical Professor, Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, Dr Matlock is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Simopoulos is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Dalton is Director, Master of Advanced Study Program, Department of Criminology, Law and Society, University of California, Irvine, CA, Dr Veale is a Consultant Psychiatrist in Cognitive Behavioral Therapy at the South London and Maudsley NHS Trust and The Priory Hospital North London, London, United Kingdom, Dr Hardwick-Smith is a cosmetic gynecologist in private practice in Houston, TX
| | - Alex F Simopoulos
- Dr Goodman is a cosmetic gynecologist in private practice in Davis, CA, Dr Placik is an Assistant Clinical Professor, Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, Dr Matlock is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Simopoulos is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Dalton is Director, Master of Advanced Study Program, Department of Criminology, Law and Society, University of California, Irvine, CA, Dr Veale is a Consultant Psychiatrist in Cognitive Behavioral Therapy at the South London and Maudsley NHS Trust and The Priory Hospital North London, London, United Kingdom, Dr Hardwick-Smith is a cosmetic gynecologist in private practice in Houston, TX
| | - Teresa A Dalton
- Dr Goodman is a cosmetic gynecologist in private practice in Davis, CA, Dr Placik is an Assistant Clinical Professor, Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, Dr Matlock is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Simopoulos is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Dalton is Director, Master of Advanced Study Program, Department of Criminology, Law and Society, University of California, Irvine, CA, Dr Veale is a Consultant Psychiatrist in Cognitive Behavioral Therapy at the South London and Maudsley NHS Trust and The Priory Hospital North London, London, United Kingdom, Dr Hardwick-Smith is a cosmetic gynecologist in private practice in Houston, TX
| | - David Veale
- Dr Goodman is a cosmetic gynecologist in private practice in Davis, CA, Dr Placik is an Assistant Clinical Professor, Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, Dr Matlock is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Simopoulos is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Dalton is Director, Master of Advanced Study Program, Department of Criminology, Law and Society, University of California, Irvine, CA, Dr Veale is a Consultant Psychiatrist in Cognitive Behavioral Therapy at the South London and Maudsley NHS Trust and The Priory Hospital North London, London, United Kingdom, Dr Hardwick-Smith is a cosmetic gynecologist in private practice in Houston, TX
| | - Susan Hardwick-Smith
- Dr Goodman is a cosmetic gynecologist in private practice in Davis, CA, Dr Placik is an Assistant Clinical Professor, Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, Dr Matlock is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Simopoulos is a cosmetic gynecologist in private practice in Los Angeles, CA, Dr Dalton is Director, Master of Advanced Study Program, Department of Criminology, Law and Society, University of California, Irvine, CA, Dr Veale is a Consultant Psychiatrist in Cognitive Behavioral Therapy at the South London and Maudsley NHS Trust and The Priory Hospital North London, London, United Kingdom, Dr Hardwick-Smith is a cosmetic gynecologist in private practice in Houston, TX
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12
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Kelishadi SS, Omar R, Herring N, Tutela JP, Chowdhry S, Brooks R, Wilhelmi BJ. The Safe Labiaplasty: A Study of Nerve Density in Labia Minora and Its Implications. Aesthet Surg J 2016; 36:705-9. [PMID: 26893524 DOI: 10.1093/asj/sjw002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Surgical techniques to alleviate labia minora hypertrophy are gaining popularity. Due to the rapidly growing number of labiaplasties performed around the world, there is concern for the safety of these procedures with respect to maintaining sensitivity to the genitalia and/or implications for sexual arousal. OBJECTIVES An anatomic study aimed at identifying the nerve density distribution of the labia minora was performed to provide unique insight into performing labiaplasty while preserving sensation. METHODS Four fresh tissue cadaver labia minora were analyzed. Each labia minora was divided into 6 anatomic areas. The samples from each of the 6 anatomic locations were analyzed for presence of nerve bundles using both a routine hematoxylin and eosin (H&E) stain and a confirmatory immunohistochemical staining for S100 protein. Nerve density was analyzed under light microscopy, counted, and then expressed as percentage nerve density as well as number of bundles per square millimeter. RESULTS Upon gross analysis, the raw data reveal that labia minora have a heterogeneous population of sensory nerves. When looking at percent nerve density, the data do not reveal any statistical differences between the anatomic locations. CONCLUSIONS Most labiaplasty techniques can be performed safely and are unlikely to cause loss of sensation as the nerve density distribution in labia minora is heterogeneous.
