The place of sexuality in women’s lives, how she experiences and internalizes sexuality, what issues she has had with sexuality throughout her life, and how to treat those issues have all received attention in our nation over the past ten years. Sexuality in women is an important component and indicator of general health and quality of life, but until recently it was only based on reproduction and fertility evaluation.
According to the World Health Organization, sexual health; It is a state of physical, emotional, mental and social well-being related to sexuality, not just illness or dysfunction.
Sexuality; It is expressed in thoughts, beliefs, attitudes, values, behaviors, roles and experiences. However, sexuality; It is shaped by the interaction of biological, psychological, social, economic, political, cultural, legal, religious and spiritual factors.
In our nation, cosmetic gynecology and genital aesthetic procedures follow the same principles as those utilized in the USA since the 1970s.
Since the 2000s, it has been on the agenda. Cosmetic gynecological operations are becoming more and more popular as a result of rising awareness, demand, and technological advancements. Now, our women have come to realize that they have the right to have a better sex life, and they can more easily explain the problems that they are unable to talk about.
Genital aesthetic procedures in women; It is performed for cosmetic purposes and/or to regulate sexual function.
When performed correctly, genital aesthetic operations provide additional benefits besides aesthetic ones, such as sexual, hygienic, psychological, and medical ones.
Being dissatisfied with the external genital(dış genital) appearance: Causes self-dislike and insecurity. The increase in self-confidence makes the woman feel better psychologically. It’s possible to experience emotional unhappiness occasionally as a result of how the genital area looks. In fact, women’s breast, abdomen(belly, tummy?) fat removal surgeries are the same reasons that cause them to need procedures such as Botox on their faces. We need to feel better internally and feel more confident physically. The feeling of embarrassment, avoidance of sexual intercourse or being uncomfortable due to physical and functional problems in the genital area are very common.
These and similar conditions are the most common complaints that patients need genital aesthetic procedures.
The most common reason for female genital plastic surgery in our country and all over the world is to be uncomfortable with the appearance.
However, problems in sexual life, painful sexual intercourse, discomfort when wearing tight clothes, sitting and getting up, episiotomy scars after normal delivery, urinary incontinence, the feeling of wideness in the vagina and its negative effects on sexual life, and vaginal dryness are the most important reasons.
Self-esteem and body image are very important in human life. They have a cause-and-effect relationship where they are both impacted by each other. In a study, it was shown that having cosmetic surgery led to a boost in self-esteem.
Additionally, it was mentioned that a person’s decision to get cosmetic surgery depends on their perspective on society, their sense of identity and their perception of their body.
Let’s share a brief overview of the genital area-related plastic operations that are performed the most commonly: It is separated into two as surgical operations and non-surgical procedures.
LABIAPLASTY (vaginal inner lip aesthetics): It is the most common genital aesthetic procedure. In fact, the same term is used for both internal and lip intervention. It is often referred to as the labia minora (inner labia of the vagina).
VAGINOPLASTY (Operation to tighten the vagina): The enlargement of the vagina over time usually causes rectum and bladder sagging, causing cosmetic and functional problems in the patient. The feeling of wideness during sexual intercourse and the feeling of gas coming out of the vagina become problems that impair the quality of life of the patients. Vaginal tightening is also known as vaginal rejuvenation surgery.
CLITORAL HUDOPLASTY : It is the removal of excess texture on the clitoris. It is usually performed simultaneously with labiaplasty operations.
LABIA MAJORA AUGMENTATION (Filling the outer lips) : It is the strengthening of weak and wrinkled outer lips with fillers. Usually, the patient’s own fat tissue or hyaluronic acid filler is used. It involves the surgical expansion and stretching of sagging and loose outer lips.
LABIA MAJORA REDUCTION (Reduction of the outer lips): In case of primary labia majora enlargement, there are excessively swollen and full outer lips due to fat storage. Secondary labia majora excess occurs as a result of volume loss in the skin. During the procedure, excess skin and, if necessary, fat tissues are also removed.
GENITAL PRP (Platelet Rich Plasma) APPLICATIONS:PRP, which is used in many areas of medicine, also gives satisfactory results in the treatment of female sexual dysfunctions. Inability to orgasm (anorgasmia) is registered as “O Shot” (Orgasm vaccine). PRP is also used in problems such as painful sexual intercourse, vaginal dryness, dryness and atrophy due to menopause.
G-SPOT MAGNIFICATION (G shot) : Fillers are used to apply it to the anterior wall of the vagina, which contributes to female orgasm (such as hyaluronic acid). To strengthen and clarify the area is the purpose. It increases the penetration surface during sexual intercourse.
