This thesis is written for the purpose of presenting the correct perspective of the above
subject and is not meant to be advertisorial.
In this day of so-called life style medicine, much is being offered in the field of aesthetic medicine. No one knows what the long term side effects of these applications. Under the same guise, CVS is offered to patients as an enhancement of appearance and sexual improvement. The other term, which is propriety, courtesy of Dr Matlock, is designer laser vaginoplasty (DLV).
In simple terms, CVS involves the alteration of the natural appearance of the external female genitalia. The appearance of the external genitalia is dependent on race and physique, and nothing in the way of normal activities alter its appearance, except the process of vaginal delivery.
Even with normal vaginal delivery, the only part of the external genital that is altered is the area between the lower edge of the vagina and the anus (the perineum). This area becomes scarred due to the need for episiotomy in the process of delivery of the baby. All other components of the external genitalia, like the labia minora and majora and the clitoris are unchanged.
This is probably the most common CVS procedure, which hopes to recreate the hymen.
The hymen is a ring of tissue that is left at the entrance of the vagina after the formation of the vagina during foetal development. It is usually torn at the first sexual intercourse and then degenerates into a very thin rim of tissue at the entrance of the vagina. It can be recreated by surgical means, and the extent of the plastic operation is dependent on the amount of residual tissue. This in turn will determine if it can be done as an outpatient or day surgical procedure.
The hymen is a sign of virginity and its importance varies greatly in different societies and cultures.
However, in the real world, recreating the hymen will not recreate virginity in total.
Virginity embodies not only the hymen, but mind, body and soul!
Trimming the labial minora is the more common procedure, as some women may complain that it is too
large. There are very few medical indications for this procedure.
In women who are very active in sport, it may be a hinderance. A large labial minora may be uncomfortable during sexual intercourse.
I suspect that the dawn of the minimalist panty (call it by any name) is the reason why there is demand for this operation.
Whatever may the reason, it is well to know that the labia minora is highly innervated, and is essential for sexual stimulation. By trimming it, the end result may be aesthetic, but sexual stimulation may be reduced. Moreover, if there is excessive scarring due to poor technique or infection, dyspareunia (painful sex) is the end result.
The other labial cosmetic surgery is enhancement of the labia majora, to make it look more prominent. It is essentially aesthetic, and adds nothing to function. The surgery involves injection of silicon or the transplantation of fat from the thighs.
Female circumcision used to be practised and is still practised in some countries, especially in
Africa, as a religious ritual. This procedure has been banned by the WHO as it very often leads to
mutiliation of the female genital organ arising from the surgery itself or its complications.
In current usage, female circumcision comes under the guise of clitorial hoodectomy. It is claimed, but never scientifically provened, that removing the excess skin around the clitoris enhances sexual response.
This procedure should never be done, as it is painful, disfiguring and sometimes fatal as there is an artery at the base of the clitoris which may be lacerated during surgery. Most importantly, it is non-aesthetic and serves no function.
This is a terminology that has been brandished around lately in the media because of its sensational
appeal. It is trade-marked in the USA by a Dr.Matlock, and is therefore propriety, and can only be
used if you have paid a fee and attended a 3 day course in his clinic. A laser is used as the cutting
instrument, hence is called laser vaginal rejuvenation (LVR).
Essentially, it involves tightening of the muscles around the vagina. These muscles are usually stretched or torn during delivery, and if not correctly repaired at the time of delivery, followed by good postnatal exercises, will loosen with time.
The surgical procedure is commonly termed anterior and/or posterior colporrhaphy, or sometimes simply called pelvic floor repair. If there is associated stress urinary incontinence, an addition procedure is carried out at the same time by way of a mid-urethral sling (TVT).
This new terminology is sensational, and adds nothing to the time honoured procedures. The use of the laser to do the surgery adds no advantage, although it is claimed to cause little bleeding.
What is important for the patient to know is that this "new procedure" has never been published in established medical journals or demonstrated in any medical/surgical forum. It is propriety, and therefore cannot be demonstrated even to medical colleagues. In short, it has to be kept a secret! This is against the code of medical practice as governed by the Hippocratic Oath, which preaches that all medical/surgical treatment should be shared by all medical practitioners if it is for the good of the patient. It has only been advertised in tabloid publications.
Included in this vaginal rejuvenation, is G-spot enhancement to heighten sexual enjoyment. This G-spot is not an anatomical landmark. Theoretically, it is said to be located on the anterior (front) vaginal wall at the junction between the bladder and the urethra (urinary passage). It cannot be identified by clinical examination or any other mean, and varies from individual to individual.
The objective of the publicity on these "new procedures" is that they improves sexual response and enjoyment.
Please remember that sexual enjoyment between man and woman is dependent on many factors, the least of which is the anatomy of the man and woman. If there is need to rejuvenate the vagina, what about rejuvenating the penis!! Why does the responsibility of improving sexual response fall on the anatomy of the woman only?
Sexual response between couples is about mind, body and soul. The most important sex organ is the 6 inches between the ears (the brain).
It is important to take note that all the procedures discussed above are real surgical procedures and are from the words of our Singapore Gynaecologist. Do not for one moment think that they are simple day surgeries. As in all surgeries, complications like haemorrhage, infection, and perforation of the rectum and anal canal, can and do occur. The end result may be painful scarring of the external genitalia and vagina, leading to dry and painful sexual intercourse, the very anti-thesis of what the patient desires.