Clinic of Aesthetic Medicine of Medical Doctor Edward Yurshevich
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Plastic surgery Intimate surgery

Intimate surgery

Intimate surgery

Modern researches prove that in intimate sphere women don’t have fewer problems than men. For example by some estimation about 45 % of women suffer from orgasmic dysfunction, by another — 67 %. 33 % of women-respondents today complain of “sleeping libido”. Doctors name such a condition “sexual dysfunction” and men call it “frigidity”, which is often groundless. There are very few frigid women; much more women are not sexually woken. Not less than 15—20 % of women have various sexual disorders, such as painful coition, vaginism, pathological hyper sexuality ... There are a lot of “corporal” diseases which are based on a psycho-emotional stress. In some situations, sexologist and psychotherapist can help, in others — gynecologist and endocrinologist. But there are problems, which can be solved only by intimate surgery. Operations are divided into two groups — improvement of genital appearance and salvation of functional problems. At some stage of her life a woman may think it necessity to change her opinion of herself. We decided to give you information, which you can use in your search of the way to solve your intimate problems and to improve your sexual appeal.

During all her life, woman “struggles” with her body. Actually she becomes a woman not at the moment of defloration but when she starts to understand the power of her external appeal and sexuality. You should not forget that the female sexuality is subtle and it is based on emotions and sensations. Meaningly improving herself, a woman aspires to give her body those forms which by her understanding are ideal. And positive changes occur only when she sincerely starts to love her body and ceases to be ashamed of it. Improvement of appeal of external genitals not only raises the level of her psycho-emotional self-estimation, but also improves the quality of her sexual life.

What is your problem?
  • Appearance of my genitals — too large small lips.
  • Large lips of pudendum are flabby and too large.
  • Age deformation of the large lips of pudendum.
  • Deformation of the pudendum lips after deliveries.
  • You are not satisfied with the look of the small lips of pudendum.
  • The small lips of pudendum are big and asymmetrical.

When should you have an operation?
It depends on your self-perception and self-appraisal. It is important to understand the main thing — any woman experiencing discomfort in connection with the imperfection of her genitals can solve her problems by means of plastic surgery. Plastics of the lips of pudendum are correction of their sizes, forms, and asymmetry. Women always experience very much complex because of the “perverted” aesthetics of their genitals. Moreover, the congenital or acquired defects create a number of functional inconveniences. And there are situations when a plastic operation in the intimate zone becomes the only opportunity to dispose of problems and to normalize sexual life. Sometimes, women aspire to enlarge their sexual lips to give themselves and their sexual partners, not only visual, but physical pleasure as well- chubby lips of pudendum make the vagina opening narrower. Genital surgery becomes more and more demanded not because the number of cases with deformations of the lips of pudendum increases but because women wish to look irreproachably “from top to toe”. Have you come to conclusion that this area of your body is far from being perfect? Each problem always has its salvation. The only thing you should do is to make an appointment with a surgeon and tell him about your problems and wishes. N. B. It is better to have an operation right after the menstruation or one week prior to it.

Operation
Depending of volume of surgical operation.

Plastic of the large lips of pudendum
If you have a surplus of hypodermic fatty deposits (too outstanding lips of pudendum) the surgeon applies a method of surgical resection (removal of excessive skin tissue), or a method of liposuction. A choice of technology depends on the surgeon’s preferences, indications and a task in view. For completion of insufficient volume of the large lips of pudendum the method of skin plastics is used (transplantation of your own skin-fatty tissue). Sometimes plastics of the small lips of pudendum are combined with the plastics of the large lips of pudendum — a complex operation.

Plastic of the small lips of pudendum
The essence of the operation: the surgeon deletes the surplus of the skin tissue so that the small lips of pudendum don’t project above the large ones and “are hidden” deeper then latent self-absorbing stitches are put in. The cicatrix in section place goes deep down (traces of surgical intervention are not visible) and it will not disturb at a sexual intercourse. Аfter operation not formed scarring. Sometimes plastics of small lips of pudendum are combined with plastics of large lips of pudendum — a complex operation.

