Vaginoplasty Surgery Blog | Rejuvenic LA

What is Menorrhagia?

About one in four women suffer from menorrhagia, or excessive menstrual bleeding. The condition can be very frustrating and lead to embarrassing situations. As a result, menorrhagia can affect a woman’s lifestyle, causing her to avoid being out in public during menstruation, which affects both her work and personal life. The condition can cause anxiety, lack of confidence, and undue stress.

Menorrhagia also results in physical symptoms, such as severe cramping, over-fatigue and anemia from the amount of blood loss. Menstrual flow is considered heavy when a woman has to change sanitary pads or tampons almost every hour. In some cases, the heavy flow can go on for as much as four or five days.

In many cases, menorrhagia is caused by hormonal imbalance between estrogen and progesterone. This imbalance causes the endometrium to accumulate and sheds heavily during menstruation.

Some benign fibroid growths and polyps in the uterus, usually appearing during childbearing years, may also cause prolonged menstrual bleeding. These polyps are often caused by high hormonal levels. In rare cases, ovarian, cervical, or uterine cancer can cause menorrhagia.

A condition called adenomyosis, where the endometrium’s glands become embedded in the uterine muscle, can also cause heavy and painful periods. This condition most often develops in middle-aged women who have had children.

Intrauterine devices or IUDs are also one of the known causes of excessive bleeding. In such cases, removing the IUD and switching to another method of birth control would solve the problem.

Other diseases such as endometriosis, pelvic inflammatory disease, kidney, thyroid, and liver have also been associated with menorrhagia. Finally, some medications such as anticoagulants and anti-inflammatory drugs can also contribute to heavy menstrual bleeding.

In diagnosing menorrhagia, our physicians typically ask patients for their observations on the length and severity of their periods. We will also perform a blood test to check for anemia and a pap test to check for infection and health of the cervix. Additionally, we may perform ultrasound imaging of the uterus and pelvis or an endometrial biopsy to look for any abnormalities.

Menorrhagia Treatment 
Treatment of menorrhagia depends on the root cause of the condition. If the cause is due to hormonal imbalance, drug therapy is often successful in treating menorrhagia. The patient is prescribed iron supplements, non-steroidal anti-inflammatory drugs, such as naproxen, and oral contraceptives to promote balanced estrogen and progesterone levels. One possible contraceptive method that can be prescribed is a hormonal IUD, which releases levonorgestrel, a progestin to help thin the uterine lining and decrease menstrual flow and cramps.

Where drug therapy is unsuccessful or leads to unacceptable side effects, more invasive methods may be required. Dilation and curettage (D&C) is one surgical method of treating menorrhagia. In this procedure, the cervix is dilated, and the uterine lining is thinned by physically scraping or suction of the tissue.

Endometrial ablation procedure is another minimally invasive method that removes the endometrium, ending your periods altogether. This method applies extreme heat to eliminate the uterine lining. The use of heat is accomplished by application of a heated ball or wire loop inserted through the cervix after dilation. Other methods of endometrial ablation procedure use probes that emit microwave or radio frequency energy to heat the endometrial tissue.

Other methods of endometrial ablation utilize either free-flowing heated saline water or a balloon filled with heated fluid to treat virtually the entire endometrium. During the above procedures the woman will be given either partial or general anesthesia.

Endometrial ablation procedure is performed on an outpatient basis and often takes only 15 minutes. It is effective in up to 90% of patients, and patients avoid side effects that result from hormone therapy.
In recovering from an endometrial ablation procedure, women may experience some cramping, which should go away within a few hours. Pain medication is prescribed to deal with cramping or other discomfort. Pink or yellowish discharge may be expelled for a few weeks after treatment. Pelvic pain and fever beyond the first 24 hours are rare and may indicate an infection requiring further medical treatment.

Most women can resume normal activity as early as the next day. The patient is advised not to use tampons and to suspend any sexual activity for up to a week to reduce chances of infection.

In extreme cases of menorrhagia, where both drug and less invasive surgical methods have failed, hysterectomy may be required, which removes the entire uterus and cervix. This is performed under general anesthesia and requires a hospital stay for the patient.