GENITAL LASER APPLICATIONS: It is a non-surgical procedure performed using a laser device. These energy-based applications; It has two functions as Radiofrequency (RF) and Carbon Dioxide laser (CO2-laser). The fundamental working principle is to heat the tissue in order to renew it. Genital laser ; It is used especially in patients with vaginal enlargement, in the treatment of vaginal tightening, vaginal dryness and stress incontinence and in combination with vaginal rejuvenation surgeries. It has few adverse effects and is painless.
In the recent 10 years, the widespread use of the internet and social media have increased our social interest in visuality. In addition, with the sociocultural changes, women are now more knowledgeable about sexual intercourse, seeking their sexual rights, not afraid to talk about these issues, and thinking about feeling better as women. In our country, women’s sexuality and genital area for centuries; There is a cultural and social judgment that it is a place that women should not be ashamed of, act as if they do not exist, and refrain from even looking in that area. According to a study, it was observed that women who are self-confident, attractive, not shy towards men, and who think that it is necessary to enhance their sexual life, are more interested in genital aesthetics.
Female normal external genitalia anatomy
Medical, sexual and gynecological history should be evaluated during the pre-operative evaluation process in genital aesthetic operations.The use of drugs in the past and present should be thoroughly examined.
Patients who would not benefit from these procedures should be differentiated. The surgeon must provide the patient with clear and understandable information about the chosen technique, including the treatment approaches and their duration,potential side effects and consequences, and the guidelines to be followed after the surgery.
There are regulations that are crucial for the patient and the doctor to follow throughout genital aesthetic surgery and cosmetic procedures. The main ones of these rules are; attention to patient privacy, patient must be at least 18 years old, the patient’s awareness of his/her own responsibility while making a decision, detailed information and consent form before the operation.
In the following cases, genital aesthetic surgeries are not performed and are not recommended by doctors. Situations where genital aesthetic surgeries are contraindicated and should not be performed;
Under 18 years old Pregnancy: In relation to all conditions, genital aesthetic surgery should be avoided during pregnancy.
Breastfeeding period: It is recommended to wait at least 6 months after delivery, especially for vaginal tightening and labiaplasty procedures.
Presence of active HPV (Human Papilloma Virus) or HSV (Herpes Simplex Virus) infections: In order to prevent the spread of active HPV or HSV infections, the therapy should be carried out first, and the genital aesthetic procedure should be carried out once the healing is complete
Uncontrolled Diabetes (DM): Surgery for genital aesthetics is not recommended in the absence of blood sugar control since it will impair wound healing. Patients with decreased glucose tolerance experience the same effect.
Morbid obesity (Body mass index > 40): Although not an absolute contraindication, morbid obesity may adversely affect wound healing. Additionally, there is a small increase in the risk of bacterial causes of infectious disease.
Body Dysmorphic Disorder: Body Dysmorphic Disorder (BDD) is a condition that should definitely be evaluated well. This group of patients may have dissatisfaction and different emotional changes after surgery. In advance of the procedure, psychiatric counseling is required in doubtful situations.
Psychiatric diseases : Conditions such as depression, anxiety, and OCD (Obsessive Compulsive Disorder) are considered by gynecologists. In addition, genital aesthetic surgery procedures are not applied in patients diagnosed with psychosis, bipolar disorder, severe depressive disorder, and eating disorders.
A mental disability: As all aesthetic operations are contraindicated in people with mental disabilities, genital aesthetic surgeries are not performed either.
Cancer or a suspicion of cancer: Vaginal laser applications should not be performed, especially in those who have abnormal cellular pathology in their genital areas due to the effect of HPV (Human Papilloma Virus). Apart from that, surgical and non-surgical genital aesthetic surgeries should be avoided in cases of genital cancer or pre-cancerous conditions that are not fully diagnosed.
Expecting too much: Just as the patient has the freedom to choose the doctor, it is perfectly natural for the doctor who will perform the aesthetic surgery to choose the patient. Genital aesthetic surgery may not be accepted for patients who have excessive expectations, excessive detail-oriented behavior, indecision, or mistrust of the surgeon.
The satisfaction of such patients after surgery also decreases. However, despite applying to the doctor, many patients do not have a clear idea of what they need. The reason for this may be problems with the spouse, cheating, depression, general anxiety disorder or different psychological disorders.
1997 yılında Ankara Gazi Üniversitesi Tıp Fakültesini bitirdi. 2000 – 2004 yılları arasında Ankara Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesinde ihtisas yaparak Kadın Hastalıkları ve Doğum Uzmanı ünvanını aldı. 2008 yılında Holistik Cinsel Terapi eğitimini tamamladı.
