A whopping more than 17.7 million surgical and minimally invasive cosmetic procedures were performed in the United States in 2018. Tummy Tuck or Abdominoplasty ranks the 5th on the list for now, but an increasing trend seen in body-shaping procedures, according to a report by the American Society of Plastic Surgeons (ASPS). Australians follow the same trend and don’t seem to be fazed by the fact that Private Health funds have stopped paying for the cosmetic Tummy Tucks.

Tummy Tuck is the only permanent way to get your pre pregnancy flat tummy in the best possible way. As regulators and advances in surgical techniques have made it much more safer for patients, there are some inherent postoperative complications that come in a package even with the best surgeon. At Esmée Clinics, Dr Mahadik endeavours to educate his patients by providing evidence and research based data to guide them through this unforeseen aspect of their cosmetic journey.

Lets briefly outline some facts on complication rates after a Tummy Tuck procedure (1). We believe that patients should be aware of them before signing up. The numbers reflect only those needing hospitalisation and those complications managed from clinics were excluded.

1. Abdominoplasty accounts to higher major complication rate of 8-10% (4) compared to other cosmetic surgery procedures
2. When combined with multiple procedures like other body contouring procedures the rate spiked higher(1)
3. Seroma, Fat Necrosis and Infection were the top 3 complications
4. They pose a significant financial burden on the surgeon and the patient as most expenses are out of pocket, uncovered by private funds.

WHAT IS FAT NECROSIS?

Fat necrosis is the death of fat cells due to shortage of or a disruption of blood flow to the abdominal fat and skin. Fat necrosis causes wound breakdown and delayed healing.

The signs are similar to wound infection. Infection,however is caused by bugs while fat necrosis is tissue death which can then be a good medium to get colonized by bugs.

HOW DO I KNOW, I HAVE FAT NECROSIS?

After an uneventful surgery patients are usually followed up day 7 to 10 to check sutures and dressing changes. The signs of fat necrosis usually take 5-7 days or sometimes 2 weeks to appear.

They appear to be similar to infection, but infection is due to bugs while fat necrosis is a death of fat cells under the skin due shortage of or a disruption of blood flow to the abdominal fat and skin.

1. Skin next to incision site is discoloured, bluish- black or scabby
2. The area becomes lumpy, firm, swollen and warm.
3. Small red patchy areas may develop on the upper skin flap below the umbilicus
4. The skin may break into tiny 3-4 mm areas at one or more locations along the scar
5. Discharge of think reddish yellow fluid from the scar.

Although it might appear to be superficial infection that can settle with antibiotics, more often than not, it is more sinister than this.

It is FAT NECROSIS of the abdominal skin flap that will cause a wound breakdown.

WHAT CAUSES FAT NECROSIS?

The primary cause is shortage of blood supply to keep the fat alive.

Sir Harold Gillies wrote that “Plastic Surgery is a constant battle between blood supply and beauty’* (Gillies and Millard, 1957)-a struggle which has not yet been resolved.

These fat cells typically located in the middle portion of the abdominoplasty scar are at the farthest point of the blood supply, may die causing the wound to break and dehise. The size of breakdown is proportional to the amount of fat death secondary to ischemia (lack of blood supply).

Skin is more tolerant than fat to ischaemia. Hence it survives and the underlying fat dies.

There are a few other contributing factors –

1. Tension closure – Over zealous cut out of the skin apron often leads to tight closure of the skin which contributes to fat necrosis. The heavy sutures cut like a cheese wire through the fat layers
2. Diabetes and Smoking – reduce the baseline blood flow to tissues. Smoking ideally should be ceased 4 weeks before the procedure.
3. Infection – Surgical site infections can cause wound breakdown and fat necrosis
4. Obesity in general and patients with massive weight reduction are high risk for fat necrosis.
5. In a small percentage of patients it can happen without an identifiable cause

WHAT TO EXPECT & HOW DOES FAT NECROSIS HEAL?

