Before you choose cosmetic genital surgery, there are some important issues to keep in mind:
Be aware that you will have scars. Although the scars may fade significantly with time, they will always be visible.
Phalloplasty can only increase the length or width of the penis shaft, not the head.
Phalloplasty to lengthen the penis will only make the penis appear longer when flaccid – it will not be longer when erect.
Think about the financial burden. Cosmetic surgery does not usually qualify for rebates from public or private health insurance companies.
Smokers are at increased risk of complications. If you are serious about undergoing cosmetic surgery, you should try to quit smoking.
Medical issues with cosmetic genital surgery
Before surgery, you need to discuss a range of medical issues with your doctor or surgeon including:
Physical health– an examination will help your doctor or surgeon to decide if the treatment is appropriate.
Medical history – some pre-existing conditions and surgeries you have had in the past may influence decisions about this operation, including the type of anaesthetic that is used.
Psychiatric history– some surgeons may suggest or insist that you receive counselling before you consider cosmetic genital surgery.
Risks and possible complications – it is important that you understand the risks and complications so that you can weigh up whether cosmetic genital surgery is right for you.
Preparations and supplements – tell the surgeon about any that you take on a regular basis or have recently taken, including over-the-counter preparations such as fish oils and vitamin supplements.
Past reactions to medications – tell the surgeon if you have ever had a bad reaction or a side effect from any medications including anesthesia.
Preparation for surgery – your surgeon will give you detailed instructions on what you should do at home to prepare for surgery. For example, you may be advised to take a particular medication or alter the dose of an existing medication. Follow all instructions carefully.
Details of cosmetic genital surgery
The details of the surgery will depend on individual factors, but generally include:
Enlargement phalloplasty – this operation increases penis length. General or local anaesthesia may be used. The surgeon makes an incision (cut) at the base of the penis and cuts the ligament that attaches the penis to the body. This will cause the penis to extend out further from the body. The penis is not actually longer, but more of it is visible
Girth enlargement phalloplasty – this operation increases the width of the penis. General or local anaesthesia may be used. Using fatty tissue harvested (removed) from another part of your body, the surgeon may sew strips of fat underneath the skin of the penis (dermal fat grafting) or inject fat into the penis (fat transfer or fat transplant)
Full phalloplasty– some men choose to have their penis increased in both length and girth during the same operation.
Immediately after cosmetic genital surgery
After the operation, you may expect: bruising and swelling; possible numbness pain and discomfort;
to wear dressings or bandages.
Complications of cosmetic genital surgery
All surgery carries some degree of risk. Some of the possible complications of cosmetic genital surgery include:
risks of general anaesthesia including allergic reaction, which may (rarely) be fatal
surgical risks such as bleeding or infection
scars that may be severe, raised, reddened and itchy
permanent colour change
nerve damage to the penis, including permanent loss of sensation
irregular shape to the penis following fat transfer
impotence (inability to get or maintain an erection)
tissue death along the wound or skin loss
further surgery to treat complications.
Self-care after cosmetic genital surgery
Recovery may take at least six weeks. Be guided by your surgeon, but general self-care suggestions include:
Follow all instructions on looking after your wounds.
Wear penile weights as directed for a few weeks after you have phalloplasty.
Avoid sex for at least six weeks.
Report any bleeding, severe pain or unusual symptoms to your surgeon.
Long-term outlook after cosmetic genital surgery
Scarring will be permanent, but should fade in time. Be patient. Improvements to scars may take around a year or so.. If fat transfer has been used to widen the penis, this is not permanent and it will disappear over time, because the body tends to reabsorb about 50 per cent of the injected fat. Top-up injections may be required.
Following phalloplasty to lengthen the penis, the angle of the erection may be lower, but this should not affect sexual intercourse.
Female cosmetic genital surgery
Labia Minora Reduction
Reshapes stretched or enlarged inner labia.
Labia minora reduction surgery, or labioplasty, is a remodeling of the enlarged inner lips of the vulva. Enlargement of the labia minora may be apparent from childhood, but most often it is acquired, caused by childbirth, age or infection. It may bother the patient in a functional (wearing clothes, during sports) or in an aesthetic way. The procedure removes skin and mucosa in a way that the scar is barely visible. The procedure may be combined with a clitoral hood reduction (removal of the skin excess around the clitoris) and labia majora surgery.
Vaginal Rejuvenation Surgery
Restores a tighter and narrower vaginal canal and opening.
Childbirth, pregnancy, weight changes and aging can cause the vaginal muscles and tissues to become relaxed, stretched, torn, and even protrude from the opening. These concerns can be repaired with vaginal rejuvenation surgery, also called vaginal tightening or vaginoplasty. Through an incision in the perineum (the area between the vaginal opening and the anus), the surgeon can remove excess skin and tissues, tighten the length of the vaginal canal, and reduce the size of the vaginal opening.
This procedure is often combined with labia reduction, which involves reshaping enlarged lips of the vulva.
The procedure typically takes between one to three hours depending on whether it is performed with additional procedures.
For better results and more comfort, general anesthesia is the rule for this surgery. However, in some patients, local anesthesia may be chosen.
The patient can leave the surgical facility the same day after recovery from anesthesia.
Possible Side Effects
When meticulous technique is applied, the procedure is without major side effects. Sometimes (< 5% of cases) breakdown of the wound may occur, but healing with local wound care resolves the problem. In some patients, the scar tends to broaden, which can be corrected later.
No important risks are correlated to this type of surgery.
The area may be swollen for 4-6 weeks. Depending on the technique, there may be a color mismatch that tends to fade after some time. Return to work is possible after one week. Sexual activity is allowed after six to eight weeks.
With good surgical technique, the results are very satisfying with an improved body image and greater physical comfort.