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Affiliation(s)
| | - Rawhi Omar
- From the University of Louisville School of Medicine, Louisville, KY
| | - Nicole Herring
- From the University of Louisville School of Medicine, Louisville, KY
| | - John Paul Tutela
- From the University of Louisville School of Medicine, Louisville, KY
| | - Saeed Chowdhry
- From the University of Louisville School of Medicine, Louisville, KY
| | - Ron Brooks
- From the University of Louisville School of Medicine, Louisville, KY
| | - Bradon J Wilhelmi
- From the University of Louisville School of Medicine, Louisville, KY
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13
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Abstract
Aesthetic alteration of the genitalia is increasingly sought by women unhappy with the size, shape, and appearance of their vulva. Although the labia minora are usually the focus of concern, the entire anatomic region--minora, labia majora, clitoral hood, perineum, and mons pubis--should be evaluated in a preoperative assessment of women seeking labiaplasty. Labiaplasty is associated with high patient satisfaction and low complication rates. The three basic labia minora reduction techniques--edge excision, wedge excision, and central deepithelialization--as well as their advantages and disadvantages are discussed to assist the surgeon in tailoring technique selection to individual genital anatomy and aesthetic desires. We present key points of the preoperative anatomic evaluation, technique selection, operative risks, perioperative care, and potential complications for labia minora, labia majora, and clitoral hood alterations, based on a large operative experience. Labiaplasty competency should be part of the skill set of all plastic surgeons.
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Affiliation(s)
- John G Hunter
- Dr Hunter is an Attending Surgeon in the Division of Plastic Surgery at the New York-Presbyterian Hospital (Weill Cornell Campus), New York, NY, and Vice Chairman in the Department of Surgery at the New York Methodist Hospital, Brooklyn, NY
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14
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Abstract
BACKGROUND The demand for female aesthetic labiaplasty surgery continues to rapidly increase. Several questions have been raised regarding the safety and effectiveness of female aesthetic genital surgery. OBJECTIVES The purpose of this study is to review our experience with aesthetic labiaplasty and describe the type and frequency of complications that have been experienced. METHODS A retrospective chart review was performed on all patients who had primary aesthetic labia minora reduction surgery from August 2007 to April 2014. A chart review of the electronic medical record was performed to examine demographic, procedural, and outcome data. RESULTS In the study period, 113 patients underwent aesthetic labiaplasty. Of these, 29 patients (25.6%) had labiaplasty performed in combination with another procedure. A total of 15 patients (13.3%) reported transient symptoms, including swelling, bruising, and pain. There was one patient (0.8%) that experienced bleeding. Four patients (3.5%) required revision surgery. All revisions were performed to excise further tissue to address persistent redundancy or asymmetry. No major complications were reported. CONCLUSIONS In our experience, aesthetic surgery of the labia minora using an edge excision technique has a very low complication rate and provides satisfactory aesthetic outcomes for our patients. More studies examining the impact of labiaplasty on a woman's self-image and quality of life would add to our understanding of the motivations and expectations of women undergoing this aesthetic surgery. This information will allow us to help our patients make well-informed decisions when considering this aesthetic genital surgery. LEVEL OF EVIDENCE 4 Risk.