Anesthesia
Depending on peculiarities of your health, volume of operative intervention.

Contraindications
Serious chronic diseases of internal organs, infectious, cardiovascular, oncological and inflammatory diseases of genitals, problems with blood coagulability, decompensated diabetes, venereal diseases, uncontrollable high arterial pressure, complete loss of skin elasticity, propensity to excessive scarring (keloid cicatrices), inflammatory diseases of the skin, mental disorder).

Postoperative period
During the first several days should be observed sparing regimen. Painful sensations/ soreness is not expressed. Tissue reactions after surgery is completely goes away during 3.5 weeks (individual parameter). It is necessary to strictly observe the doctor's recommendations. The most important point: sexual rest before the wound's complete healing - 3-5weeks (depending of volume of surgical operation. The sutures resolve on their own in 2-3 weeks. Within 2-3 weeks it is necessary to abstain from physical activities, sauna and hot baths. During the first week hygienic care of the operation area must be observed as recommended by the surgeon. In some cases antibacterial preparations to prevent inflammation are prescribed. The final result can be estimated in 2 months after an operation - lips of pudendum assume a normal/natural form.

In our clinic
We perform laser rejuvenation of the intimate zone. Owing to the application of innovative laser technologies and the laser equipment of the new generation from the company Asclepion Laser Technologies GmbH, we can offer our patients laser rejuvenation of the large lips of pudendum. Laser rejuvenation of the intimate zone is performed by means of the multipurpose erbium laser MCL 30 Dermablate and the Micro Spot technology, which works on the principle of fractional photothermolysis. The technology enables to exert dosing and careful influence upon the micro sites of the “aged” toneless skin of the lips of pudendum. Stimulation of an antiage process in its cells occurs and young skin tissue is formed. The unique laser procedure is safe, it suits patients with any type of skin, it does not require long rehabilitation and it has no by-effects. Result: significant improvement of structure, color, tone and turgor of skin; normalization of blood supply and reinforcement of the exchange processes in the deep layers of skin, restoration of elasticity, smoothing of rugosity, disappearance of cosmetic defects, that is-full rejuvenation.

Complications and risks
They are minimal.

Before the occurrence of the theory of psycho-sexual development of an individual by Sigmund Freud this feeling had been called voluptuousness. A woman did not even dare think of asking the doctor to help her to raise the level of sensuality. Thanks to the father of psychoanalysis for our having a new reality and an opportunity to safely estimate our sexuality and not to be ashamed of the desire to receive a maximum pleasure from this tremendous part of the human life. The term “libido”, by the way, is Freud’s “invention” too, it designates a sexual desire. To make the intimate life “painted” by bright colors of emotions, the libido should be top-level. But what is to be done, if the libido gradually comes to a naught because of the problems in the intimate zone — diseases and aesthetic defects. “Secrets” of the body hold down women’s sexuality. Plastic aesthetic and reconstructive intimate surgery can render a real help in such cases.

What is your problem?
  • You had episiotomy (a section of the perineum at deliveries) twice in the same place. For the first time the tissues were not put together correctly. Next time they were stitched better, but there formed a cavity in which secretions accumulate.
  • After the deliveries the perineum was greatly stretched.
  • Discomfort because of air accumulation in the vagina.
  • Impairment of flora in the vagina because of the perineum deformation.
  • Impairment of coitus.
  • After the deliveries the perineum and the vagina are too wide.
  • There were breaks during deliveries, 4 external and 4 internal stitches were put. Ever since I feel discomfort when sitting long, doing some physical activities and I feel pain during a sexual intercourse. A plastic operation on the perineum is necessary.