Mild cases – The inflammation, induration and lumpiness settles over time and the skin may not breakdown

Moderate to Severe cases – Small areas of skin breakdown will continue to ooze thin fluid. Gradually, the broken down areas will grow into a bigger wound with more discharge. This may progress depending on how much of the fat is subject to slow death.

1. Yellow Dots – Perforators (Blood supply to the skin flaps) 2. Blue Arrows – Indicate the pull of the upper skin flap to achieve a fine line bikini scar. 3. Broken White Line – Mid line dissections allowed 4. Fat Necrosis – increases if Critical Zone is breached

Treatments may include :

1. Surgical debridement procedures – This is usually the first step to excise dead tissues, up to bleeding healthy tissue. This will create an environment for faster healing from healthy viable tissue. The wound is left open for dressings and to be healed by secondary intention.
2. Short period of hospitalization – should be expected after debridement for a couple dressing changes till the wound is stable and suitable to be managed in the clinic setting.
3. Regular dressings over a period of 4 -10 wks on average. Frequency of dressings depend on the wound size and the amount of wound discharge.

Dressings that are offered :-

a) VAC (vacuum assisted closure) dressings gold standard that heal the wound faster, help the wounds to contract in size and are patient friendly. They work on the principle of negative pressure therapy and are quite expensive, unless funded by public health. VAC is to be changed twice a week.

b) Gauze dressings – The wounds may be packed with guaze soaked with an antiseptic with some tapes to hold it in place. They need more frequent changing than VAC and could be managed by wound nurses or GP’s.

4. Skin graft or Secondary closure – Once the wound is clean and healthy, the surgeon may decide to cover it with a split skin graft or close it with sutures. Skin graft – can be quite unsightly with a darker color tone and a visible indentation. It is however a good means to cover and close a large wound that otherwise may take ages to heal. The unsightly graft can be later excised and converted into a good scar.

TAKE HOME MESSAGE

Medicine is a science and there are no fixed answers for all questions as science still continue to unlock new things every day.

Esmée Clinics would like to summarize this a small take home message for those considering an abdominoplasty procedure. As long as patients are educated, they are better prepared mentally and financially to face any odds.

1. Tummy Tuck has a higher complication rate of 8-10%
2. Certain surgical principles should be followed to minimize fat necrosis, but some patient factors play an important contribution
3. Most cases of fat necrosis can drag the healing process over 4-10 weeks
4. Delayed healing can be resource intensive and cause a significant mental and financial stress to the surgeon and the patient.

References

1. Science daily .’Tummy Tuck’ Complications—Study Looks at Rates and risk factors. October 28, 2015
2. Matarasso A. Abdominolipoplasty. Clin Plast Surg 1989; 16: 289–303.

3. Grazer FM, Goldwyn RM. Abdominoplasty assessed by survey, with emphasis on complications. Plast Reconstr Surg 1977; 59: 513–17.

4. Abdominoplasty wound-healing complications: assisted closure using foam suction dressing. C. H. Fenn and P. E. M. Butler,Department of Plastic Surgery, St George’s Hospital, London, UK
5. Patient Care & Health Information Tests & Procedures Tummy tuck
6. Minimising complications in abdominoplasty: An approach based on the root cause analysis and focused preventive steps, Mohan Rangaswamy

Plastic Surgery Department, American Academy of Cosmetic Surgery Hospital, Dubai Healthcare City, Dubai, U.A.E


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Even in these recent times, we find that even men who undergo penile enlargement procedures do not like to talk much about them. Unlike female cosmetic procedures there isn’t much data and research that could help men to decide what is suitable for them. This article tries to find some answers in this direction.

Is there a problem?

Increasing number of Men present to Cosmetic Surgeons with size concerns about their penises and want to get them enlarged. Between 2013 to 2017 Aesthetic Surgeons around the world performed 45,605 Penile Enhancement procedures and the number is ever increasing with newer trends of Scrotal Lifts or Ball Lifts joining the queue.

