Recent times have seen an improvement in awareness about the appearance of genitals due to easy access to pornography and genital hair removal. If a woman feels 'deformed' due to the appearance of her genitals, it can result in psychological issues with feelings of low self-esteem and confidence. Many of such individuals hide their concerns from their physicians. Proper treatment begins with a consultation when a patient is able to express her concerns to the physician. The various treatment options, plan, and risks are discussed with the patient after a physical examination.
Some of the commonly performed FGCS procedures are:
1. Labia minora reduction: This is a procedure carried out for women who desire a change in the appearance of their enlarged labia minora ( inner labia). Most commonly labia minora are enlarged from birth. Aging and childbirth can contribute in some cases. Enlarged labia may be a source of discomfort during sports or while wearing tight undergarments. It can result in chronic irritation. Labia minora reduction or 'labiaplasty' involves removal of the most protuberant part of the labia as a 'V'. This may be extended to tackle enlarged clitoral hoods. The suture line is usually undetectable. The procedure is carried out under local anesthesia with sedation or under general anesthesia. It is usually carried out as an outpatient procedure. Patients can return to light office work in 5 to 6 days. Sexual intercourse can be resumed after 8 weeks in sexually active individuals.
2. Labia majora reduction: Labia majora ( outer labia ) can be enlarged as a result of childbirth, aging and weight gain. This can be due to an excess of fat or skin. Both can contribute to the enlargement in some cases. Preoperative consultation enables the surgeon to understand patient's concerns. The enlarged labia are treated with excision of skin and/or fat as bilateral ellipses. The procedure is carried out under local anesthesia with sedation or general anesthesia. It is carried out as a short stay procedure and the patient can return home the same or next day.
3. Mons lift and liposuction: Mons can undergo enlargement following weight gain or aging. This may be accompanied by drooping of the tissues. Mons lift is carried out for a reduction in the size and improvement in position. This involves reduction of the fatty tissues with liposuction and anchoring of tissues of mons to abdominal fascia for long standing results.
The techniques in FGCS continue to evolve along with an increase in the application of these procedures. When undertaken after proper screening and counseling, these procedures have been found to significantly improve the associated psychological issues with high satisfaction rates.