When should you have an operation?
If by means of Perineoplasty the surgeon-gynecologist improved only the appearance of genitals, we, would certainly say: “It depends on your self-perception and desire to change something in you”. Perineoplasty is a functional-aesthetic operation. It is plastics of the entrance to vagina, its surrounding parts and the perineum. It is performed to women with an acquired deformation of the external genitals. The main causes of deformation are often deliveries with an extensive birth injury or badly accrete sections of the perineum. Perineoplasty is also performed to women of 50—55 years with a lowered elasticity of the conjunctive tissue of the vagina and the perineum (the entrance to the vagina is gaping). What is the cause of it? Influence of the age, hormonal changes/imbalance and congenital peculiarities of the vulva structure. Complaints of such patients: dissatisfaction at a sexual intercourse, frequent inflammations of the vagina, urethra, unpleasant sensations when walking, etc. The main objective of Perineoplasty is elimination of defects and harmonization of a patient’s sexual activity.

Operation
Duration of an operation depends on the volume of surgical manipulations. The idea is to correct the vagina's form, i.e. to restore the anatomic structures of the vagina together with the perineum (the muscles and the fascias), suturing of the pelvic floor muscles (Levatorplasty), excision of an old and deforming scars.Posterior colporrhaphy is indicated to women whose perineums were deformed at deliveries (a wide input to the vagina) or their vagina walls are lowered.

Anesthesia
It depends on peculiarities of the patient's state of health and the volume of the operative intervention. The choice of anesthesia is determined by the anesthesiologist.

In our clinic
If necessary during an operation it is possible to remove various new growths in the genitals area (condylomas of vulva, vagina, perineum and perianal areas, as well as papillomas of vulva, vagina and genital nevuses). Method of their removal depends on the etiology, the size and the location of the new growths (it may be surgical or laser). Removal of new growths can also be performed out-patiently. Diagnostics of suspicious new growths is always performed by a dermatologist/oncodermatologist. The removed tissues are always sent for histologic research.

Contraindications
Serious chronic diseases of internal organs, infectious, cardiovascular, oncological and inflammatory diseases of genitals, problems with blood coagulability, decompensated diabetes, venereal diseases, uncontrollable high arterial pressure, complete loss of skin elasticity, propensity to excessive scarring (keloid cicatrices), inflammatory diseases of skin, mental disorders.

Postoperative period
As a rule, a patient is in hospital 1 or 3 days. It is necessary to strictly observe all the surgeon's recommendations, plus careful hygiene of external genitals is obligatory. Painful sensations are not expressed but can keep for a few days. Monitoring of the patient's condition/out-patient control - are carried out according to the surgeon's prescriptions. On the first days it is recommended to eat only liquid and semi liquid food (to avoid a delay of defecation). Physical activities and sexual life are excluded within 1 month after an operation.

Complications and risks
To exclude/minimize complications the performance of operation must be entrusted to a skilled surgeon-gynecologist and all his recommendations must be strictly observed in the postoperative period.

The reason of 75% of divorces in the European countries officially sounds as “irreconcilable contradictions”. Sexologists confirm: these disagreements begin in the bedroom — they have a sexual underlying reason-dissatisfaction with the quality of the intimate life. Experts say that orgasm and its great value in married couples's life which is much spoken and written of today, in the majority is not physiological but psychological, it is fed by emotions and experiences. And they are material. One of the reasons of the woman’s “frigidity” is vaginal muscles. They can be weak, underdeveloped, deformed by deliveries, injured... Fortunately the arsenal of the plastic surgeons contains methods, which can help to eliminate vaginal problems, to restore a harmony of sexual relations and to renovate sensations.

What is your problem?
  • After deliveries the size of the vagina has not come to the former size. There are problems in the intimate life.
  • During the delivery there were significant breaks of the vaginal walls and muscles. After suturing, the rough conjunctive tissue (a scar) was formed.
  • After a delivery the muscles of the vagina atrophied a little.
  • Postnatal anorgasmia (a lack of orgasm).
  • After a deliveries the width of the vagina increased (the pudendal fissure is gaping) — the look is not aesthetic.
  • Delivery consequence — the expanded vaginal ring. I am dissatisfied with my sexual life.