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Affiliation(s)
- Frank Lista
- Dr Lista is an Assistant Professor and Dr Ahmad is a Lecturer, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Canada. Mr Mistry is a Medical Student in the Faculty of Medicine, University of British Columbia, Vancouver, Canada. Ms Singh is a Medical Student in the School of Medicine at the Royal College of Surgeons in Ireland, Dublin
| | - Bhavik D Mistry
- Dr Lista is an Assistant Professor and Dr Ahmad is a Lecturer, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Canada. Mr Mistry is a Medical Student in the Faculty of Medicine, University of British Columbia, Vancouver, Canada. Ms Singh is a Medical Student in the School of Medicine at the Royal College of Surgeons in Ireland, Dublin
| | - Yashoda Singh
- Dr Lista is an Assistant Professor and Dr Ahmad is a Lecturer, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Canada. Mr Mistry is a Medical Student in the Faculty of Medicine, University of British Columbia, Vancouver, Canada. Ms Singh is a Medical Student in the School of Medicine at the Royal College of Surgeons in Ireland, Dublin
| | - Jamil Ahmad
- Dr Lista is an Assistant Professor and Dr Ahmad is a Lecturer, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Canada. Mr Mistry is a Medical Student in the Faculty of Medicine, University of British Columbia, Vancouver, Canada. Ms Singh is a Medical Student in the School of Medicine at the Royal College of Surgeons in Ireland, Dublin
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15
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Zwier S. "What Motivates Her": Motivations for Considering Labial Reduction Surgery as Recounted on Women's Online Communities and Surgeons' Websites. Sex Med 2014; 2:16-23. [PMID: 25356297 PMCID: PMC4184612 DOI: 10.1002/sm2.20] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Increasing numbers of women are seeking labial reduction surgery. We studied the motivations for considering labial reduction surgery as recounted on women's online communities and surgery provider's websites. AIMS The study analyzed motivations for considering labial reduction surgery expressed by women on online communities, looked at the role of the women's age and nationality, compared findings with motivations indicated on the websites of an international sample of surgery providers, and identified similarities to and differences from what is known from extant studies. METHODS Quantitative content analysis of the posts of 78 American, British, and Dutch women on online communities, and 40 international surgery providers' websites about labial reduction surgery was conducted. MAIN OUTCOME MEASURES Main outcome measures concerned the incidence and prominence of different motivational categories (functional/emotional and discomfort/enhancement related). Differences in motivations as a function of age, national background, and women's vs. surgeons' stated motivations were tested. RESULTS Emotional discomfort regarding self-appearance and social and sexual relationships was found to be the most frequent and most prominent motivation for considering labial reduction surgery on women's online communities, regardless of age and national background. Functional discomfort and desired emotional enhancement ranked second. Very few age or national differences were found. The surgeons' websites recognized functional discomfort more and elaborated upon emotional issues in sexual relationships less than members of the online communities. CONCLUSIONS Feelings of emotional and psychosexual distress in addition to functional distress are a highly prevalent motivation among women considering labial reduction surgery. Emotional distress appears to be greater and more freely emphasized when women communicate on online communities, while functional issues appear to receive greater notice on surgery provider's websites. Zwier S. "What motivates her": Motivations for considering labial reduction surgery as recounted on women's online communities and surgeons' websites. Sex Med 2014;2:16-23.
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Affiliation(s)
- Sandra Zwier
- Amsterdam School of Communication Research ASCoR, University of Amsterdam Amsterdam, The Netherlands
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16
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Iglesia CB, Yurteri-Kaplan L, Alinsod R. Female genital cosmetic surgery: a review of techniques and outcomes. Int Urogynecol J 2013; 24:1997-2009. [PMID: 23695382 DOI: 10.1007/s00192-013-2117-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 04/18/2013] [Indexed: 11/28/2022]
Abstract
The aesthetic and functional procedures that comprise female genital cosmetic surgery (FGCS) include traditional vaginal prolapse procedures as well as cosmetic vulvar and labial procedures. The line between cosmetic and medically indicated surgical procedures is blurred, and today many operations are performed for both purposes. The contributions of gynecologists and reconstructive pelvic surgeons are crucial in this debate. Aesthetic vaginal surgeons may unintentionally blur legitimate female pelvic floor disorders with other aesthetic conditions. In the absence of quality outcome data, the value of FGCS in improving sexual function remains uncertain. Women seeking FGCS need to be educated about the range and variation of labia widths and genital appearance, and should be evaluated for true pelvic support disorders such as pelvic organ prolapse and stress urinary incontinence. Women seeking FGCS should also be screened for psychological conditions and should act autonomously without coercion from partners or surgeons with proprietary conflicts of interest.
