A mini-review of aesthetic gynecology and leading gynecology associations' approaches to this issue

Abstract

Aesthetic gynecology has seen increasing patient and physician demand. Although this typically falls in the reign of obstetrics and gynecology, plastic surgeons and cosmetic surgeons have also developed great interest in this field. Currently, few if any obstetrics and gynecology residency or fellowship programs teach this subject matter though inroads have taken place in plastic surgery and cosmetic surgery training programs that had the foresight to include specific training in this field. Currently, many surgeons start by first training in various established certification and preceptorship programs based in the United States and the United Kingdom. New programs worldwide in 2016-2017 have also been launched to offer certification training to interested physicians in both surgical and non-surgical treatments. A steady flow of certificate programs continues to evolve in Turkey, the Middle East, Spain, and South America, as a second wave of experts emerge. We present a review of surgical and non-surgical techniques of what is presently called "aesthetic gynecology" and the approaches of prominent gynecologic societies regarding this relatively new subspecialty.

Keywords: Aesthetic gynecology; labiaplasty; radiofrequency; rejuvenation; vaginoplasty.

Figure 1. Young lady in her 20s felt uncomfortable with her labia and redundant and loose perineal tissues. She requested an aggressive labiaplasty for both comfort and personal confidence a) before surgery, b) two months after surgery (labia minoraplasty, clitoral hood reduction, and perineoplasty)

Figure 2. Middle-aged multiparous female, unhappy with the appearance of her loose labia majora and her introitus. She requested a labia majoraplasty and perineoplasty and declined vulvar filling procedures a) before labia majoraplasty: front view, b) months after labia majoraplasty: front view

Figure 3. A 66-year-old female with severe genitourinary syndrome of menopause and labia majora laxity underwent monthly transcutaneous temperature-controlled radiofrequency vaginal rejuvenation x6 to achieve maximum labia majora shrinkage without surgery. Shown is the progressive tightening effects obtained over the 6-month period. Internal treatments were also done that enabled comfortable sex to be possible without the need for added lubricants a) before treatment, b) after 3 treatments, c) after 6 treatments

Figure 4. A 60-year-old female with severe genitourinary syndrome of menopause and tearing of perineum during intercourse. She underwent transcutaneous temperature-controlled radiofrequency monthly for 3 sessions and obtained excellent relief from the dryness and dyspareunia. Her incidentally-found mild cystocele was also reduced in size a) before treatment, b) after 2 treatments, c) after 3 treatments