Risks and Complications
Drug therapy is only effective in treating about half of menorrhagia cases. However, it can lead to side effects, such as headaches, nausea, and weight gain. It may also affect cardiovascular health and is contraindicated in those with diabetes or history of heart disease. In addition, menstrual periods may be altered with oral contraceptives.

Endometrial ablation procedures are extremely successful in treating the condition but are only an option once a woman is done with child bearing. Women who may want to have children in the future should avoid this procedure.

Hysterectomy results in permanent infertility because the entire womb and other reproductive parts are removed. The procedure also results in premature menopause for women. This should be considered only if other methods have failed to treat menorrhagia.

Posted in Minimally Invasive Procedures |

What is a Labiaplasty?

What is Labiaplasty?
A labiaplasty (also called labia reduction) is a procedure in which the labia minora, (the inner fold of skin around the vagina and clitoris), and/or the labia majora, (the outer rounded folds), is reduced in size or made more symmetrical. This is not to be confused with a vaginoplasty or vaginal rejuvenation, which is a procedure in which the vagina is tightened or rejuvenated.

Reasons for Obtaining a Labiaplasty
There are many reasons for obtaining a labiaplasty. Some women with large labia’s may experience pain or chafing during sexual relations or when they play sports or are physically active. Large labia’s may be noticeable when women wear form-fitting clothing or even hang out from panties or a bathing suit. In addition, some women have a labiaplasty simply because they wish to improve the appearance of their labia.

Who is a Good Candidate?
Any woman who would like to have their labia reshaped or reduced in size may be a good candidate for labia surgery. Because each situation is different, you should schedule a no cost consultation with us to discuss your options. Our physicians are skilled in performing labiaplasty surgery and we will be happy to meet with you to discuss your needs.

The Consultation
During the consultation, you can discuss your expectations with our physicians who will determine the best way to achieve the results you desire. Our clinic has labiaplasty before and after photos as well as other materials that can explain the procedure and what you can expect during and after the procedure.

The cost of this surgical procedure can vary by region or by the physician. Ask the physician about the cost during the consultation. However, the main consideration should be your physician’s skill and experience with labiaplasty.

The Procedure
A labiaplasty is a short, outpatient surgery that lasts 60 to 90 minutes. Our physicians will use local anesthesia so you will be awake during the procedure, but you will not experience pain or discomfort. Some physicians use lasers and others use cutting tools to reduce the size of the labia. We perform labiaplasty’s using the Ellman Surgitron as our preferred method ensuring the most precise incisions to get the most desired natural cosmetic appearance.  This method is much less destructive to cutting tools, and traditional lasers.

Patients can return home after the procedure is finished. Your surgeon will recheck the incisions the following week to make sure that you are healing well. You will also come in for a one-month post op visit.

You may experience some minor to moderate discomfort for one to two weeks after the procedure, but you may be able to return to work after a period of a day or so. During recovery, you will be instructed not to use tampons or to wear thong underwear or tight clothing that may chafe against the incisions. Additionally, you will be instructed to avoid strenuous activities or intercourse for a period of six to eight weeks.

Labia surgery are minor cosmetic procedures. Scarring is very rare and the labia typically heal without physical signs of the surgery. You may be permitted to return to normal activities and intercourse after six weeks, but full healing may take up to three months. Your doctor will explain the recovery process during the consultation, as well as give you detailed instructions about the recovery process.

Like any surgical procedure, there are risks associated with a labiaplasty. Scarring or an asymmetrical labia as a result of labia surgery is extremely rare, but these results are possible in some cases. As part of your follow up,  will do any touch ups if needed at no cost. In addition, infections are possible. Bleeding may occur after the surgery. If you experience any of these side effects, call our office and ask the nurse or physician how to proceed. Depending on the nature of the problem we will advise you every step if the way.

Some people have claimed that a labiaplasty can interfere with childbirth later on due to an accumulation of scar tissue. However, this is not true. Labiaplasty surgery does not interfere with the vagina or any other area directly associated with childbirth. Many women go on to have normal pregnancies and births after having a labiaplasty.

Deciding Whether to Have a labia reduction surgery
Labia reduction is typically painless and simple and can offer real benefits for a woman who is uncomfortable with the size of her labia. It is important to find a Dr with whom you are comfortable before you commit to labia surgery. Schedule a consultation with our office and ask our surgeons all the detailed questions you may have.