In doing so, one concern of ethics is raised in that, most men seeking Penile Enlargement for small size penises, in reality may have almost normal range of penile size [1]. One study shows only 2% of the population are abnormally small (defined as 2 standard deviations below the mean) [2]. In Another study around 50% men who perceived their penile sizes to be normal, desired to have larger sizes.

Another concern is whether the expectations of outcomes after Penile Lengthening procedures are realistic which directly affect the satisfaction rates in patients choosing to go under the knife.

Thirdly, should all men be subject to a routine per procedure psychiatric assessment to assess expectations or exclude the penile dysmorphic disorder that may be found in a minority of such patients. Is this any different than women wanting breast augmentations in spite of having normal breasts and whether penile lengthening now, is on the same journey of increasing social acceptance that Breast Enlargements have almost finished.

Interestingly enough, as this trend for Penile Enlargement procedures grows at rapid rate. we at Esmee Clinics decided to do a review of the published research around the topic to clarify some facts.

Size defines masculinity

Historically and even in this age, penis defines masculinity, casually even referred to as one’s ‘manhood’. This concept is phallocentrism – that the penis is essential to a man’s identity [4]. As a result, many men seek identity through size, with the idea that bigger is better.

As described by Vardi (8),’ Phallic Identity’, is the concept of a man seeking identity in his penis, with a focus on bigger is better. This phenomenon remains the same universally

Penis size is widely believed to correlate positively with desired physical characteristics of dominance – height, shoe size and hand size. There is little evidence that this is more than lore [4]. However, a smaller penis is definitely associated as one being less manly [6]. Men who think they have a smaller penis may hide them from partners [3] because penis size not only symbolises masculinity but also sexual prowess [6].

Societal pressure

The crucial issue is likely not actual size, but the perception of size relative to another man [3]. Penis size has also been the topic of jokes amongst friends and colleagues. Social lighthearted conversation and jokes about penises and their sixes has a profound effect on Men and their psychology culminating in a feeling of insecurity and sub-optimal function (6). Societal pressure is therefore exerted making some men anxious about their size. This anxiety can result in dissatisfaction with one’s own size and even sexual dysfunction [5].

Men would see another man’s penis size in the locker room or gyms. Now they can see this in the media. TV shows and men’s magazines which frequently emphasise this alleged connection between size and masculinity [Leh Man 1993].

One study [3] found that 85% of women were satisfied with their partner’s penis size while only 55% of men were satisfied with their own penis size. It also shows 45% of men wanted a bigger penis [3] , even when they thought they were of an average size

Pornography and TV shows

The 2 recent developments which have strongly contributed to the penile maina are

• Proliferation of pornography &
• Rise of TV shows where brutal physical objectification has become, for the first time, an equal-opportunities phenomenon.

Young men generally become preoccupied with the size of their genitals when they compare with others.

Pornography features men with larger than average penises which reinforces this message. The women in this media also have exaggerated responses to these men, which makes men think women have a preference for larger members [3]. Even where men know this is fact, depicting men with larger than average size will anchor them to this when estimating what is average. This leads to further feelings of inadequacy. The crucial issue is likely not actual size, but the perception of size relative to another man [3].

Most men are aware that the penises in these pornographic images are typically large, but persistent expo- sure to these images make them underestimate the size of their own penis with one troubling insecurity;

Am I small? Psychologically, this makes them uncomfortable with the idea that they may not be ‘normal’. This feeling of inadequacy may make them avoid homosocial situations such as locker rooms, gyms and swimming. They are not necessarily small, but they want to feel more confident in front of women and in front of other men too.

Many men have said they avoided sex or situations where they would be exposed, out of embarrassment. Penile Enlargement makes them happier.

Am I really able to please her? – Men may feel uncomfortable if they do not feel they can ‘dazzle’ women. It is necessary to have a thick long penis in the pants to impress women they feel.

Pressure to confirm and perform. Can I please her?

To a lesser extent that are also concerned with pleasuring a sexual partner [5] and whether their partner is satisfied with their size [3]. They may be uncomfortable if they do not feel they can ‘dazzle’ women.

