perineoplasty

Perineum; It is the name of the genital area between the vagina and the anus. Correcting the stitch marks that are usually present at birth and making them more aesthetically smooth is known as perineoplasty, that is, 'perineal area aesthetics'. However, perineal area aesthetics can also be performed on those who have not given birth, due to folds, excess skin and wrinkles between the vagina and anus, called perineum.

What is perineoplasty?

perinoplastyBirth scar aesthetics are performed to tidy up the vaginal areas of women who have given birth normally and to eliminate wear and tear. The perineum area lies between the lower part of the vagina and the anus area. It is normal for the vaginas of women who give birth to a baby weighing over 1.5 kilos to expand and wear out.

In genital aesthetic applications, the decision is not only based on appearance expectations; Functional complaints should be evaluated together with the impact on sexual life and the patient's realistic expectations [1][2].

The muscles of the vaginal area, which is very sensitive, may be deformed after normal birth. To tighten these muscles and restore them to their prenatal state.perinoplastyHaving birth scar aesthetics would be the right choice. It is very easy to achieve the desired attractive appearance and sexual life by erasing the traces of normal birth from the genital area.

During normal birth, an incision is made with scissors on the right side of the perineum in order to ensure that the baby's head comes out easily and to prevent irregular tears. This right perineal incision made to facilitate birth is called 'episio incision', 'episiotomy incision' or 'birth incision'.

Episiotomy scars that do not heal well after normal birth or become infected later can cause many psychological and physical discomfort for women. Surgery to correct the stitch marks left after normal birth with genital aesthetics, to clean the skin folds between the vagina and the anus, and to give this genital area an aesthetically pleasing appearance.perinoplastyis given the name. Perineal aesthetics is most often performed simultaneously with vaginal tightening surgeries. In some cases, it can even be performed together with labiaplasty and clitoris aesthetic surgeries.

Why is the Perineum Region Deformed?

Perineum area, that is, the area between the part under the vagina and the anusnormal birthbecomes abundant due to its effect. Deformation of this area is more common, especially in women who give birth more than once and give birth to large babies. At the same time, the relaxation of the pelvic floor muscles, which are excessively stretched during birth, causes the perineal area to become looser. With increasing births, the flexibility of the pelvic muscles will decrease and the vagina will sag more. The enlargement of the perineal area makes sexual intercourse less enjoyable.

In preoperative counseling, normal anatomical diversity, healing process, scar, change in sensation, and the possibility of revision should be clearly discussed [1][2].

It causes people to become tense and unhappy during sexual intercourse. Kegel exercises are recommended to tighten the perineal area. Kegel exercises should be guided by a doctor. These muscles around the urethra, vagina and anus can be tightened by kegel exercises. However, although kegel exercises are performed, they do not produce results as effective and fast as surgery.

How is Perineoplasty Surgery Performed?

Perineal birth scar aesthetics occur during normal birth. Especially in midwife-led and home births, the perineal area may tear towards the anus. Some birth tears can be very extreme and into the vagina. It is known that these tears are less common in births performed in a hospital environment.

Choice of surgical or non-surgical application; It should be personalized according to examination findings, tissue structure, birth history and the person's complaint [1][3].

Perineal birth scars that appear during birth are closed after birth and aesthetic stitches are applied. Women who want a tighter vaginal opening can have vaginal tightening surgery one year after birth.Vaginal tightening aesthetics It makes the vaginal area of ​​women tighter. Thus, the pleasure in sexual intercourse increases.

perinoplastyPain that lasts for a few days after surgery is considered normal. And leakage in the form of spots is seen as a complication of the procedure in case of bleeding. After the operation, apply ice to the treated area.

Common problems solved by perineoplasty include:

• Loose vaginal structure
• vaginal itching
• Damaged perineum (possibly after birth)
• incontinence
• genital warts
• painful sex
• Introital stenosis
• vaginismus
• vulvar vestibulitis
• Decreased sexual sensation

Perineoplasty Procedure

two typesperineoplastyThere is. The first tightens the perineal muscles and vagina, while the second relaxes the perineal muscles. Naturally, which one to choose depends on the person's body structure and doctor's preference.

Why Should We Tighten Perineal Muscles and Vagina?

1. Birth:

If a woman who has given birth has stretched, torn, or had a cut on her vaginal tissue, the tissue may heal before the stitches are removed, causing them to heal improperly.

2. Obesity:

Obese women overextend and damage the perineum and stressed perineal muscles, which can eventually separate. MoreoverliposuctionThis page may also attract your attention.

3. Sexual penetration:

Sex can cause perineal laxity, especially if a woman has abnormalities in her vagina.

Problems may include separation of the anal muscles and perhaps collapse of the rectum.

Perineal Stretch Surgery

In perineoplasty surgery, a V-shaped incision is made in the back wall of the vagina, depending on the degree of tightening required. Damaged tissue and excess scar tissue are removed. The muscles can be stitched together or separated from the perineal structure.

Perineoplasty for Painful Sex (Dyspareunia) Caused by Vaginismus

Vaginismus (ineffective contraction of the pubococcygeus muscles) can be treated in some women by using perineoplasty to loosen the vaginal entrance. This involves a simple cutout on the rear four channels. This surgery is considered effective for dyspareunia and possibly vulvar vestibulitis caused by lichen sclerosus and vaginismus, but nonsurgical methods should be tried first.

References

• [1] ACOG - Elective Female Genital Cosmetic Surgery- Expert opinion for consultancy, expectation management and ethical evaluation in genital plastic surgery.
• [2] RCOG - Ethical considerations in relation to female genital cosmetic surgery- Ethical and clinical evaluation principles in female genital aesthetic applications.
• [3] ISSWSH - Patient resources- Patient resources about women's sexual health and genital area complaints.