Female Genital Plastic and Cosmetic Surgery (eBook)

Michael P. Goodman (Herausgeber)

eBook Download: PDF

2016
John Wiley & Sons (Verlag)
978-1-118-84847-0 (ISBN)

Infos

Female genital plastic surgery has become an increasingly sought-after option for women seeking “improvement” in genital appearance, relief from discomfort, and increased sexual pleasure. These surgeries are a combination of gynecologic, plastic, and cosmetic procedures. Every year sees a higher demand for physicians properly trained and able to perform them.

This unique text from the acknowledged experts in the field covers;

• the anatomy of the area
• the specific surgical procedures and all their variations
• patients' rationales for surgery
• training guidelines and ethical issues
• outcome statistics
• sexual issues
• patient selection
• potential risks and complications.

Examining the issues from individual patient's perspectives, it is written in an academic but easy-to-read style with understandable and unambiguous drawings and photographs. It contains a step-by-step surgical approach, how to best select the right surgical candidates, how to treat this select group of patients, the sexual issues involved, how to individualize techniques for each specific patient, how to deal with criticism from colleagues or journalists, psychosexual issues, and patient protection.

Michael P Goodman, MD, FACOG, Medical Director, Caring For Women Wellness Center, Davis, CA, USA.

Inhalt

Title Page 5
Copyright Page 6
Contents 7
List of contributors 8
Preface 9
Acknowledgments 10
Chapter 1 Introduction 11
References 12
Chapter 2 Genital plastics: the history of development 13
References 17
Chapter 3 Anatomic considerations 19
Introduction 19
General pelvic floor anatomy 19
The bony pelvis 19
Pelvic floor musculature 20
Pelvic floor muscle (pelvic diaphragm) 20
Perineal membrane (urogenital diaphragm) 21
Perineum 22
Vascular supply 23
Somatic innervation 23
External genital anatomy 23
Labia majora 24
Labia minora 24
Clitoris 26
The G-spot 27
The vulvar vestibules 28
Bartholin’s glands 28
Skene’s glands 28
Three integrated levels of pelvic floor support 29
Level I: apical support 29
Level II: lateral support 31
Level III: distal support 31
Clinical applications 31
References 32
Chapter 4 Definitions 35
References 40
Chapter 5 Philosophy, rationale, and patient selection 41
References 46
Chapter 6 Ethical considerations of female genital plastic/cosmetic surgery 49
Autonomy 49
Nonmaleficence 50
Beneficence 53
Justice 54
Conclusion 54
References 54
Chapter 7 Patient protection and pre-operative assessment 55
Reference 60
Chapter 8 Surgical procedures I: vulva and mons pubis 61
Labiaplasty, labia minora (LP-m) 61
LP, labia majora (LP-M) 79
RCH (“clitoral unhooding”) 91
Hymenoplasty 94
The Procedure 95
Multiple procedures 95
Final note 97
References 97
Chapter 9 Surgical procedures II: perineoplasty, vaginoplasty, colpoperineoplasty (“vaginal rejuvenation”) 98
Introduction 98
Vaginal rejuvenation 98
Prolapse and sexual function 99
Vaginal relaxation and effect on sexual function and sensation 101
Data to support vaginal rejuvenation techniques 102
Vaginal rejuvenation—surgical techniques 103
Importance of proper evaluation and diagnosis 103
Surgical procedures 104
Rejuvenation of the vaginal canal and introitus 104
Posterior wall, introitus, and rejuvenation 104
Post-operative care 109
Risks/complications 109
Conclusion 109
References 110
Chapter 10 The biomechanics and physiology of clitoral and vaginally activated orgasm: impact of vaginal tightening operations 112
Anatomic relationships 112
Orgasm physiology 114
What do vaginal tightening operations accomplish? 115
References 116
Chapter 11 The G-spot 118
Introduction 118
Evaluating the evidence: genetic studies 118
Evaluating the evidence: anatomical studies 119
Evaluating the evidence: imaging studies 119
Evaluating the evidence: clinical studies 119
G-spot amplification 120
Conclusion 120
References 121
Chapter 12 Post-operative care 122
Pre-operative preparation for post-operative care 122
Specific instructions 122
Labiaplasty, minora (LP-m), majora (LP-M) reduction, clitoral hood (RCH)
PP/VP/CP/“VRJ” 126