Our physicians and office staff will be happy to answer any questions and work with you to get your desired results. We know how important it is for you to look good and feel comfortable with your body. Let us help you feel good about your body.

For more information or to schedule a consultation with a surgeon, please contact us.

Posted in Cosmetic Gynecology |

A Solution to Painful Intercourse

Laser Augmentation of the Vaginal Area is a new and revolutionary treatment for dyspareunia, due to narrowing or decreased elasticity of the vagina which causes painful intercourse. This procedure is gaining momentum as an improved option for some women due to it being less invasive, non-hormonal and highly effective.

Women of various ages may experience pain during sex. In some cases, this may be caused by the vaginal opening being too small to accommodate their partner, whether this is naturally occurring, or the result of a prior surgery or trauma. In other cases, a woman may have enjoyed pain-free sex until perimenopause or menopause, but changes in hormones may have caused narrowing or decreased elasticity of the vaginal opening. Not only is this painful, but can cause irritation and tearing to the vagina, which creates scar tissue and further narrows the area. In any case, sex should be an enjoyable experience for both people involved and vaginal loosening can provide that for many women.

Women that are candidates for vaginal loosening are those experiencing painful intercourse due to a narrowed vagina, decreased vaginal elasticity or narrowing of the vagina as a result of scar tissue formation. More specifically, these women feel pain on insertion during intercourse. For these women, conventional treatments such as vaginal dilators or hormone-based creams must have failed or cannot be used safely. The traditional use of estrogen replacement to increase the elasticity of the vagina can be too risky for some women due to the increased risk of some types of cancer. Furthermore, women that have risk factors for blood clots, heart disease or suffer with migraines are at high risk for having a fatal medical condition when using estrogen therapies. Vaginal loosening offers a minimally invasive, permanent solution unlike dilators and without the potential side effects of estrogen therapy.

Vaginal loosening can be performed in an outpatient medical setting. The procedure involves the use of a laser to modify the vaginal opening. A laser is used to specifically target certain regions of the vaginal opening. The nerves and muscles in the vagina and at the opening are not impacted, so there is no interference with sensation. A woman’s vaginal opening is sculpted based on her unique situation and to accommodate the size of her partner. The treated areas are closed with fine sutures that dissolve on their own during the recovery period.

Since using a laser is less invasive than other surgical techniques, patients have more options in their use of anesthesia. For those patients that desire complete sedation during the procedure, general anesthesia can be provided.  Lastly, for those patients that want to spend less time recovering from anesthesia, they can receive a local anesthetic. There are numerous methods for patients to achieve a pain-free procedure that is adjusted for their desired level of comfort. Most women chose to be sedated with any method of anesthesia.

Vaginal loosening can be completed in less than one hour and patients are discharged shortly after. The entire recovery period lasts six to eight weeks, but normal activities can be resumed in 48 hours. During the recovery period, patients must abstain from sex and cannot insert anything into the vagina. This includes the use of tampons or other personal devices. The only object that can be inserted into the vagina is an applicator used to insert a medicated cream, once daily. Patients should also wear loose-fitting undergarments and clothing until the area as completely healed. Heavy lifting should be avoided, in addition to any strenuous activity that can cause strain on the pelvic area or rupture of sutures.

After healing is complete, the patient will need to engage in regular sexual activity or use dilators to maintain the integrity of the vaginal enlargement. Some women may experience pain or discomfort during intercourse after the healing process is complete, but this is temporary. The main objective from the procedure is to have no pain during intercourse, and this is typically accomplished within months after the procedure.

As with any other procedure there can be risks or complications. Risks attributed to the laser surgery are bleeding, infection and scarring. However, these risks are minimal. Some amount of soreness is expected after the procedure, but should resolve during the recovery period. There are also separate risks associated with the various sedatives and anesthetics that can be used. Patients electing to have the procedure should follow all aftercare instructions to reduce the likelihood of complications after surgery.

Vaginal loosening can be an effective dyspareunia treatment for many women that have not had success with other treatments or are not candidates. Although this is a new procedure, it has been highly successful in helping women regain pain-free intercourse.

