Female Genital Surgery

Many Women feel insecure about the appearance and the function of their genital areas.

The unsightly appearance of the vagina, labia and pubic region can cause insecurity and low self. It also produces irritation, discomfort, avoidance of sexual activity and difficulty exercising.

You may have been born with saggy and lax skin or had damage due to previous labour, forceps injury, inadequately repaired episiotomy, female circumcision, or simply the effect of aging, weight loss/weight gain and menopause taken its toll and resulted in “unpleasant look and lack of function” of the female genital areas.

Those conditions can now be treated in a specialist field in Plastic Surgery known as Aesthetic Genital Surgery.

If you are experiencing those conditions and want to look and feel good “down there” then make sure Dr Barnouti and his team will look after you. He is experienced in female sexual health and vaginal rejuvenation and has helped many thousands of women restore their confidence, sexual relationships and regain a sense of femininity. All consultations are Private and Confidential.

The Procedures available for female genital surgery include vaginal tightening and labiaplasty:

• Labia Majora remodelling, Labiaplasty or labioplasty
• Labial fat injection
• Clitoral Hood reduction
• Clitorpexy
• Vaginoplasty, also known as pelvic floor muscle repair and reconstruction
• Laser Vaginal Rejuvenation, LVR
• Labia Repair
• Pubic liposuction
• Pubic Lift
• External Genital deformity reconstruction

A weak and lax pelvic floor muscle can cause a lack of sexual pleasure for the woman and loss of friction for her partner. The looseness of the vagina is often associated with urinary control problems and bulging of the bowel into the floor of the vagina. Tightening of the vagina will enhance the sexual pleasure of the woman and her male partner. At the same time, correction for uterine prolapse, perineal repair ( the distance between the vagina and anal opening is shortened in a procedure known as perineoplasty) and anecdotal evidence of urinary leakage improvements.

Some women are born with large, irregular and uneven labia(vaginal inner lips). Women have 2 pairs of labia, the inner labia (inner vaginal lips) and an outer labia (outer Vaginal lips).  This redundant skin can be unhygienic and uncomfortable during sex. Inner labia that protrude beyond the outer lips cause chaffing, especially in tight clothing, which is generally less appealing aesthetically and may cause urinary infections. The procedure to correct this condition is known as Labiaplasty.

The Pubic area can develop “unwanted pockets of fat,” which can cause an “uncomfortable large bulge” in the Mons Pubis. This bulge shows through tight clothing and can be embarrassing in an intimate situation. The recommended procedure for this condition is either Pubic liposuction or a pubic lift.

The appearance and function of female genitalia can be restored through a variety of procedures, collectively known as “Vaginal rejuvenation procedures”. There are many options available to correct and enhance the appearance of the vagina, which can be discussed with Dr Barnouti in a confidential consultation.

Labia Minora reduction

Labia minora reduction is a procedure that reduces the size of larger labia minora so that they do not protrude outward from the vagina.

Women often complain that their inner lips protrude beyond the vaginal entrance. Some find the often swollen & roughened appearance of the free edge of the inner labia too uncomfortable. Dr.Barnouti will discuss your concerns and address your problem smartly and efficiently.

If the concern is just excess protrusion, Dr Barnouti may recommend preserving the free edge of the labia and reducing scarring by performing a “Wedge Labiaplasty.” If the free edge is at least part of the problem, a ” linear labiaplasty” might be the answer. The aim is to “hide the inner labia” in a standing position.

About the procedure

A labiaplasty involves excising and sealing excess, roughened tissue that can cause the labial folds to look asymmetrical or stretched. Younger patients opt for labiaplasty alone to correct an uneven appearance of the labial folds. Essentially, if a roughened edge is the issue, this needs to be removed. If not, the edges of the labia minora are slightly reduced back to the level, same as the labia majora, and often excess skin covering the clitoral hood is decreased.

Most women experience improved vaginal hygiene after the labioplasty procedure. Larger labia can cause urine to be trapped in the area, allowing bacteria from the bowel to migrate and colonise in the urethra. This can result in chronic urethral contamination or even cause infection to be flushed back into the bladder, causing bladder infections. Patients must refrain from penetrative sex for at least 4 weeks after a labiaplasty procedure.

Labia Majora remodelling

Labia Majora Reduction is a procedure to decrease the size of enlarged outer lips of the vagina.

The outer lips of the vagina can be enlarged with excess skin or fat, or both. The labia majora may be enlarged from birth, secondary to childbirth, ageing and menopause. This enlargement causes an embarrassing bulge in pants or swimsuits. In some cases, the large labia cause discomfort with clothes or sex or difficulties with hygiene.

The excess tissue requires remodelling by removing a crescent-shaped portion of each inner labium. If skin excess is the problem, then only skin will be removed. Both can be removed and restored to the original shape in cases with excess skin and fat. Extreme care is used to create symmetrical labial. The incisions on each side are closed meticulously with sutures under the skin, so no unsightly crosshatched scars exist. The scar is hidden in the concavity between the inner and outer labia. This surgery takes about one and a half hours.

The surgery is minor and is not very uncomfortable. It is performed in a day surgery facility under General Anesthesia or twilight sedation with local Anesthesia. The complication rate is rare. You can return to light work within 3 days. You can resume sexual relations in 6 weeks. None of my patients have complained of any loss of sensation or any decline in the ability to have orgasms.

The labia majora reduction (labioplasty) can be combined with other procedures such as a labia minora reduction, clitoropexy with clitoral hood reduction, or vaginal tightening.