When should you have an operation?
The purpose of Vaginoplasty is to reduce the size, to narrow or to expand the muscles of the vagina. Operation is performed at reduction of the tone of perineum muscles and the pelvic floor. If there is a damage of muscles during the delivery (especially repeated), as a consequence there can be a stretch of the perineum soft tissues, lowering of the vaginal walls (front, back or both), enlargement of its volume or formation of deforming scars in the place of the perineum break. If the internal volume of the vagina is increased, a woman cannot enjoy sex in full measure and receive sensual pleasure. There is also a medical aspect of this problem. Colpoptosis can be accompanied by descent of the bladder and rectum. Such a problem is solved only surgical by. The necessity of an operative treatment and the volume of operation are solved individually after a gynecological examination. An operation is carried out on medical indications and is a unique opportunity to cope with the expressed physical and psychological discomfort. Do you personally need Vaginoplasty? The only person who can answer this question at present is you. All depends on feelings and the problems which force you to read this section.

Operation
Duration of the operation depends on the volume and complexity of the surgical intervention.

Notice
  • The vagina is very elastic and can adapt to the penis of any size. There is a concept: "a vaginal accommodation" (if woman has a regular partner, her vagina adapts to the size of the penis of this man).
  • Besides difficulties in an intimate life, appearance of serious health problems is possible - the increased vagina promotes the descent of vagina walls.

Anesthesia
It depends on peculiarities of the patient's state of health and the volume of the operative intervention. The choice of anesthesia is determined by the anesthesiologist.

Postoperative period
1-3 days in hospital. For 2 or 3 weeks you should sit in a special posture, offered by the surgeon. To prevent complications (inflammation) the surgeon can prescribe antibiotics to you. On the first days it is necessary to keep a diet (liquid or semi liquid food) to not complicate the process of defecation. You mustn't lift weights or go in for sports. It is necessary to avoid overheating (sauna, sun deck, hot bath). The sutures are not removed - a self-resolving suture material is used. Renewal of sexual activity is possible in 4-5 weeks after an operation.

The anomaly we are talking about is rather rare — 1 case for 5 thousand women. But the bitterness is that someone in fact gets in such a situation. Those who are suffering this fate think that nature has outraged upon them for nothing. But what is to be done? Nature has disposed in such a way that some women have underdeveloped vaginas and uteruses and some women don’t have them at all. In medicine such pathology is called “the MRKH syndrome”. With this “syndrome” it is possible to live, but the natural pathology takes from the women not only the pleasure of normal sex... but it deprives her opportunity to fulfill the main mission of the woman — to give birth to a child and to become mother. To restore what was lost or is not available at all is the task of the intimate plastic surgery.

What is your problem?
  • Absence of menstruations.
  • I can not become pregnant — barrenness.
  • It is impossible to perform a sexual intercourse normally.
  • Periodically there is pain in the abdomen.
  • Frequent inflammatory diseases of the urinogenital tract.
  • Pains in the backbone and joints.
Notice
  • The syndrome of Mayer-Rokitansky-Kuster-Hauser is a heavy congenital developmental anomaly of urinogenital system. This is impairment of formation of internal female genitals. There are various forms of this syndrome. All forms are incorporated by the common pathogenesis.
  • Women with this illness have normally generated mammary glands and a typical female set of chromosomes — 46 XX.
  • Often the diagnosis is made on the basis of the main complaint — absence of menstruations.
  • To receive a full spectrum of diagnostic researches and to define the tactics of treatment of the “MRKH syndrome”, it is necessary to consult an endocrinologist, a geneticist, an orthopedist and a psychiatrist.

