๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Introduction
CHAPTER 81 Approaches to Female
Genital Rejuvenation
Christine A. Hamori
SUMMARY
The popularity of vaginal rejuvenation has increased dramatically over the past
decade.
Several trends are responsible for this surge in interest, including the Internet
and significant changes in grooming habits, as well as improvement in surgical techniques.
There is a bimodal age distribution of women seeking vaginal rejuvenation with
peaks in both the fourth and sixth decades.
Beginner Tips
A thorough and comprehensive understanding of vulvar anatomy is a prerequisite for
considering female genital rejuvenation.
A full perineal evaluation should be performed when labia minora reduction is
requested.
Baseline photography, both standing and in lithotomy, is very helpful.
Noninvasive treatments, such as ablative and nonablative fractional laser treatments,
are increasing in popularity.
Expert Tips
Labiaplasty may be combined with fat grafting and laser resurfacing to provide an
optimal outcome in the appropriate patient.
Treatment of the labia majora should be done with caution, as scars tend to be
significantly more visible than those associated with labia minora reduction.
Thin labia minora are less amenable to wedge resection.
Patients with large clitoral hoods are better treated with an extended wedge technique,
rather than an edge trim.
Donโt Forget!
Atrophic labia majora may contribute significantly to the appearance of labia minora
redundancy.
While still controversial, the net effect of labiaplasty in the absence of complications
is an improvement in sensation.
Pitfalls and Cautions
A common complication of inadequate closure of the wedge defect is a window, or
mid incisional partial dehiscence.
Repair of the defect is difficult, as the temptation exists to re-excise the wedge, which
frequently results in a secondary dehiscence.
Patient Education Points
Controlling patient expectations is critical.
Review the patientโs anatomy with a mirror in the standing and lithotomy positions to
make sure that their expectations are realistic.
Recovery is often extensive, and patients should understand that they will need a
lengthy period of pelvic rest.
CHAPTER 81 Approaches to Female