Much of this concern is based on the fact that they will not measure up to her previous partners. Penis enlargement advertisements reinforce this message very well to add to the insecurity.

Many testimonials show that women are more sexually satisfied with larger penis [3] even if in reality in one study, 85% of women are satisfied with the size of their partners[3]. It is uncertain if they fancy a larger penis as opposed to a smaller.

One such testimonial says – “I was satisfied with our lovemaking . . . . However, my husband did not like the size of his penis . . . . Since his surgery, he has more confidence. And, to my surprise, I have been overwhelmed with the difference in our sex life. His increased length, and especially his added thickness have satisfied me more than I ever dreamed possible”. (Total Life Enhancement, 2005b)

Even if a man knows his partner is satisfied with him, he may still want to be larger as a way to feel more masculine [3]. As long as men continue to equate penis size with masculinity, they will continue to feel sexual anxiety [7].

No typical patient for Penile Enhancement

Dr Raheem from London, who has done around 250 such procedures over last 15 yrs explains that there isn’t a stereotype patient who seeks Penile Lengthening surgery. The problem is universal across all professions, all ethnicities, married, single, gay, straight, rich, poor. It’s across the board and all ages. Men even in their 60s often have such procedures done which shows that patients come in all shapes and sizes.

Those who are already large enough will need their expectations have to be managed.There is no miracle worker to make it as large as they could fancy. A minority of such men may seek multiple such procedures in the pursuit of being bigger and bigger, but never happier.They could have penile dysmorphia disorder, which requires therapy.

Summary and Take Home Message

Although it is hard to establish ethical boundaries for cosmetic surgery, there is s general consensus about ways such procedures should be undertaken which has increased the safety and increased satisfaction rates amongst patients seeking them.

We conclude that in a democratic society like ours men have every right to decide what suits them better. Penile Enlargement procedures certainly improve confidence and social well being in men across all ages. As long as the procedure is performed by a competent surgeon following the 3 core principles of surgical ethics, they should be acceptable.

Moreover, operations can be made more safer and can achieve increased satisfaction rate if the following points proposed by us are strictly followed.

1. Clear idea about realistic expectations and complications so an informed decision making is facilitated
2. Mandatory regulations for the procedures to be done in accredited day surgery hospitals rather than doctors surgery
3. No promises on specific figures for length gain since anatomy and body frames differ. A range of gain (eg 1-4 cm) is acceptable,so that the patient does not hold on to the exact number of centimetres gained.
4. Identifying patients with body image problems and offering therapy rather than surgery

References

1. Veale, D., Miles, S., Bramley, S., Muir, G., & Hodsoll, J. (2015). Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15 521 men. BJU international, 115(6), 978-986.
2. Wessells, H., Lue, T. F., & McAninch, J. W. (1996). Penile length in the flaccid and erect states: guidelines for penile augmentation. The Journal of urology, 156(3), 995-997.
3. Lever, J., Frederick, D. A., & Peplau, L. A. (2006). Does size matter? Men’s and women’s views on penis size across the lifespan. Psychology of Men & Masculinity, 7(3), 129.
4. Dillon, B. E., Chama, N. B., & Honig, S. C. (2008). Penile size and penile enlargement surgery: a review. International journal of impotence research, 20(6), 519-529.
5. Littara, A., Melone, R., Morales-Medina, J. C., Iannitti, T., & Palmieri, B. (2019). Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases. Scientific reports, 9(1), 1-10.
6. Oates, J., & Sharp, G. (2017). Nonsurgical medical penile girth augmentation: experience-based recommendations. Aesthetic surgery journal, 37(9), 1032-1038.
7. Kilmartin, C. T. (2000). The masculine self (2nd ed.). Boston: McGraw-Hill.
8. Vardi Y, Lowenstein L . Penile enlargement surgery—fact or illusion? Nat Clin Pract Urol 2005; 2: 114–115.