Chapter 13 Aesthetic male-to-female transsexual surgery 130
Cosmetic one-stage vaginoplasty: introduction 130
Management 131
Preparation for surgery 131
Demographics 131
Surgery 133
Recovery 138
Outcomes 139
Complications 139
Summary 140
References 140
Chapter 14 Anesthetic choices and office-based surgery 141
Anesthesia 141
Sedation 141
Regional block 141
Local infiltrative 142
Candidates 144
Office-based surgery 144
Room setup 144
Equipment and supplies 145
Chapter 15 Non-surgical cosmetic vulvovaginal procedures 148
Autologous fat grafting (AFG) and platelet-rich plasma (PRP) 148
Guidelines for AFG 148
Complications of fat augmentation 151
Factors that have substantial influence on the success of autologous fat transplantation [8] 151
Best donor areas for fat transfer 151
How we can improve the quality of the fat tissue: autologous PRP 152
Degranulation 152
AFG + PRP 153
Use of minimally traumatic harvesting and handling techniques 153
Labia majora lipografting 155
Vaginal recalibration by lipograft technique 156
Conclusion 158
References 158
Radiofrequency fractional CO2 laser
Fractional laser and RF treatment for vaginal relaxation 159
Fractional laser and miscellaneous treatments for vulvar hyperpigmentation 161
Miscellaneous vulvar and perineal lightening techniques 163
References 163
Chapter 16 Surgical risks and untoward outcomes 164
Introduction 164
Scope 164
Surgical technique 166
Procedure-specific risks 166
A Mons reduction/liposuction/lift 166
B Labia majora reduction 170
C Elective clitoral hood surgery 173
D Labia minora reduction 175
E Vaginoplasty/perineoplasty (“vaginal rejunvenation”) 181
F Hymenoplasty/hymenorrhaphy 188
G Labia majora augmentation 191
Summary 194
References 194
Chapter 17 Revisions and re-operations 196
Factors influencing patients’ decisions for revisions 196
Factors influencing patients’ decisions for re-operations 197
Revisions 197
Circumstances 197
Patient presentation 197
Your negotiation with the patient and decision whether and when to proceed 198
How to effect revisions: procedure, equipment, setup, anesthesia, surgical venue 198
Situation-specific operative techniques 198
Consenting for and scheduling revision 204
Should you charge? 204
Re-operations (aka “re-do”) 204
Reasons for re-operations 204
How patients present 205
Should you do it or refer to another? 206
When to initially see the patient for a re-operation when to have her return to her original surgeon
Re-operation techniques 208
Informed consent pricing
Summary 209
Chapter 18 Psychosexual issues 210
References 214
Chapter 19 Outcomes 216
References 221
Chapter 20 Pearls for practice 222
Whom to operate on 222
Whom not to operate on 222
How to get into trouble 222
How to stay out of trouble 223
What skills must the genital plastic/cosmetic surgeon possess? 223
Patient protection 223
Patient and physician protection 223
Physician protection 223
Chapter 21 Standards of care 225
Why are standards of care needed? 225
Medical versus legal standards of care 226
Who should perform specific surgical procedures: “credentialing” for genital plastics 227
Suggested minimal standards 229
Post-graduate (“residency”) training 229
Freestanding training programs 229
“Grandfathering” 230
Continuing medical education 230
Experience and quality of care 230
References 231
Index 232
EULA 238

Produkt-Details

• Erscheint lt. Verlag: 3.2.2016
• Mitarbeit: Stellvertretende Herausgeber: Otto Placik, David Matlock, Alex Simopoulos, Robert Moore, Linda Cardozo, John Miklos, Andrew T. Goldstein, David Veale, Bernard Stern, Marci Bowers, Gail Goldstein
• Sprache: englisch
• Themenwelt: Medizinische Fachgebiete ► Chirurgie ► Ästhetische und Plastische Chirurgie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Gynäkologie / Geburtshilfe
• Schlagworte: Colpoperineoplasty • cosmetic surgery • female genital plastic surgery • Gynäkologie • Gynäkologie u. Geburtshilfe • Gynäkologie • Gynäkologie u. Geburtshilfe • Medical Science • Medizin • Obstetrics & Gynecology • perineoplasty • Plastic & Reconstructive Surgery • Plastische Chirurgie • Plastische u. rekonstruierende Chirurgie • Vaginoplasty
• ISBN-10: 1-118-84847-0 / 1118848470
• ISBN-13: 978-1-118-84847-0 / 9781118848470