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Affiliation(s)
- Cheryl B Iglesia
- Section of Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Center, Washington, DC, USA,
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17
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López-olmos J. Hipertrofia de labios menores y/o asimetría: petición de resección, ¿casualidad o moda? Estudio de dos periodos, 1994-2007 y 2008-2010. Clínica e Investigación en Ginecología y Obstetricia 2013; 40:2-7. [DOI: 10.1016/j.gine.2011.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Triana L, Robledo AM. Refreshing labioplasty techniques for plastic surgeons. Aesthetic Plast Surg 2012; 36:1078-86. [PMID: 22718365 DOI: 10.1007/s00266-012-9916-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 04/08/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Patient requests for plastic surgery of the female genitalia have become more common. There are several technical options to manage hypertrophic labia minora, including direct excision, wedge resection, and deepithelialization. Labia majora hypertrophy and hypoplasia can also be managed surgically. The aim of this study was to summarize labioplasty techniques to date, and describe the senior author's technique for labia minora and majora labioplasty. METHODS Seventy-four patients underwent direct labia minora excision with or without clitoral hood molding and management of labia majora by the senior author from January 2009 to August 2011. RESULTS The average follow-up time was 6 months. The range of the patients' ages was wide with an average age of 35 years. One patient had an infection and one had wound dehiscence. Six patients had palpable fatty cysts in the labia majora after fat injections; the cysts of five of these patients reabsorbed before 6 months. In one patient a palpable mass persisted 8 months after surgery; however, it was not visible or painful and the patient was satisfied with the result. No cases of scar contracture, painful scar, or discomfort because of labial edge distortion were noted. The satisfaction rate was close to 100 %. CONCLUSION The direct excision of the excess labia minora is a good technique and does not produce scar-associated problems. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article.
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Goodman M, Fashler S, Miklos JR, Moore RD, Brotto LA. The Sexual, Psychological, and Body Image Health of Women Undergoing Elective Vulvovaginal Plastic/Cosmetic Procedures: A Pilot Study. ACTA ACUST UNITED AC 2011. [DOI: 10.5992/0748-8068-28.4.219] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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20
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Abstract
BACKGROUND Labia minora reduction (labioplasty, labiaplasty) is the most common female genital aesthetic procedure. The majority of labia reductions are performed by trimming the labial edges. Many of these women present with (1) asymmetry; (2) scalloping of the labial edges with wide, occasionally painful scars; and (3) abrupt termination and distortion of the clitoral hood at its normal junctions with the clitoral frenula and the upper labium. Reconstruction can usually be performed with wedge excisions, labial YV advancement, and touch-up trimming. Reconstruction of a labial amputation, however, required the development of a new clitoral hood flap. METHODS Twenty-four clitoral hood flaps were performed on 17 patients from June of 2006 through May of 2010. An island clitoral hood flap randomly based on the dartos fascia of the lower clitoral hood and medial labium majus is transposed to the ipsilateral labial defect to reconstruct a labium. Of the 10 patients with unilateral flaps, nine of the patients had previous bilateral labial reductions. Reconstruction of the opposite side in these nine women was performed using one or a combination of the following: wedge excisions, YV advancement flaps, or controlled touch-up trimming. RESULTS All 24 flaps survived, with four minor complications. Five patients underwent revision of a total of seven flaps, but only two were for complications. As experience increased, revisions for aesthetic improvement became less common. CONCLUSION Reconstruction of labia minora defects secondary to trimming labia reductions is very successful using a combination of clitoral hood flaps, wedge excisions, and YV advancements.
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21
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Ostrzenski A. Cosmetic gynecology in the view of evidence-based medicine and ACOG recommendations: a review. Arch Gynecol Obstet 2011; 284:617-30. [PMID: 21479923 DOI: 10.1007/s00404-011-1896-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 03/21/2011] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To conduct a methodological review of the existing scientific literature within the field of cosmetic gynecology in the view of evidence-based medicine and to establish their relevance to the ACOG Committee Opinion No. 378. STUDY DESIGN The appropriate medical subject heading terms were selected and applied in the search of the Internet multiple databases since 1900 until January 2010. Articles focusing on cosmetic gynecology were reviewed. Also, anecdotal and advertising literatures were analyzed. A methodological review of the literatures was conducted. RESULTS In peer review journals, 72 relevant articles related to cosmetic gynecology were identified. Anecdotal information was identified in 3 sources and over 1,100 published marketing literatures were identified on the Internet and no scientific journals. Among reviewed articles on cosmetic gynecology, only two articles met the level II-2 in evidence-based medicine. The absence of documentations on the safety and effectiveness of cosmetic vaginal procedures in the scientific literatures was ACOG's main concern. CONCLUSIONS Practicing cosmetic gynecology within ACOG recommendations is desirable and possible. Currently, the standard of practice of cosmetic gynecology cannot be determined due to the absence of the documentation on safety and effectiveness. Traditional gynecologic surgical procedures cannot be called cosmetic procedures, since it is a deceptive form of practice and marketing. Creating medical terminology trademarks and establishing a business model that tries to control clinical-scientific knowledge dissemination is unethical.