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It’s the new millennium, a world of automation, virtual reality, and sophistication. While Women rise as fierce competitors in the corporate world, aesthetics carry far greater weight than ever before. Grooming has become as equally important for men as it is for women, there’s no escaping it, style and prowess count and there is no room for self-doubt in or out of the office.

Humans have become more aware of the benefits of healthy eating and exercise and with technological advancements, have the potential to feel and look their best. Dedication to a good gym programme can yield brilliant results and turn even the skinny guy buff and rippled, but no matter how many nights you spend in the gym, man cannot defy gravity. Seriously, can you imagine how great you feel after months of blood sweat and tears sporting your perfectly sculptured body? Proud as punch until you take your jocks off and are betrayed by a loose and saggy ball sack. Yep, you can buff your body, have a face lift, get a sophisticated cut and color only to be betrayed by those two little nuggets.

As we age out skin loses elasticity and for most men over 50 there is a noticeable sagging of the scrotum. Whether it be due to age, certain medical conditions, injury or the way you were born, having a loose scrotum can not only be a confidence spoiler, but can get in the way during physical activity and cause discomfort. A growing number of men both hetero and homosexual of all ages are opting for the nip and tuck for cosmetic and comfort reasons and have reported being less self conscious in the sack and the results giving them a real confidence boost.

At Esmee Clinic we offer complete men’s grooming services in a safe and non intrusive way. We correct perceived deficiencies as well as physical deformities, remove excess scrotum skin and provide a relief from discomfort. To learn more about how the procedure is performed and other frequently asked questions follow the link https://esmeeclinics.com.au/intimate-aesthetics/scrotal-lifts

Growing in popularity for aesthetic reasons is “scrotox” or Botox injections to the scrotal area. These are a non surgical scrotum enhancement option and work to enlarge the scrotum, smooth out wrinkles and provide a firmer, youthful appearance. At a health level, Botox also reduces sweating, the cause of that dreaded jock itch and for the ultimate bonus, Botox injections increase sensitivity in the area and thus enhance your sexual experience.

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I’ve heard many testimonials from women who have had breast augmentation that it was the best thing they have ever done, that they “just didn’t feel feminine” with small breasts. That sense of inadequacy, particularly when related to sexual attractiveness has a significant impact on your sense of self worth, your ability to feel sexually comfortable and confident and ultimately your ability to have fulfilling relationships. Even though in western society we are superficially embracing gender equality, the quest to live up to gender stereotypes is as strong as ever and men suffer the pangs of inadequacy as much if not more than women.

There still exists the “macho man” concept-bigger appendage suits his bigger body, and we have men flaunting their socks under their shorts at sports games and beaches. Like a peacock displaying his grand feathers, attracting females is inherent to all animals, including man.

Rightly or wrongly there is a perception from men that their manliness is very much associated with penis size and actually believe that women like big dicks. Conversely if a man has a smaller penis there is a belief that he cannot properly satisfy a woman, he is self-conscious, gets performance anxiety and his manhood goes south. It’s a spiral affect that can have a devastating effect on his whole psychological and physical health. And let’s face it, we’ve all heard stories of guys getting ribbed in the showers after a football game and the girls getting together whispering about the guy with the little penis. The poor bloke stops playing sport, stops dating women and suffers both mentally and physically, after all we can’t separate or compartmentalise our bits from each other or from our emotions.

The side of this is that there is no need to suffer and if god drew you the short straw, there are ways to remedy this so that you can feel confident, and more masculine, which in turn enhances your relationships, your sex life and your self esteem. You don’t need to take pills or use pumps or stretching apparatus as we offer several simple, non invasive procedures to enhance what you already have. At Esmee clinic you can experience a penis enlargement naturally and organically without the need for artificial devices or medication. Our procedures work with your own body to re adjust and reshape your genital area to reveal more length, or width or both.

While there are a number of products and promises available, pills and traction devices have temporary and possibly damaging side effects and side effects and can do more damage than good. It’s really important to do your research and consult with an expert to determine your exact needs and the best way forward for you. Some people benefit from one procedure, others a combination. At Esmee Clinic, our professional staff are at the forefront of male enhancement treatments by providing simple, non intrusive but life changing services.