Posted in Minimally Invasive Procedures |

What is a vaginoplasty?

Overview of Vaginoplasty
A vaginoplasty is a surgical procedure that corrects the enlarged vagina and weakened pelvic floor. This procedure will restore the look and feel of your vagina to its pre-childbirth size and appearance, or make it the small size that you feel you should have had to begin with. Our physicians can surgically correct the large vagina, allowing you to enjoy intercourse more. In addition, a vaginoplasty can improve the look of your vaginal area, which will allow you to feel more confident in intimate situations. Essentially, a vaginoplasty is both a cosmetic procedure because it improves the look of the vaginal area, and a medical surgical procedure, because it changes the structure of the vagina and reinforces the pelvic floor muscles.

What a Vaginoplasty is Not
A vaginoplasty does not correct an enlarged or irregularly-shaped labia minora or majora. It will merely tighten the vagina and the area around it. However, you can have a labiaplasty, or a procedure that reduces or reshapes the labia, at the same time as your vaginoplasty. Having the two procedures performed at the same time will reduce the total amount of recovery time and may reduce the expense of having each procedure performed separately. Ask your physician what procedures are available to you that may help improve the look or feel of your intimate areas.

Who is a Good Candidate
There are many reasons why a woman might feel that her vagina is too large. For example, vaginal labor can weaken the pelvic floor as well as stretch the vaginal muscles. The vaginal muscles also begin to stretch as you age. Alternatively, some women have a sexual partner who has a smaller penis. When the diameter of the vagina is too large for any of these reasons, the amount of friction that you and your partner experience during intercourse can be greatly reduced.

Most women who have experienced stretching of the vaginal muscles or a weakened pelvic floor because of childbirth are good candidates for a vaginoplasty, as are women who feel that the diameter of their vagina is too large. As long as you are in good health and are generally in good physical condition, you can probably have the vaginoplasty procedure performed. Call our office for a consultation if you are interested in having a vaginoplasty. Our skilled physicians can determine whether you are a good candidate for a vaginoplasty, as well as discuss the results you wish to achieve and answer any questions you may have about the procedure.

The Procedure
During the vaginoplasty procedure, the surgeon will remove the excess vaginal mucosa, or vaginal lining. This will reduce the diameter of the vagina. There are several methods for doing this, but the traditional vaginoplasty procedure involves making an incision inside of the vagina and removing the excess lining. The incision can be made with a knife or a laser. After the excess vaginal tissue is removed, the surgeon will re-approximate the incision incorporating muscle & vaginal tissue resulting in a stronger and tighter vagina. Our physician will be happy to explain how he or she performs the vaginoplasty, as well as show you before and after photographs that illustrate the effects of the procedure so you know what to expect.

A vaginoplasty is a minimally invasive procedure, and you should be able to walk without pain within a few days. You will probably be able to return to work within a few days, depending on how quickly and well you heal after the procedure as well as the amount of physical activity your job requires. During the consultation, your physician can estimate the amount of time you will need to take off work. You can return to having sexual intercourse within four to six weeks, with the physician’s approval. The incision will heal with minimal scarring, and it will not be immediately obvious that you have had any surgical procedure done.

The risks of the vaginoplasty procedure are few. These risks include scarring, bleeding, infection, nerve damage, and painful intercourse. Your physician will explain the risks in detail during the consultation and help you determine if a vaginoplasty is right for your needs.

The cost of a vaginoplasty will vary according to the method the physician uses, as well as the amount of work the physician must perform to tighten the vaginal area. This cost may be covered by your insurance under certain circumstances. For example, if the weakened pelvic floor muscles or vaginal muscles are causing other physiological problems, such as contributing to incontinence, your insurance may cover the procedure. Our office can contact your insurance provider on your behalf and determine how much, if any, of the cost your insurance provider will cover. Ask our office about financing options and the accepted methods of payment.

Effects of a Vaginoplasty
A vaginoplasty can significantly improve the look of your vaginal area, which will help you regain your confidence during intercourse. You can’t fully enjoy intimate moments if you are worried about your partner’s perception of your vagina. In addition, you and your partner may enjoy more frequent and intense orgasms because of your tighter vagina.

Posted in Cosmetic Gynecology |