When should you have an operation?
It depends first of all on suspicions/confidences that you have such pathology of internal genitals. A woman suspects something wrong, when she reached her sexual maturity and her natural menstrual cycle is absent and she cannot get pregnant. Ovaries develop normally and maintain a sufficient hormonal background, so externally the problem is not visible at all. For the first time the woman learns about the diagnosis when being examined by a gynecologist and complex inspection confirms it later. The woman is unable to be engaged in sex with a man as all her attempts are accompanied by a sharp pain. If you suspect, that something similar is happening to you it is necessary to make an appointment with a gynecologist and if the diagnosis proves to be true, try to find a skilled surgeon. This illness is treated only by means of surgery.

Contraindications
Serious chronic diseases of internal organs, infectious, cardiovascular, oncological and inflammatory diseases of genitals, problems with blood coagulability, diabetes, uncontrollable high arterial pressure, complete loss of skin elasticity, propensity to excessive scarring (keloid cicatrices), inflammatory diseases of skin, venereal diseases and mental disorders.

Operation
The choice of method depends on the patient’s anamnesis. During an operation a new vagina is formed. To make a new vagina the surgeon uses the patient’s self-tissue. Unfortunately, he cannot give the woman a genital function but he will help to overcome the period of bitter disappointment. Henceforth she can receive only positive impulses from her intimate life.

Anesthesia
General combined.

Postoperative period
3—5-7 days in hospital (on indications). Physical activity for this time is as much as possible limited. Two days — a confinement to bed. During your stay in hospital your state of health is constantly monitored and a full spectrum of medical postoperative measures is carried out. Subsequently it is necessary to come for control examinations (during one year) — periodicity of your visits to the clinic is determined by the surgeon. To keep the newly created vagina deep and functional the patient should do special exercises (bougienage) and strictly observe the surgeon’s recommendations. The first sexual contact is possible in 2—3 months after an operation.

The majority of our emotional needs are reduced to an only significant formula in life: a need for love. The top of relations between man and woman is a sexual intercourse. The temptation “answers” for desire and sexual dialogue. Women are capable of much to keep the ideas for it inexhaustible. Hymenoplasty is one of the “tools” of their strategy of temptation. To try to understand the female logic is quite an ungrateful occupation. And why should you? Sexual “theatre” provides a variety of roles. Any woman is charmed by the words: “darling”, “my love”, “honey”... Every man is impressed by the fact that it is him who has the right to open the door to the world of sensual pleasures for his beloved. According to the calculations of neurobiologists the “hot” period of the couple lasts 90 days. Some more optimistic sexologists speak about a honeymoon of two years long. After its expiration the passion dies. Someone needs to have it reanimated urgently...

What is your problem?
  • One year ago I decided to get rid of purity by all means. But soon I am going to get married and in the first marriage night I very much want to appear a virgin before the husband.
  • Home life is calm, without emotional splashes. I have conceived to repeat the first marriage night and the honeymoon.
  • I wish to become a virgin again — this is my whim.
  • On the occasion of the 15th anniversary of our wedding I decided to make a special gift for my husband.

When should you have an operation?
There are several surgical techniques. It may be made at any age and repeatedly (according to your desire), but as many times as your genitals can afford (presence of mucous membrane which can be pulled together and fixed). It is necessary to understand precisely, Hymenoplasty is not a return of virginity literally. Nobody can return to you what is already lost in physico-biological sense. That natural hymen was a fragment of the vagina mucous membrane — regeneration is impossible. Hymenoplasty is an illusive operation. Why do women have it? The motivation for this kind of operation can be beyond understanding and expectation. But during your consultation the incentive reasons become extremely clear. As is well known, sex assumes love for imagination and Hymenoplasty can suit here very well. It can be planned as one of the “dishes” of the sexual menu. There are other cases as well. The plastic surgeon is also addressed by women — victims of rape. The relation of cause and effect is obvious here. Hymenoplasty is an opportunity to erase this terrible event from the body memory and to get rid of the burden of the psycho-physical trauma. Other patients simply wish to eliminate the consequences of love affairs. Sometimes girls lose virginity “by nonsense” — not how they saw it in their maiden dreams. For this reason they wish to be reflowered. And nevertheless in most cases the reason of their application to the surgeon is rather positive. It does not matter how old your alliance is. One year, five or twenty five years. In relations of the two there are always new sides. Hymenoplasty can become a way of regaining the lost romanticism in relations. It is possible to become a virgin again and to stage that first romantic appointment with which your relations started. “Deprivation” of virginity after an operation is even more pronounced than at the first defloration. The main thing is that this action must be adequately appreciated. If you give yourself a task to appear a pure maiden before your man again to go through the moment of deflowering, it is your right and desire. The only indication for this operation is the patient’s desire.

