OFFICE LABIAPLASTY & HOOD REDUCTION
Labia minoraplasty is divided into three categories based on the primary reason for which reshaping is requested.
Some procedures are limited to one side only. Others may involve surrounding anatomical structures of the vulva such as the clitoral hood, the fourchette (the zone where the labia meet posteriorly), the labia majora or the perineum (the deeper muscular tissues between the vagina and the anus.
COSMETIC REDUCTION LABIAPLASTY
Reshapes the labia minora to a shape and contour desired by the patient. Some of the frequent reasons why women request this type of surgery are to make the labia minora more symmetric when there is large visible difference between the two sides, to reduce undesired bulging of labial tissue when wearing certain types of swimsuits, lingerie or other tight fashions, to display less hyperpigmented skin (labial skin that is much darker than the vulva which surrounds it), or to achieve less protrusion (hanging) of the labia when nude.
Most women who seek these procedures prefer to keep the entire bikini zone including the vulva smooth and free of body hair & often request laser hair removal of the bikini zone to reduce the need for frequent and painful brazilian waxing or shaving and razor burn. These treatments are available at the Spa.
THERAPEUTIC REDUCTION LABIAPLASTY
Focuses on the resection of elastic, loose or pendulous labia minora tissue which has become a source of chronic discomfort as these tissues experience traction or pulling pain during normal activities, sports or sexual relations. Currently, medical healthcare insurance plans do not view the symptoms which drive women to seek reconstructive labiaplasty or therapeutic reduction labiaplasty as indications for surgical treatments and they regard all such procedures as purely cosmetic in nature and currently, the surgeries must be financed by those who request them.
ABOUT THE LABIA MINORA
The labia minora are composed of connective tissue covered with skin on their lateral (outer) surface. They extend from the clitoris anteriorly to the fourchette posteriorly. The anterior (front) portion of the labium minus splits into an outer portion which forms the clitoral hood (clitoral prepuce) and an inner portion which fuses with the undersurface of the clitoral head to form the frenulum.
The labia minora display their greatest span halfway between the clitoris and the fourchette. When measured from the base to the edge, most labia measure 4 to 5 centimeters in this dimension. The width of the labia minora is typically around 5 milllimeters.
The labia minora contain many sebaceous glands. They do not contain sweat glands or hair follicles. Mucus present on the labia minora is produced from glands within the vestibule
Microscopically, the lateral (outer surface) of the labium minus displays inner and outer layers of squamous epithelium (normal skin cells) sandwiching a central layer of connective tissue.
The medial (vaginal or inner surface) of the labia minora is partially covered with skin, along the edge, and with a thinner layer of pale skin near the base. The borderline between these two types of skin is known as Hart’s line. The skin of the vaginal opening inside of Hart’s line is called the vestibule.
LABIA MAJORA AESTHETIC SURGERY
LASER HAIR REMOVAL
Frequently requested for the skin of the labia majora to avoid frequent and painful Brazilian waxing or razor burn. This may be combined with treatment of the mons pubis or other sites such as legs, arms, back, etc. These treatments are available through The Spa and consist of multiple sessions typically within a two-month time frame. The number of sessions depends upon the density of the hair follicles and your skin type.
LABIA MAJORA REDUCTION
Also known as reduction labia majoraplasty. A surgical treatment for excess loose skin and subcutaneous tissue of the labia majora which sometimes accompanies massive weight loss or excess labial stretching from other causes. Recovery is quick a relatively painless process since the procedure only involves the skin and superficial fat layers.
CLITORAL HOOD COSMETIC SURGERY
The clitoral hood, also known as the prepuce is layer of loose skin which envelops and protects the clitoral shaft and the head, or glans, of the clitoris from constant and unwanted friction.
Sometimes redundant folds of loose skin unrelated to the body of the clitoris (shaft and glans) develop alongside the lateral borders of the clitoris. This lax tissue may occur on either or both sides of the midline, may fuse with the labia minora and may exceed the clitoral hood in size.
Clitoral hood reduction procedures focus on these lateral folds of loose tissue. The glans clitoridis, the head of the clitoris, is not exposed by this type of surgery. Meticulous superficial dissection and precise incisions which avoid the course of the clitoral nerve supply protect the sensitive nerves which supply this region.
Clitoral hood reduction is usually performed in conjunction with labia minora reduction procedures (reduction labiaplasty, reduction labia minoraplasty, laser reduction labiaplasty). Since both structures are intimately fused, combined treatment of both structures yields better cosmetic flow than isolated treatment of either structure alone.
ANATOMY OF THE CLITORIS
The clitoris receives its nerve and blood supply from the pudendal nerves and vessels.
These structures emerge from behind bony structures known as the ischial tuberosities – in lay terms, they are called the “sit bones”.
The pudendal nerves and vessels then course along the muscles beneath the labia majora (the bulbocavernosus muscles) and emerge from the deep tissues within the superfical layers of the clitoral shaft.
The skin of the clitoral hood (top arrow) is formed from the skin of the labia minora. This skin is also know as the prepuce.
The clitoral hood covers the entire shaft and head (glans of the clitoris; bottom arrow).
A cross-section view of the clitoris (inset) shows how the nerves (yellow) which provide sensation to the clitoris are not actually in the skin layer, but much deeper in the shaft of the clitoris itself.
The structure of the clitoris is identical to that of the penis except for the absence of the urethra.
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