Genital surgery

When use surgery

Genital plastic surgery has been well-known for years in the United States and South America, but it is also becoming popular in our region. The discussion on its legitimacy and procedures is still a current topic, even in the United States. For example, the American Gynecological Society has issued a statement expressing its opposition to purely aesthetic genital surgery without functional justifications. Meanwhile, the American Society of Plastic Reconstructive Surgery (AAPRS) dedicated an entire session to the topic at its annual congress held in Baltimore.

The considerations made during the session, unanimously shared, were of great interest:

  • Aesthetic surgery of female genitalia falls within the scope of reconstructive plastic surgery because its treatment, even from an aesthetic perspective, draws from decades of experience in reconstructive surgery of external genitalia and the vaginal cavity. This experience is gained in treating malformative pathologies and correcting intersex pathologies.

  • The pathologies to be treated should not be confined to mere aesthetics but should also have functional and corrective significance, addressing malformations or significant psychophysical distress.

  • Polyspecialist preparation is necessary, involving reconstructive plastic surgery, urology, and gynecology.

  • The interest in this field is evident from numerous articles published in recent years in reputable journals of reconstructive plastic surgery. For example, in 2007, three articles focused on labiaplasty were published in the prestigious AAPRS journal, along with two articles in neurophysiopathology regarding vaginismus and two on techniques for repairing vaginal lacerations.

  • The results of these procedures, when correctly performed and with a genuine indication, are more than satisfactory.

The prostheses

It should be noted that this is a delicate field, challenging not only due to the implications of reconstructive, aesthetic, and functional plastic surgery but also because of the significant psychological motivations often involved.

The human anatomy of the genital area is highly variable, and it is incorrect to standardize aesthetic norms with clear and decisive limits. For example, the normal size of the penis (in the absence of pathology) varies greatly, just as the length of the labia minora or the size of the clitoris varies in women.

However, there can be relevant alterations that lead to significant discomfort, limiting daily life and, even more so, sexual well-being. Moreover, over time, the anatomy of the genital area changes: the mons pubis becomes fatter, the labia majora may sag, and the labia minora can elongate. After childbirth, especially multiple births, vaginal muscles lose tone, and the sexual experience may lose some of its allure.

Surgical intervention is not simple and should be reserved for cases that genuinely require it. Surgery should be limited to anatomical conditions that are clearly pathological and those that, while falling within the range of the “great variability of normality,” are psychologically significant. The need for correction should be established by both a surgeon and a psychologist.

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