Contraindications
Oncological diseases of genitals, problems with blood coagulability, venereal diseases, propensity to excessive scarring (keloid cicatrices), inflammatory diseases of genitals in the acute form, mental disorders.

Anesthesia
The anesthetic technique determined by doctor-anesthetist.

Notice
Hymenoplasty is performed not later than 4—5 days before the next menstruation.

Operation
Duration of operation depending on the used method and volume of surgical manipulations.

Postoperative period
A sensation of discomfort in the perineum area disappears within the day. The diet must exclude products which can cause swelling of the abdomen and a process of fermentation in the intestines. We recommend liquid food to delay defecation for a day. First time it is necessary to avoid physical activities as well as overheating (hot bath, sauna). Careful hygiene is necessary.

It is not necessary to convince anyone that sex is a rather pleasant pastime. Everyone knows this without superfluous explanations. The road to “the big sex” everyone begins equally — there should be that very first time. For girls it is not only novelty of sexual experience, but also... “programmed” by the nature of sexual relations defloration. How to be prepared for the first contact with the partner is written enough. But an eternal question is put again and again because besides the physical action itself, the first experience has much of a psychological context. If the first sexual intercourse happens on the maximum of pleasant impressions, it will essentially influence the further attitude to the sexual activity and it will be much easier for the couple to comprehend the art of the Kama Sutra. Sometimes the ritual of farewell to purity becomes simply impossible...

What is your problem?
  • I am 25 years. I wish to have a surgical defloration not to look “an old maiden” before the man whom I want.
  • I have got married, but “a love ceremony” of first marriage night is a failure.
  • I tried to make sex with my young man, but nothing turns out, it pains awfully. I wish to have a surgical defloration made.
  • The hymen is very dense; it prevents a sexual intercourse and causes pain.
  • very elastic hymen — it does not break.

When should you have an operation?
All innocent maidens of the planet are anxious by the problem of loss of purity. Novelty attracts and frightens simultaneously. The main maiden experiences and fears are possible pain and blood. The problem of loss of virginity is actual depending on the age the two people meet ... That very first time can happen at 17, 23, and at 35 years ... Loss of chastity is not limited by the framework of age. There is an opinion that the virgin hymen loses its elasticity with the years; for this reason some already adult women, loose it with great difficulty. Partly it is really so. At 18—20 years all tissues are much more elastic and better stretched than at thirty. A key to the problem is not only in the age but also in peculiarity of genital structures. Each woman’s hymen has individual parameters: the look, the size, the form, the density, the nerves and blood vessels “supply”. For this reason all women endure defloration on their “individual scenario”. It happens so that irrespective of age the hymen is so dense that a sexual intercourse becomes impossible. Certainly, we stand for a natural/traditional way of defloration but if by virtue of some reasons of physiological and psychological character this process is complicated, it is necessary to take advantage of opportunities of intimate plastic surgery. When should you have an operation? The answer is unequivocal: when the surgical defloration becomes urgent for you.

Contraindications
Oncological diseases of genitals, problems with blood coagulability, inflammatory diseases of genitals in the acute form, mental disorders.

Operation
Duration is no more than 5—10 minutes.

Anesthesia
The anesthetic technique determined by doctor-anesthetist.

Postoperative period
It is necessary to observe personal hygiene carefully. Control examination by the surgeon/gynecologist in 7—10 days. After complete healing it is possible to begin sexual activity without fears.

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