What is on offer?

Injectable –

• P Shot (like a female Counterpart G spot) – A PRP injection derived from your own blood is known to increase the length and strength of erection. Young and olds are flocking to such lunch time procedures to please their partners even more.
• Fillers – Temporary and some permanent fillers can enhance girth and sometimes length
• Surgery – Increasing number of men are choosing to go under the knife as a one stage shot. Technology and modern medicine has made surgery safer. They can go home the same day with a brand new large and long penis. Cosmetic Surgery is about providing exactly what the patient wants.

Primarily surgery can be of 3 types –

• Structured fat grafting to build up length
• Advancement V-Y plasty of skin and
• Ligament release

Go safe with a surgeon who is experienced in the area and do your research well.

Follow the link below to learn more about the procedures and what else we have on offer. https://esmeeclinics.com.au/intimate-aesthetics/penile-enhancement-surgery

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• Breast enhancement (augmentation, reduction, and lifts)
• Facial contouring
• Body contouring (tummy tucks and liposuction)
• Rhinoplasty
• Rejuvenation (face lifts)
• Reconstructive surgeries following accident or injury
• Reparative surgery on birth defects

The favourable outcomes of cosmetic surgery are:

• Improved appearance
• Improved physical health
• Improved confidence
• Improved mental health
• Permanent or long-term results

Improved Appearance

This is a self-explanatory outcome. People are often dissatisfied with parts of their body. This ranges from flaccid skin brought about by dramatic weight loss, to unhappiness about the appearance of a body part such as the ears, and in some instances, the genitalia. If you are unhappy and self-conscious about any aspect of your appearance, you have the option to have it altered, resulting in a new and improved (and happier) you.

Improved Physical Health

Although cosmetic surgery deals with the appearance, some procedures have added physical health benefits. For example, people who have undergone breast reconstruction surgery report alleviation in the back pain that is often suffered by larger-breasted women. Similarly, rhinoplasty can not only improve the appearance of your nose but can also assist with and resolve any previous respiratory problems. Body contouring cosmetic procedures have the ‘flow-on effect’ of better physical health owing to the lifestyle changes necessary to maintain the surgical results; changes such as regular exercise, better dietary choices, and giving up smoking.

Improved Confidence

With the improved appearance comes improved confidence. If you feel you are looking your best, your self-esteem will rise. Your optimism will increase. You will instinctively ‘walk tall’, thus improving your posture. People will respond to the warmth and friendliness that confident people have. You will feel more encouraged to apply for that job or approach that person. You will feel less anxious about speaking in public. It is widely accepted that when you feel you’re looking your best, you will exude more charm. You will not regret your decision to undergo cosmetic surgery when your social circle and career options have been widened and enhanced.

Improved Mental Health

On a more serious note, people who are unhappy about their appearance are vulnerable to anxiety and depression, both of which can be extremely debilitating. In some cases, cosmetic surgery will prove beneficial to the patient’s mental health after the problem, whether it be injury or congenital, is corrected. This will lead to an increased inclination to socialise, become more involved in the community, a boost to the libido, forming of relationships, and improve chances of employment; all of which will lead to greater overall well-being. To be healthy, we must also be HAPPY.

Permanent or Long-Term Results

An added advantage to cosmetic surgery is that the results are permanent, or at the very least, long-lasting. You need not worry about the problem reappearing, which is not only reassuring for the mind, but for the wallet. As mentioned, there are occasions where you must be responsible to maintain the outcome, for example, body contouring, but this healthy lifestyle will only add to your sense of self-worth. You will have a very long time to enjoy the results of your breast augmentation, facial contouring, rhinoplasty, liposuction, labioplasty, or whatever procedure you have chosen to enhance your happiness.

People express concern about the pain associated with cosmetic surgery procedures. Cosmetic surgery is not entirely painless, but today’s technological innovations will certainly ensure the pain is kept to a minimal level, and you will be able to enjoy the results very quickly.