Labia majora fat injections

As a result of childbirth, ageing, weight loss, heredity, skin laxity, and menopause, the labia majora tends to get larger and appear deflated and redundant. This can be filled by a procedure known as a Labia fat injection. Aging, weight loss, or heredity can cause the labia majora to lose its youthful fullness. This is easily corrected by injecting fat from another body area. The procedure is minor and takes about an hour.

Labia majora fat injections can be performed to increase the fullness of the outer lips of the vagina, or the area can be reduced using liposuction if fat is abundant. If excess, stretched skin is the cause of the change in the labia majora, skin from the inner surfaces of the labia can be removed in discreet locations to reduce protrusion and create a neater appearance.

Recovery periods for these techniques vary according to the patient and the extent of the procedure. Dr Barnouti will explain what’s involved in the recovery process in great detail during the consultation. Post-operative care instructions, including bed rest and hygiene, should be followed to ensure the best results and a safe recovery. Sexual activity can be resumed six weeks after the procedure.

Surgery is usually performed under sedation with local anaesthesia. It can be done alone or in conjunction with another procedure. You can resume sexual relations in about two weeks.

Clitoral Hood Reduction

A stretched or enlarged clitoris and clitoral hood can potentially cause discomfort, skin irritation, and infection and can interfere with sexual stimulation.

Reduction in the sides of the clitoral hood can be part of a labiaplasty procedure but can also be performed on its own. For some women, the degree of protrusion of the clitoris can feel and appear like a very small penis, which can cause deep insecurity and sexual anxiety. For these women, a clitoral hood reduction can provide dramatic psychological relief.

Every concern and procedural approach is unique and different according to the patient. Dr Barnouti will explain the surgical techniques and recovery process during the consultation in great detail. Post-operative care instructions, including bed rest and hygiene, ensure the best results and a safe recovery. Sexual activity can be resumed six weeks after the procedure.

Vaginoplasty

After childbirth, menopause and aging women experience stretched pelvic floor muscles, stretched pelvic ligaments and skin that can change the shape and function of the vagina significantly, both internally and externally. A comprehensive approach and assessment are crucial as some women also experience uterine prolapse, urinary incontinence, lack of friction during sex, and deterioration of sexual life, just to mention a few.

A vaginoplasty is a day procedure that involves tightening the sling muscles in the vagina by lifting the muscles, removing the excess vaginal lining and then reattaching these muscles.

Objectives of surgery:

• It fully restores the vagina to its original state.
• It restores the perineal body and perineum, the area between the vagina and anus,
• Repair a poorly performed episiotomy
• Involve repair and plication of Levator Ani, Pubo Vaginalis and Pubo-rectalis.
• Fashioning the Fourchette
• Tightening the introitus, the vaginal opening.

This surgery can be combined with other vaginal rejuvenation surgery, such as Labiaplasty.
Vaginal rejuvenation surgery can also be performed by Laser, an Erbium Yag Laser, known as Intimilase and Incontilase Laser. The studies about this is encouraging, however at this stage Surgery will produce a better outcome.

Post-operative care instructions, including light duties and hygiene, should be followed to ensure the best results and a safe recovery. Dr Barnouti will provide you with a post-operative information sheet and explain exactly what’s required in great detail during the consultation.

Vaginal tightening (Perineoplasty, Perineorapy, Designer Vagina, Vagina rejuvenation, Pelvic floor repair, Pelvic floor muscle reconstruction) can be performed under general anaesthesia or twilight sedation & local anaesthesia.

Pain after surgery is well tolerated with simple analgesia. It is not considered to be painful surgery.

Labia Repair and Reconstruction

This procedure is designed to enlarge and build up a small Labia or to repair poor labioplasty results where too much Labia has been removed by inexperienced doctors. Different techniques can achieve this. Dr Barnouti can explain that to you during a private consultation.

Pubic liposuction and Pubic Lift

Liposuction as we know it is commonly associated with areas such as the abdomen, flanks and buttocks, it is also used to remove pockets of fat that cause a large bulge in the pubic region called the mons pubis – the layer of fat lying above the pubic bone. Women can accumulate more fat than usual in their pubic mound with age, after childbirth or due to obesity

Pubic liposuction can be performed alone, depending on the concerns and anatomy of the patient. Sometimes, it is combined with a Pubic lift and abdominoplasty (tummy tuck) procedure, but modern liposuction techniques are minimally invasive, requiring only a small incision to insert the cannula and remove unwanted fat from the area.

There is minimal recovery associated with the procedure, with swelling and bruising subsiding after 2 – 3 weeks. Excess tumescent fluid may seep through the tiny incision for a week or so after the procedure, and a compression garment is usually worn. Patients may feel tender and tight in the area for 1 – 2 weeks post-procedure. You are encouraged to go back to light duties and work within 48 hours of performing the liposuction on the Mons Pubis. Dr Barnouti will explain the recovery process and outline the post-procedural care instructions required for a swift and smooth healing process.

External Genital deformity

For some women, external vaginal deformities resulting from surgical removal of cancer, trauma, birth defects, female “circumcision”, intersex, or other causes are not uncommon. They cause huge psychological and physical distress. Reconstruction with major improvement is possible for many of these deformities.

Various techniques are used depending on the type and extent of reconstruction required. Dr Barnouti is your medical expert in vaginal rejuvenation and reconstruction can help you to restore the area and have a new start.

You may book your consultation appointment with Dr Barnouti to discuss these procedures / treatments in a detailed and confidential approach.