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23
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Deffieux X, Leonard F, Fernandez H. [Surgical reduction of hypertrophy of labia minora]. ACTA ACUST UNITED AC 2010; 39:679-81. [PMID: 20452734 DOI: 10.1016/j.jgyn.2010.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Revised: 02/11/2010] [Accepted: 02/16/2010] [Indexed: 11/22/2022]
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Solanki NS, Tejero-Trujeque R, Stevens-King A, Malata CM. Aesthetic and functional reduction of the labia minora using the Maas and Hage technique. J Plast Reconstr Aesthet Surg 2009; 63:1181-5. [PMID: 19596626 DOI: 10.1016/j.bjps.2009.05.053] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Revised: 05/16/2009] [Accepted: 05/29/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Enlarged labia minora can cause functional, aesthetic and psychosocial problems. There are many reported techniques for their surgical correction in both the gynaecological and surgical literature suggesting that no one method is superior to the others. The problem is compounded because an individual surgeon's experience is likely to be small given the infrequent request for surgery. For these reasons it is important that existing techniques are validated by independent surgeons rather than describing yet another variation. METHODS Patients who underwent surgical reduction of their labia minora from 2001-2008 were retrospectively reviewed. All cases were performed by the same surgeon using the Maas and Hage technique of a running interdigitating W-shaped excision. RESULTS 12 patients aged from 15 to 52 years underwent reduction labioplasty for idiopathic hypertrophy. Postoperatively there were no wound dehiscences or infections. One patient developed a painful haematoma 2h after surgery necessitating surgical evacuation while another went into postoperative urinary retention relieved by overnight catheterisation. Both made uneventful recoveries. All patients were satisfied with their 'natural looking' cosmetic results and have returned to their normal activities without recurrence of their presenting symptoms. The mean follow up was 14 weeks but none have subsequently required or requested revisional surgery. CONCLUSIONS The running W-shaped resection was found to be an easy and effective method of reducing the labia minora by a single operator in a small series of cases. This independent review demonstrates the reproducibility of this technique and the favourable aesthetic and functional outcomes for the patient.
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Affiliation(s)
- N S Solanki
- Clinical School of Medicine, Cambridge University, Cambridge UK
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Heusse J, Cousin-verhoest S, Aillet S, Watier É. Mise au point sur les techniques de nymphoplastie de réduction. ANN CHIR PLAST ESTH 2009; 54:126-34. [DOI: 10.1016/j.anplas.2008.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Accepted: 03/26/2008] [Indexed: 11/22/2022]
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Abstract
Demand for cosmetic genitoplasty is increasing. Lih Mei Liao and Sarah M Creighton argue that surgery carries risks and that alternative solutions to women's concerns about the appearance of their genitals should be developed
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Affiliation(s)
- Lih Mei Liao
- Middlesex Centre, UCL Institute for Women's Health, Elizabeth Garrett Anderson and Obstetric Hospital, London WC1E 6DH.
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27
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Fayad S, Srom V, Delotte J, Bafghi A, Sorci K, Bongain A. [Psychological factors of genital automutilation and medico-ethical interest in emergency vulvoplasty]. ACTA ACUST UNITED AC 2006; 34:134-6. [PMID: 16495110 DOI: 10.1016/j.gyobfe.2005.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Accepted: 12/22/2005] [Indexed: 10/25/2022]
Abstract
The genital self-mutilation is not rare in women. Risk factors found in these cases are: mood disorders, food behavior anomalies and antecedents of sexual aggression. However, surgical repair is not done in emergency: we find no similar report to our clinical case describing an added up bilateral reduction nymphoplasty carried out in emergency after hemorrhagic genital self-mutilation. We discuss psychological risk factors, psychiatric diagnosis and optimal treatment, studied from medico-ethical point of view, for this surgical emergency.
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Affiliation(s)
- S Fayad
- Service de Gynécologie-Obstétrique, Reproduction et Médecine Foetale, Hôpital Archet-II, CHU de Nice-Sophia-Antipolis, BP 3079, 151, route de Saint-Antoine-de-Ginestière, 06202 Nice cedex 03, France
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