Although cosmetic surgery is very accessible and more affordable than in days of yore, it is very important to understand cosmetic surgery might not be the right choice for your personal situation. When consulting with a cosmetic surgeon, you should feel comfortable and have open lines of communication. The ethical surgeon will discuss not only the procedure you seek, but also whether that procedure is the correct choice, or whether you would instead benefit from further counselling and psychiatric assistance. Like any surgeon, it is an overriding principle with the cosmetic surgeon to not cause harm. The ethical cosmetic surgeon cares about the overall health of his or her patient. Whilst cosmetic surgery can improve aspects of your life, it will not change your life if the root cause of your unhappiness goes beyond the physical. Like any practitioner, the cosmetic surgeon wants what is right for YOU, and in conjunction with other health professionals, will assist you to reach the decision that is right for YOU.

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Options available for men are phalloplasty (which addresses the length of the penis), and penile thickening (which addresses the girth of the penis).

Phalloplasty is an operation designed to lengthen the penis. The suspensory ligaments attaching the penis to the under-surface of the penis bone are released, which creates a gap that is subsequently filled with the patient’s own fatty tissue. The results depend upon the patient’s own anatomy, but the usual outcome is a further 1cm to 2.5cm is added to the length of the penis. A positive aspect of phalloplasty is that it does not affect the sensation, and because it is performed on an outpatient basis there is minimal disruption to the patient’s life, and with the healing process being relatively quick, the patient can return to work after several days.

Penile thickening entails a similar process wherein the patient’s own fat cells are transferred from the pubic area and injected into the penile shaft and crown. Again, this is done on an outpatient basis and has a quick recovery time, which allows the patient to resume work and other activities after just a few days.

Common cosmetic surgery options for women include:

• Hymenoplasty
• G-Spot rejuvenation
• Vaginal tightening
• Labiaplasty

Hymenoplasty is a temporary restoration of the hymen. It is often performed for cultural reasons to create an appearance of ‘virginity’.

G-Spot rejuvenation an injection of collagen into the anterior wall of the vagina and is designed to enhance sexual pleasure with possible subsequent boost to self-confidence and self-esteem. It is a very quick procedure; the initial consultation and preparation lasts between twenty-five and thirty minutes, the injection takes less than eight seconds, and the results last approximately four months.

Vaginal tightening and vaginal rejuvenation address the changes that can occur to the vaginal wall, vaginal canal, and pelvic floor following vaginal birth or menopause. It is a reconstructive procedure that is usually performed under general anaesthetic.

Labiaplasty is a cosmetic surgery to alter the appearance of the labia minora. The main reasons women seek this surgery is the aesthetic and/or to alleviate discomfort and self-consciousness caused by excessively long labia. Larger-than-usual labia can cause discomfort in physical activities, or else cause the ‘owner’ to become embarrassed and self-conscious when wearing swimwear or activewear. The ratio of these reasons among patients is approximately 50/50. Although the patient will require some pain medication and possibly a week off work, recovery is usually swift.

The risks associated with these surgeries are:

• Pain
• Infection
• Scarring
• Permanent changes to sensation

Women should be aware that genitals vary for person to person, just the same as eyes, noses, and ears do. What you might think is odd or deformed could very well just be extremely normal and unique to YOU. However, if you believe you are a candidate for any of these procedures, there are questions you should ask the surgeon, such as:

• What are the risks?
• What are the benefits, and do they outweigh the risks?
• What is the likelihood of reduced sensation?
• Will it affect my ability to orgasm?
• Will there be restrictions on the feminine hygiene products I can use?
• How will it affect any future pregnancy or childbirth?
• Are there non-surgical options available?
• Are my expectations realistic?

Once your questions have been answered, and you have had the appropriate counselling, you will be able to make the informed decision that is right for you. This decision will help you regain your self-confidence, which will then lead to improved relationships because you have a greater sense of self-worth and are more relaxed. Your sexual health and well-being will also be boosted and reawakened, and you will see a whole new happy YOU.

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